Comparison between Effectiveness of Hand Arm Bimanual Intensive Training and Repetitive Facilitation Exercises on Upper Limb Functions In Post Stroke Hemiparetic Patients
Background and Objective: According to world Health Organization (WHO) stroke is defined as œrapidly developing clinical sign of focal (or global) disturbance of cerebral function lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin.1 Focal neurological deficits must persists for at least 24 hours, motor deficits are characterized by paralysis (hemiplegia) or weakness (hemiparesis), typically on the side of the body opposite site of lesion.Materials and Methods: The study was performed among 30 patients of both genders, aged 45-60 years. Subjects were selected on the basis of inclusion criteria and randomly divided into two groups by convenience sampling and allocating alternate patient group A and group B, 15 in each group. Group A was treated with Repetitive Facilitation Exercises (RFE), Group B was treated with Hand Arm Bimanual Intensive Training (HABIT). Baseline assessments were taken using WMFT and FMA and data was analyzed.Results: The groups showed significant differences in WMFT and FMA variables. But on comparing the mean of both the groups: there was no significant difference between both the groups. Conclusion: This study concluded that RFE and HABIT both are effective in treatment of patients with hemiparesis. Dr. Shilpy Jetly | Sukhwinder Kaur | Dr. Jaspinder Kaur"Comparison between Effectiveness of Hand Arm Bimanual Intensive Training and Repetitive Facilitation Exercises on Upper Limb Functions In Post Stroke Hemiparetic Patients" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-1 | Issue-5 , August 2017, URL: http://www.ijtsrd.com/papers/ijtsrd2375.pdf http://www.ijtsrd.com/medicine/other/2375/comparison-between-effectiveness-of-hand-arm-bimanual-intensive-training-and-repetitive-facilitation-exercises-on-upper-limb-functions-in-post-stroke-hemiparetic-patients/dr-shilpy-jetly
A Study to compare the effect of Open versus Closed kinetic chain exercises i...IOSR Journals
Abstract: Background And Purpose Of The Study: Patello-femoral arthritis is the most common type of
arthritis especially older people sometimes it is called as degenerative joint disease. Patello- femoral arthritis is
one of the common causes of physical disability in adults. It is the second most common cause of chronic
conditions. 50% of older persons after 55 years are affected. Some of the young people get arthritis from the
joint injuries. Arthritis is the leading cause of disability in our nation more than other systemic diseases like
heart diseases, cancer and diabetes. There are many therapeutic interventions for the treatment of patellofemoral
arthritis. The study is to determine whether closed kinetic chain exercise offer any advantages over
open kinetic chain exercises.
Method: The patients are randomly selected based on inclusion and exclusion criteria and divided into two
groups. Group A and Group B. Group A is trained with closed kinetic chain exercise and Group B is trained
with open kinetic chain exercises for a period of 12 weeks. the pre and post treatment readings of VAS and
KUJALA scale are taken in both groups for statistical analysis.
Results: The results showed reduction in pain and improvement in functional activity in both Group A and
Group B, significant improvement has been noted in Group A after 12 weeks of training.
Conclusion: This study shows that there was significant improvement in functional ability and reduction of pain
as a result of both open and closed kinetic chain exercises program. There are only few significant differences
between closed kinetic chain exercises (GROUP-A) and open kineticchain exercises (GROUP-B). It reviles that
closed kinetic chain exercises are more effective in the treatment of patello-femoral arthritis than the
(GROUP-B) open kinetic chain exercises
Abstract
Background: Physiotherapy is multi-dimensional and can treat a vast variety of conditions, ranging from musculoskeletal aches, arthritis, joints problems, paraplegia, hemiplegic, sports injuries and frozen shoulder etc. Apart from culture competency and core medical knowledge a physiotherapist must be competent enough in all physiotherapist medical conditions where physical therapy plays a vital role. This study aims to identify the frequency of common clinical conditions among client presented at Habib Physiotherapy Complex (HPC), Hayatabad during 2010.
Methodology: This was a descriptive study; the data were retrieved from record register of HPC (Indoor and Outdoor patients) recording their presenting complaints and known diagnoses. Data was collected on a structure grid. Data was analyzed using SPSS version 15 and presented in term of frequency and percentages.
Result: The majority of clients (1280 (29%)) were suffering from low back pain. The second common condition 891(20%) was osteoarthritis of the knee joint and cerebrovascular accidents 824(18.4%), while cervical pain accounted for 734(16.4%). The rest of clinical conditions included; frozen shoulder, pelvic inflammation, cerebral palsy, polio effected and paraplegia.
Conclusion: The Study reveals the occurrence of Osteoarthritis (Low Back, Cervical Pain, and Knee Joints Pain) were the most common condition which deteriorated the performance of common individuals in our society.
Efficacy of PNF Training Vs Agility Training on Mobility and Balance in Unila...ijtsrd
Introduction According to W.H.O, there are more than one million amputations performed every year, with up to 70 of these amputations related to diabetes. There were an estimated 1.6 million individuals living with the loss of a limb in 2006, these estimation are expected to more than double to 3.6 million such individuals by the year 2050. Objective To find out the effect of two different types of training procedure on mobility and balance in unilateral transtibial amputees using prosthesis during walking. Hypothesis To measure the effect of Pnf training on mobility and balance in unilateral transtibial amputees using prosthesis during walking. To measure the effect of Agility training on mobility and balance in unilateral transtibial amputees using prosthesis during walking. Design Pretest Post test experimental study. Participants Total 30 15 numbers of subjects were taken each in the Group A Proprioceptive Neuromuscular Facilitation group , Group B Agility group .Main outcome measures Berg balance scale Amputee mobility predictor Results The group A PNF training showed significant results p value=.04 , and the group B Agility training showed significant results p value=.02 . The Group B Agility training showed more significant results as the P value was lesser than that of Group A PNF training .Thus Agility training treatment method is more effective than the PNF training treatment method.Conclusions On the basis of the finding of the study, it can be concluded that both the Proprioceptive neuromuscular facilitation and Agility training both are effective in improving mobility and balance in unilateral transtibial amputee patient. But, conventional therapy along with Agility training yields more significant improvement in balance and mobility than the Proprioceptive neuromuscular facilitation along with conventional occupational therapy. Gopal Sharan | Mrs. Eva S Kujur | Mr. Pankaj Bajpai "Efficacy of PNF Training Vs Agility Training on Mobility & Balance in Unilateral Trans Tibial Amputee" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-2 , February 2021, URL: https://www.ijtsrd.com/papers/ijtsrd38365.pdf Paper Url: https://www.ijtsrd.com/medicine/other/38365/efficacy-of-pnf-training-vs-agility-training-on-mobility-and-balance-in-unilateral-trans-tibial-amputee/gopal-sharan
A Study to compare the effect of Open versus Closed kinetic chain exercises i...IOSR Journals
Abstract: Background And Purpose Of The Study: Patello-femoral arthritis is the most common type of
arthritis especially older people sometimes it is called as degenerative joint disease. Patello- femoral arthritis is
one of the common causes of physical disability in adults. It is the second most common cause of chronic
conditions. 50% of older persons after 55 years are affected. Some of the young people get arthritis from the
joint injuries. Arthritis is the leading cause of disability in our nation more than other systemic diseases like
heart diseases, cancer and diabetes. There are many therapeutic interventions for the treatment of patellofemoral
arthritis. The study is to determine whether closed kinetic chain exercise offer any advantages over
open kinetic chain exercises.
Method: The patients are randomly selected based on inclusion and exclusion criteria and divided into two
groups. Group A and Group B. Group A is trained with closed kinetic chain exercise and Group B is trained
with open kinetic chain exercises for a period of 12 weeks. the pre and post treatment readings of VAS and
KUJALA scale are taken in both groups for statistical analysis.
Results: The results showed reduction in pain and improvement in functional activity in both Group A and
Group B, significant improvement has been noted in Group A after 12 weeks of training.
Conclusion: This study shows that there was significant improvement in functional ability and reduction of pain
as a result of both open and closed kinetic chain exercises program. There are only few significant differences
between closed kinetic chain exercises (GROUP-A) and open kineticchain exercises (GROUP-B). It reviles that
closed kinetic chain exercises are more effective in the treatment of patello-femoral arthritis than the
(GROUP-B) open kinetic chain exercises
Abstract
Background: Physiotherapy is multi-dimensional and can treat a vast variety of conditions, ranging from musculoskeletal aches, arthritis, joints problems, paraplegia, hemiplegic, sports injuries and frozen shoulder etc. Apart from culture competency and core medical knowledge a physiotherapist must be competent enough in all physiotherapist medical conditions where physical therapy plays a vital role. This study aims to identify the frequency of common clinical conditions among client presented at Habib Physiotherapy Complex (HPC), Hayatabad during 2010.
Methodology: This was a descriptive study; the data were retrieved from record register of HPC (Indoor and Outdoor patients) recording their presenting complaints and known diagnoses. Data was collected on a structure grid. Data was analyzed using SPSS version 15 and presented in term of frequency and percentages.
Result: The majority of clients (1280 (29%)) were suffering from low back pain. The second common condition 891(20%) was osteoarthritis of the knee joint and cerebrovascular accidents 824(18.4%), while cervical pain accounted for 734(16.4%). The rest of clinical conditions included; frozen shoulder, pelvic inflammation, cerebral palsy, polio effected and paraplegia.
Conclusion: The Study reveals the occurrence of Osteoarthritis (Low Back, Cervical Pain, and Knee Joints Pain) were the most common condition which deteriorated the performance of common individuals in our society.
Efficacy of PNF Training Vs Agility Training on Mobility and Balance in Unila...ijtsrd
Introduction According to W.H.O, there are more than one million amputations performed every year, with up to 70 of these amputations related to diabetes. There were an estimated 1.6 million individuals living with the loss of a limb in 2006, these estimation are expected to more than double to 3.6 million such individuals by the year 2050. Objective To find out the effect of two different types of training procedure on mobility and balance in unilateral transtibial amputees using prosthesis during walking. Hypothesis To measure the effect of Pnf training on mobility and balance in unilateral transtibial amputees using prosthesis during walking. To measure the effect of Agility training on mobility and balance in unilateral transtibial amputees using prosthesis during walking. Design Pretest Post test experimental study. Participants Total 30 15 numbers of subjects were taken each in the Group A Proprioceptive Neuromuscular Facilitation group , Group B Agility group .Main outcome measures Berg balance scale Amputee mobility predictor Results The group A PNF training showed significant results p value=.04 , and the group B Agility training showed significant results p value=.02 . The Group B Agility training showed more significant results as the P value was lesser than that of Group A PNF training .Thus Agility training treatment method is more effective than the PNF training treatment method.Conclusions On the basis of the finding of the study, it can be concluded that both the Proprioceptive neuromuscular facilitation and Agility training both are effective in improving mobility and balance in unilateral transtibial amputee patient. But, conventional therapy along with Agility training yields more significant improvement in balance and mobility than the Proprioceptive neuromuscular facilitation along with conventional occupational therapy. Gopal Sharan | Mrs. Eva S Kujur | Mr. Pankaj Bajpai "Efficacy of PNF Training Vs Agility Training on Mobility & Balance in Unilateral Trans Tibial Amputee" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-2 , February 2021, URL: https://www.ijtsrd.com/papers/ijtsrd38365.pdf Paper Url: https://www.ijtsrd.com/medicine/other/38365/efficacy-of-pnf-training-vs-agility-training-on-mobility-and-balance-in-unilateral-trans-tibial-amputee/gopal-sharan
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Effectiveness of Passive Range of Motion Exercises on Hemodynamic parameters ...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Acute cardiopulmonary and metabolic responses to high intensity interval trai...Fernando Farias
Results from the present study quantify the effects of altering either the intensity of the
work or the recovery interval when performing interval sessions consisting of 60s of work and
60s of recovery for multiple repetitions. The information provided may aid those interested in
designing interval training sessions by providing ranges of values that could be expected for
individuals who possess moderate levels of cardiopulmonary fitness. Using a work intensity of
80% or 100% VGO2peak and a recovery intensity of 0% or 50% VGO2peak, subjects were able to
exercise within the ACSM recommended range for exercise intensity. Based upon the data it
would appear that a protocol such as the 80/0 may be appropriate for those individuals who
are just beginning a program or have little experience with interval-type activity. By contrast, a
100/50 protocol could not be completed by all of the subjects and therefore may be too intense
for some individuals.
Hamstring strain prevention in elite soccer playersFernando Farias
Hamstring strains are among the most
common injury in sport and are most
often observed in sports that involve
sprinting, turning, and jumping
(8,38,63). The prevalence of hamstring
strains has been measured between 11
and 16% in studies of soccer, Australian
rules football, and cricket (92). This can
result in an average of 6 players per squad
suffering a hamstring injury (defined as
“preventing player participation in
a match”) each season in professional
soccer and Australian rules football
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Effectiveness of Passive Range of Motion Exercises on Hemodynamic parameters ...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Acute cardiopulmonary and metabolic responses to high intensity interval trai...Fernando Farias
Results from the present study quantify the effects of altering either the intensity of the
work or the recovery interval when performing interval sessions consisting of 60s of work and
60s of recovery for multiple repetitions. The information provided may aid those interested in
designing interval training sessions by providing ranges of values that could be expected for
individuals who possess moderate levels of cardiopulmonary fitness. Using a work intensity of
80% or 100% VGO2peak and a recovery intensity of 0% or 50% VGO2peak, subjects were able to
exercise within the ACSM recommended range for exercise intensity. Based upon the data it
would appear that a protocol such as the 80/0 may be appropriate for those individuals who
are just beginning a program or have little experience with interval-type activity. By contrast, a
100/50 protocol could not be completed by all of the subjects and therefore may be too intense
for some individuals.
Hamstring strain prevention in elite soccer playersFernando Farias
Hamstring strains are among the most
common injury in sport and are most
often observed in sports that involve
sprinting, turning, and jumping
(8,38,63). The prevalence of hamstring
strains has been measured between 11
and 16% in studies of soccer, Australian
rules football, and cricket (92). This can
result in an average of 6 players per squad
suffering a hamstring injury (defined as
“preventing player participation in
a match”) each season in professional
soccer and Australian rules football
Similar to Comparison between Effectiveness of Hand Arm Bimanual Intensive Training and Repetitive Facilitation Exercises on Upper Limb Functions In Post Stroke Hemiparetic Patients
Long-Term Effect of Exercise Therapyand Patient Education on.docxwkyra78
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T.
Long-Term Effect of Exercise Therapyand Patient Education on.docxcroysierkathey
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T ...
The Effectiveness of Mirror Therapy with Stroke Patients in Producing Improve...CrimsonPublishersTNN
The Effectiveness of Mirror Therapy with Stroke Patients in Producing Improved Motor and Functional Outcomes by Hassan Izzeddin Sarsak in Techniques in Neurosurgery & Neurology
To Compare The Effect Of Proprioceptive Neuromuscular Facilitation and Static...ijtsrd
Background: Flexibility is an important physiological component of physical fitness and reduced flexibility can cause inefficiency in the workplace and is also a risk factor for low back pain. Increasing hamstring flexibility was reported to be an effective method for increasing hamstring muscle performance.Objective: To compare the effects of modified hold-relax proprioceptive neuromuscular facilitation stretching technique and static stretching on flexibility of hamstring muscle.Materials and Methods: In this comparative study 60 subjects were selected by convenience sampling and research design was comparative and experiment in nature. Subjects were selected on the basis of inclusion criteria. Subjects were divided into two groups, group A and group B allocating alternate subjects to group A and group B, 30 in each group. Group A was treated with Proprioceptive Neuromuscular Facilitation with cryotherapy and Group B was treated with Static Stretching with cryotherapy. Baseline assessment was taken on pre stretch, post stretch and after 24 hours using Active Knee Extension test and Modified back saver sit and reach test.Results: Both the groups showed significant improvement in hamstring flexibility. (p0.05).Conclusion: Thus we concluded that the Proprioceptive Neuromuscular Facilitation Stretching Technique and Static Stretching both are effective to improve flexibility of hamstring muscle and clinically both the interventions are equally effective. Tanu Kapila | Dilpreet Kaur | Jaspinder Kaur"To Compare The Effect Of Proprioceptive Neuromuscular Facilitation and Static Stretching on Flexibility of Hamstring Muscle: A Comparative Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-1 | Issue-5 , August 2017, URL: http://www.ijtsrd.com/papers/ijtsrd2266.pdf http://www.ijtsrd.com/other-scientific-research-area/other/2266/to-compare-the-effect-of-proprioceptive-neuromuscular-facilitation-and-static-stretching-on-flexibility-of-hamstring-muscle-a-comparative-study/tanu-kapila
journal reading about physical medicine and rehabilitation
Similar to Comparison between Effectiveness of Hand Arm Bimanual Intensive Training and Repetitive Facilitation Exercises on Upper Limb Functions In Post Stroke Hemiparetic Patients (20)
‘Six Sigma Technique’ A Journey Through its Implementationijtsrd
The manufacturing industries all over the world are facing tough challenges for growth, development and sustainability in today’s competitive environment. They have to achieve apex position by adapting with the global competitive environment by delivering goods and services at low cost, prime quality and better price to increase wealth and consumer satisfaction. Cost Management ensures profit, growth and sustainability of the business with implementation of Continuous Improvement Technique like Six Sigma. This leads to optimize Business performance. The method drives for customer satisfaction, low variation, reduction in waste and cycle time resulting into a competitive advantage over other industries which did not implement it. The main objective of this paper ‘Six Sigma Technique A Journey Through Its Implementation’ is to conceptualize the effectiveness of Six Sigma Technique through the journey of its implementation. Aditi Sunilkumar Ghosalkar "‘Six Sigma Technique’: A Journey Through its Implementation" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64546.pdf Paper Url: https://www.ijtsrd.com/other-scientific-research-area/other/64546/‘six-sigma-technique’-a-journey-through-its-implementation/aditi-sunilkumar-ghosalkar
Edge Computing in Space Enhancing Data Processing and Communication for Space...ijtsrd
Edge computing, a paradigm that involves processing data closer to its source, has gained significant attention for its potential to revolutionize data processing and communication in space missions. With the increasing complexity and data volume generated by modern space missions, traditional centralized computing approaches face challenges related to latency, bandwidth, and security. Edge computing in space, involving on board processing and analysis of data, offers promising solutions to these challenges. This paper explores the concept of edge computing in space, its benefits, applications, and future prospects in enhancing space missions. Manish Verma "Edge Computing in Space: Enhancing Data Processing and Communication for Space Missions" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64541.pdf Paper Url: https://www.ijtsrd.com/computer-science/artificial-intelligence/64541/edge-computing-in-space-enhancing-data-processing-and-communication-for-space-missions/manish-verma
Dynamics of Communal Politics in 21st Century India Challenges and Prospectsijtsrd
Communal politics in India has evolved through centuries, weaving a complex tapestry shaped by historical legacies, colonial influences, and contemporary socio political transformations. This research comprehensively examines the dynamics of communal politics in 21st century India, emphasizing its historical roots, socio political dynamics, economic implications, challenges, and prospects for mitigation. The historical perspective unravels the intricate interplay of religious identities and power dynamics from ancient civilizations to the impact of colonial rule, providing insights into the evolution of communalism. The socio political dynamics section delves into the contemporary manifestations, exploring the roles of identity politics, socio economic disparities, and globalization. The economic implications section highlights how communal politics intersects with economic issues, perpetuating disparities and influencing resource allocation. Challenges posed by communal politics are scrutinized, revealing multifaceted issues ranging from social fragmentation to threats against democratic values. The prospects for mitigation present a multifaceted approach, incorporating policy interventions, community engagement, and educational initiatives. The paper conducts a comparative analysis with international examples, identifying common patterns such as identity politics and economic disparities. It also examines unique challenges, emphasizing Indias diverse religious landscape, historical legacy, and secular framework. Lessons for effective strategies are drawn from international experiences, offering insights into inclusive policies, interfaith dialogue, media regulation, and global cooperation. By scrutinizing historical epochs, contemporary dynamics, economic implications, and international comparisons, this research provides a comprehensive understanding of communal politics in India. The proposed strategies for mitigation underscore the importance of a holistic approach to foster social harmony, inclusivity, and democratic values. Rose Hossain "Dynamics of Communal Politics in 21st Century India: Challenges and Prospects" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64528.pdf Paper Url: https://www.ijtsrd.com/humanities-and-the-arts/history/64528/dynamics-of-communal-politics-in-21st-century-india-challenges-and-prospects/rose-hossain
Assess Perspective and Knowledge of Healthcare Providers Towards Elehealth in...ijtsrd
Background and Objective Telehealth has become a well known tool for the delivery of health care in Saudi Arabia, and the perspective and knowledge of healthcare providers are influential in the implementation, adoption and advancement of the method. This systematic review was conducted to examine the current literature base regarding telehealth and the related healthcare professional perspective and knowledge in the Kingdom of Saudi Arabia. Materials and Methods This systematic review was conducted by searching 7 databases including, MEDLINE, CINHAL, Web of Science, Scopus, PubMed, PsycINFO, and ProQuest Central. Studies on healthcare practitioners telehealth knowledge and perspectives published in English in Saudi Arabia from 2000 to 2023 were included. Boland directed this comprehensive review. The researchers examined each connected study using the AXIS tool, which evaluates cross sectional systematic reviews. Narrative synthesis was used to summarise and convey the data. Results Out of 1840 search results, 10 studies were included. Positive outlook and limited knowledge among providers were seen across trials. Healthcare professionals like telehealth for its ability to improve quality, access, and delivery, save time and money, and be successful. Age, gender, occupation, and work experience also affect health workers knowledge. In Saudi Arabia, healthcare professionals face inadequate expert assistance, patient privacy, internet connection concerns, lack of training courses, lack of telehealth understanding, and high costs while performing telemedicine. Conclusions Healthcare practitioners telehealth perceptions and knowledge were examined in this systematic study. Its collection of concerned experts different personal attitudes and expertise would help enhance telehealths implementation in Saudi Arabia, develop its healthcare delivery alternative, and eliminate frequent problems. Badriah Mousa I Mulayhi | Dr. Jomin George | Judy Jenkins "Assess Perspective and Knowledge of Healthcare Providers Towards Elehealth in Saudi Arabia: A Systematic Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64535.pdf Paper Url: https://www.ijtsrd.com/medicine/other/64535/assess-perspective-and-knowledge-of-healthcare-providers-towards-elehealth-in-saudi-arabia-a-systematic-review/badriah-mousa-i-mulayhi
The Impact of Digital Media on the Decentralization of Power and the Erosion ...ijtsrd
The impact of digital media on the distribution of power and the weakening of traditional gatekeepers has gained considerable attention in recent years. The adoption of digital technologies and the internet has resulted in declining influence and power for traditional gatekeepers such as publishing houses and news organizations. Simultaneously, digital media has facilitated the emergence of new voices and players in the media industry. Digital medias impact on power decentralization and gatekeeper erosion is visible in several ways. One significant aspect is the democratization of information, which enables anyone with an internet connection to publish and share content globally, leading to citizen journalism and bypassing traditional gatekeepers. Another aspect is the disruption of conventional media industry business models, as traditional organizations struggle to adjust to the decrease in advertising revenue and the rise of digital platforms. Alternative business models, such as subscription models and crowdfunding, have become more prevalent, leading to the emergence of new players. Overall, the impact of digital media on the distribution of power and the weakening of traditional gatekeepers has brought about significant changes in the media landscape and the way information is shared. Further research is required to fully comprehend the implications of these changes and their impact on society. Dr. Kusum Lata "The Impact of Digital Media on the Decentralization of Power and the Erosion of Traditional Gatekeepers" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64544.pdf Paper Url: https://www.ijtsrd.com/humanities-and-the-arts/political-science/64544/the-impact-of-digital-media-on-the-decentralization-of-power-and-the-erosion-of-traditional-gatekeepers/dr-kusum-lata
Online Voices, Offline Impact Ambedkars Ideals and Socio Political Inclusion ...ijtsrd
This research investigates the nexus between online discussions on Dr. B.R. Ambedkars ideals and their impact on social inclusion among college students in Gurugram, Haryana. Surveying 240 students from 12 government colleges, findings indicate that 65 actively engage in online discussions, with 80 demonstrating moderate to high awareness of Ambedkars ideals. Statistically significant correlations reveal that higher online engagement correlates with increased awareness p 0.05 and perceived social inclusion. Variations across colleges and a notable effect of college type on perceived social inclusion highlight the influence of contextual factors. Furthermore, the intersectional analysis underscores nuanced differences based on gender, caste, and socio economic status. Dr. Kusum Lata "Online Voices, Offline Impact: Ambedkar's Ideals and Socio-Political Inclusion - A Study of Gurugram District" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64543.pdf Paper Url: https://www.ijtsrd.com/humanities-and-the-arts/political-science/64543/online-voices-offline-impact-ambedkars-ideals-and-sociopolitical-inclusion--a-study-of-gurugram-district/dr-kusum-lata
Problems and Challenges of Agro Entreprenurship A Studyijtsrd
Noting calls for contextualizing Agro entrepreneurs problems and challenges of the agro entrepreneurs and for greater attention to the Role of entrepreneurs in agro entrepreneurship research, we conduct a systematic literature review of extent research in agriculture entrepreneurship to overcome the study objectives of complications of agro entrepreneurs through various factors, Development of agriculture products is a key factor for the overall economic growth of agro entrepreneurs Agro Entrepreneurs produces firsthand large scale employment, utilizes the labor and natural resources, This research outlines the problems of Weather and Soil Erosions, Market price fluctuation, stimulates labor cost problems, reduces concentration of Price volatility, Dependency on Intermediaries, induces Limited Bargaining Power, and Storage and Transportation Costs. This paper mainly devoted to highlight Problems and challenges faced for the sustainable of Agro Entrepreneurs in India. Vinay Prasad B "Problems and Challenges of Agro Entreprenurship - A Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64540.pdf Paper Url: https://www.ijtsrd.com/other-scientific-research-area/other/64540/problems-and-challenges-of-agro-entreprenurship--a-study/vinay-prasad-b
Comparative Analysis of Total Corporate Disclosure of Selected IT Companies o...ijtsrd
Disclosure is a process through which a business enterprise communicates with external parties. A corporate disclosure is communication of financial and non financial information of the activities of a business enterprise to the interested entities. Corporate disclosure is done through publishing annual reports. So corporate disclosure through annual reports plays a vital role in the life of all the companies and provides valuable information to investors. The basic objectives of corporate disclosure is to give a true and fair view of companies to the parties related either directly or indirectly like owner, government, creditors, shareholders etc. in the companies act, provisions have been made about mandatory and voluntary disclosure. The IT sector in India is rapidly growing, the trend to invest in the IT sector is rising and employment opportunities in IT sectors are also increasing. Therefore the IT sector is expected to have fair, full and adequate disclosure of all information. Unfair and incomplete disclosure may adversely affect the entire economy. A research study on disclosure practices of IT companies could play an important role in this regard. Hence, the present research study has been done to study and review comparative analysis of total corporate disclosure of selected IT companies of India and to put forward overall findings and suggestions with a view to increase disclosure score of these companies. The researcher hopes that the present research study will be helpful to all selected Companies for improving level of corporate disclosure through annual reports as well as the government, creditors, investors, all business organizations and upcoming researcher for comparative analyses of level of corporate disclosure with special reference to selected IT companies. Dr. Vaibhavi D. Thaker "Comparative Analysis of Total Corporate Disclosure of Selected IT Companies of India" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64539.pdf Paper Url: https://www.ijtsrd.com/other-scientific-research-area/other/64539/comparative-analysis-of-total-corporate-disclosure-of-selected-it-companies-of-india/dr-vaibhavi-d-thaker
The Impact of Educational Background and Professional Training on Human Right...ijtsrd
This study investigated the impact of educational background and professional training on human rights awareness among secondary school teachers in the Marathwada region of Maharashtra, India. The key findings reveal that higher levels of education, particularly a master’s degree, and fields of study related to education, humanities, or social sciences are associated with greater human rights awareness among teachers. Additionally, both pre service teacher training and in service professional development programs focused on human rights education significantly enhance teacher’s knowledge, skills, and competencies in promoting human rights principles in their classrooms. Baig Ameer Bee Mirza Abdul Aziz | Dr. Syed Azaz Ali Amjad Ali "The Impact of Educational Background and Professional Training on Human Rights Awareness among Secondary School Teachers" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64529.pdf Paper Url: https://www.ijtsrd.com/humanities-and-the-arts/education/64529/the-impact-of-educational-background-and-professional-training-on-human-rights-awareness-among-secondary-school-teachers/baig-ameer-bee-mirza-abdul-aziz
A Study on the Effective Teaching Learning Process in English Curriculum at t...ijtsrd
“One Language sets you in a corridor for life. Two languages open every door along the way” Frank Smith English as a foreign language or as a second language has been ruling in India since the period of Lord Macaulay. But the question is how much we teach or learn English properly in our culture. Is there any scope to use English as a language rather than a subject How much we learn or teach English without any interference of mother language specially in the classroom teaching learning scenario in West Bengal By considering all these issues the researcher has attempted in this article to focus on the effective teaching learning process comparing to other traditional strategies in the field of English curriculum at the secondary level to investigate whether they fulfill the present teaching learning requirements or not by examining the validity of the present curriculum of English. The purpose of this study is to focus on the effectiveness of the systematic, scientific, sequential and logical transaction of the course between the teachers and the learners in the perspective of the 5Es programme that is engage, explore, explain, extend and evaluate. Sanchali Mondal | Santinath Sarkar "A Study on the Effective Teaching Learning Process in English Curriculum at the Secondary Level of West Bengal" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd62412.pdf Paper Url: https://www.ijtsrd.com/humanities-and-the-arts/education/62412/a-study-on-the-effective-teaching-learning-process-in-english-curriculum-at-the-secondary-level-of-west-bengal/sanchali-mondal
The Role of Mentoring and Its Influence on the Effectiveness of the Teaching ...ijtsrd
This paper reports on a study which was conducted to investigate the role of mentoring and its influence on the effectiveness of the teaching of Physics in secondary schools in the South West Region of Cameroon. The study adopted the convergent parallel mixed methods design, focusing on respondents in secondary schools in the South West Region of Cameroon. Both quantitative and qualitative data were collected, analysed separately, and the results were compared to see if the findings confirm or disconfirm each other. The quantitative analysis found that majority of the respondents 72 of Physics teachers affirmed that they had more experienced colleagues as mentors to help build their confidence, improve their teaching, and help them improve their effectiveness and efficiency in guiding learners’ achievements. Only 28 of the respondents disagreed with these statements. With majority respondents 72 agreeing with the statements, it implies that in most secondary schools, experienced Physics teachers act as mentors to build teachers’ confidence in teaching and improving students’ learning. The interview qualitative data analysis summarized how secondary school Principals use meetings with mentors and mentees to promote mentorship in the school milieu. This has helped strengthen teachers’ classroom practices in secondary schools in the South West Region of Cameroon. With the results confirming each other, the study recommends that mentoring should focus on helping teachers employ social interactions and instructional practices feedback and clarity in teaching that have direct measurable impact on students’ learning achievements. Andrew Ngeim Sumba | Frederick Ebot Ashu | Peter Agborbechem Tambi "The Role of Mentoring and Its Influence on the Effectiveness of the Teaching of Physics in Secondary Schools in the South West Region of Cameroon" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64524.pdf Paper Url: https://www.ijtsrd.com/management/management-development/64524/the-role-of-mentoring-and-its-influence-on-the-effectiveness-of-the-teaching-of-physics-in-secondary-schools-in-the-south-west-region-of-cameroon/andrew-ngeim-sumba
Design Simulation and Hardware Construction of an Arduino Microcontroller Bas...ijtsrd
This study primarily focuses on the design of a high side buck converter using an Arduino microcontroller. The converter is specifically intended for use in DC DC applications, particularly in standalone solar PV systems where the PV output voltage exceeds the load or battery voltage. To evaluate the performance of the converter, simulation experiments are conducted using Proteus Software. These simulations provide insights into the input and output voltages, currents, powers, and efficiency under different state of charge SoC conditions of a 12V,70Ah rechargeable lead acid battery. Additionally, the hardware design of the converter is implemented, and practical data is collected through operation, monitoring, and recording. By comparing the simulation results with the practical results, the efficiency and performance of the designed converter are assessed. The findings indicate that while the buck converter is suitable for practical use in standalone PV systems, its efficiency is compromised due to a lower output current. Chan Myae Aung | Dr. Ei Mon "Design Simulation and Hardware Construction of an Arduino-Microcontroller Based DC-DC High-Side Buck Converter for Standalone PV System" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64518.pdf Paper Url: https://www.ijtsrd.com/engineering/mechanical-engineering/64518/design-simulation-and-hardware-construction-of-an-arduinomicrocontroller-based-dcdc-highside-buck-converter-for-standalone-pv-system/chan-myae-aung
Sustainable Energy by Paul A. Adekunte | Matthew N. O. Sadiku | Janet O. Sadikuijtsrd
Energy becomes sustainable if it meets the needs of the present without compromising the ability of future generations to meet their own needs. Some of the definitions of sustainable energy include the considerations of environmental aspects such as greenhouse gas emissions, social, and economic aspects such as energy poverty. Generally far more sustainable than fossil fuel are renewable energy sources such as wind, hydroelectric power, solar, and geothermal energy sources. Worthy of note is that some renewable energy projects, like the clearing of forests to produce biofuels, can cause severe environmental damage. The sustainability of nuclear power which is a low carbon source is highly debated because of concerns about radioactive waste, nuclear proliferation, and accidents. The switching from coal to natural gas has environmental benefits, including a lower climate impact, but could lead to delay in switching to more sustainable options. “Carbon capture and storage” can be built into power plants to remove the carbon dioxide CO2 emissions, but this technology is expensive and has rarely been implemented. Leading non renewable energy sources around the world is fossil fuels, coal, petroleum, and natural gas. Nuclear energy is usually considered another non renewable energy source, although nuclear energy itself is a renewable energy source, but the material used in nuclear power plants is not. The paper addresses the issue of sustainable energy, its attendant benefits to the future generation, and humanity in general. Paul A. Adekunte | Matthew N. O. Sadiku | Janet O. Sadiku "Sustainable Energy" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64534.pdf Paper Url: https://www.ijtsrd.com/engineering/electrical-engineering/64534/sustainable-energy/paul-a-adekunte
Concepts for Sudan Survey Act Implementations Executive Regulations and Stand...ijtsrd
This paper aims to outline the executive regulations, survey standards, and specifications required for the implementation of the Sudan Survey Act, and for regulating and organizing all surveying work activities in Sudan. The act has been discussed for more than 5 years. The Land Survey Act was initiated by the Sudan Survey Authority and all official legislations were headed by the Sudan Ministry of Justice till it was issued in 2022. The paper presents conceptual guidelines to be used for the Survey Act implementation and to regulate the survey work practice, standardizing the field surveys, processing, quality control, procedures, and the processes related to survey work carried out by the stakeholders and relevant authorities in Sudan. The conceptual guidelines are meant to improve the quality and harmonization of geospatial data and to aid decision making processes as well as geospatial information systems. The established comprehensive executive regulations will govern and regulate the implementation of the Sudan Survey Geomatics Act in all surveying and mapping practices undertaken by the Sudan Survey Authority SSA and state local survey departments for public or private sector organizations. The targeted standards and specifications include the reference frame, projection, coordinate systems, and the guidelines and specifications that must be followed in the field of survey work, processes, and mapping products. In the last few decades, there has been a growing awareness of the importance of geomatics activities and measurements on the Earths surface in space and time, together with observing and mapping the changes. In such cases, data must be captured promptly, standardized, and obtained with more accuracy and specified in much detail. The paper will also highlight the current situation in Sudan, the degree to which survey standards are used, the problems encountered, and the errors that arise from not using the standards and survey specifications. Kamal A. A. Sami "Concepts for Sudan Survey Act Implementations - Executive Regulations and Standards" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63484.pdf Paper Url: https://www.ijtsrd.com/engineering/civil-engineering/63484/concepts-for-sudan-survey-act-implementations--executive-regulations-and-standards/kamal-a-a-sami
Towards the Implementation of the Sudan Interpolated Geoid Model Khartoum Sta...ijtsrd
The discussions between ellipsoid and geoid have invoked many researchers during the recent decades, especially during the GNSS technology era, which had witnessed a great deal of development but still geoid undulation requires more investigations. To figure out a solution for Sudans local geoid, this research has tried to intake the possibility of determining the geoid model by following two approaches, gravimetric and geometrical geoid model determination, by making use of GNSS leveling benchmarks at Khartoum state. The Benchmarks are well distributed in the study area, in which, the horizontal coordinates and the height above the ellipsoid have been observed by GNSS while orthometric heights were carried out using precise leveling. The Global Geopotential Model GGM represented in EGM2008 has been exploited to figure out the geoid undulation at the benchmarks in the study area. This is followed by a fitting process, that has been done to suit the geoid undulation data which has been computed using GNSS leveling data and geoid undulation inspired by the EGM2008. Two geoid surfaces were created after the fitting process to ensure that they are identical and both of them could be counted for getting the same geoid undulation with an acceptable accuracy. In this respect, statistical operation played an important role in ensuring the consistency and integrity of the model by applying cross validation techniques splitting the data into training and testing datasets for building the geoid model and testing its eligibility. The geometrical solution for geoid undulation computation has been utilized by applying straightforward equations that facilitate the calculation of the geoid undulation directly through applying statistical techniques for the GNSS leveling data of the study area to get the common equation parameters values that could be utilized to calculate geoid undulation of any position in the study area within the claimed accuracy. Both systems were checked and proved eligible to be used within the study area with acceptable accuracy which may contribute to solving the geoid undulation problem in the Khartoum area, and be further generalized to determine the geoid model over the entire country, and this could be considered in the future, for regional and continental geoid model. Ahmed M. A. Mohammed. | Kamal A. A. Sami "Towards the Implementation of the Sudan Interpolated Geoid Model (Khartoum State Case Study)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63483.pdf Paper Url: https://www.ijtsrd.com/engineering/civil-engineering/63483/towards-the-implementation-of-the-sudan-interpolated-geoid-model-khartoum-state-case-study/ahmed-m-a-mohammed
Activating Geospatial Information for Sudans Sustainable Investment Mapijtsrd
Sudan is witnessing an acceleration in the processes of development and transformation in the performance of government institutions to raise the productivity and investment efficiency of the government sector. The development plans and investment opportunities have focused on achieving national goals in various sectors. This paper aims to illuminate the path to the future and provide geospatial data and information to develop the investment climate and environment for all sized businesses, and to bridge the development gap between the Sudan states. The Sudan Survey Authority SSA is the main advisor to the Sudan Government in conducting surveying, mappings, designing, and developing systems related to geospatial data and information. In recent years, SSA made a strategic partnership with the Ministry of Investment to activate Geospatial Information for Sudans Sustainable Investment and in particular, for the preparation and implementation of the Sudan investment map, based on the directives and objectives of the Ministry of Investment MI in Sudan. This paper comes within the framework of activating the efforts of the Ministry of Investment to develop technical investment services by applying techniques adopted by the Ministry and its strategic partners for advancing investment processes in the country. Kamal A. A. Sami "Activating Geospatial Information for Sudan's Sustainable Investment Map" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63482.pdf Paper Url: https://www.ijtsrd.com/engineering/information-technology/63482/activating-geospatial-information-for-sudans-sustainable-investment-map/kamal-a-a-sami
Educational Unity Embracing Diversity for a Stronger Societyijtsrd
In a rapidly changing global landscape, the importance of education as a unifying force cannot be overstated. This paper explores the crucial role of educational unity in fostering a stronger and more inclusive society through the embrace of diversity. By examining the benefits of diverse learning environments, the paper aims to highlight the positive impact on societal strength. The discussion encompasses various dimensions, from curriculum design to classroom dynamics, and emphasizes the need for educational institutions to become catalysts for unity in diversity. It highlights the need for a paradigm shift in educational policies, curricula, and pedagogical approaches to ensure that they are reflective of the diverse fabric of society. This paper also addresses the challenges associated with implementing inclusive educational practices and offers practical strategies for overcoming barriers. It advocates for collaborative efforts between educational institutions, policymakers, and communities to create a supportive ecosystem that promotes diversity and unity. Mr. Amit Adhikari | Madhumita Teli | Gopal Adhikari "Educational Unity: Embracing Diversity for a Stronger Society" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64525.pdf Paper Url: https://www.ijtsrd.com/humanities-and-the-arts/education/64525/educational-unity-embracing-diversity-for-a-stronger-society/mr-amit-adhikari
Integration of Indian Indigenous Knowledge System in Management Prospects and...ijtsrd
The diversity of indigenous knowledge systems in India is vast and can vary significantly between different communities and regions. Preserving and respecting these knowledge systems is crucial for maintaining cultural heritage, promoting sustainable practices, and fostering cross cultural understanding. In this paper, an overview of the prospects and challenges associated with incorporating Indian indigenous knowledge into management is explored. It is found that IIKS helps in management in many areas like sustainable development, tourism, food security, natural resource management, cultural preservation and innovation, etc. However, IIKS integration with management faces some challenges in the form of a lack of documentation, cultural sensitivity, language barriers legal framework, etc. Savita Lathwal "Integration of Indian Indigenous Knowledge System in Management: Prospects and Challenges" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63500.pdf Paper Url: https://www.ijtsrd.com/management/accounting-and-finance/63500/integration-of-indian-indigenous-knowledge-system-in-management-prospects-and-challenges/savita-lathwal
DeepMask Transforming Face Mask Identification for Better Pandemic Control in...ijtsrd
The COVID 19 pandemic has highlighted the crucial need of preventive measures, with widespread use of face masks being a key method for slowing the viruss spread. This research investigates face mask identification using deep learning as a technological solution to be reducing the risk of coronavirus transmission. The proposed method uses state of the art convolutional neural networks CNNs and transfer learning to automatically recognize persons who are not wearing masks in a variety of circumstances. We discuss how this strategy improves public health and safety by providing an efficient manner of enforcing mask wearing standards. The report also discusses the obstacles, ethical concerns, and prospective applications of face mask detection systems in the ongoing fight against the pandemic. Dilip Kumar Sharma | Aaditya Yadav "DeepMask: Transforming Face Mask Identification for Better Pandemic Control in the COVID-19 Era" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd64522.pdf Paper Url: https://www.ijtsrd.com/engineering/electronics-and-communication-engineering/64522/deepmask-transforming-face-mask-identification-for-better-pandemic-control-in-the-covid19-era/dilip-kumar-sharma
Streamlining Data Collection eCRF Design and Machine Learningijtsrd
Efficient and accurate data collection is paramount in clinical trials, and the design of Electronic Case Report Forms eCRFs plays a pivotal role in streamlining this process. This paper explores the integration of machine learning techniques in the design and implementation of eCRFs to enhance data collection efficiency. We delve into the synergies between eCRF design principles and machine learning algorithms, aiming to optimize data quality, reduce errors, and expedite the overall data collection process. The application of machine learning in eCRF design brings forth innovative approaches to data validation, anomaly detection, and real time adaptability. This paper discusses the benefits, challenges, and future prospects of leveraging machine learning in eCRF design for streamlined and advanced data collection in clinical trials. Dhanalakshmi D | Vijaya Lakshmi Kannareddy "Streamlining Data Collection: eCRF Design and Machine Learning" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63515.pdf Paper Url: https://www.ijtsrd.com/biological-science/biotechnology/63515/streamlining-data-collection-ecrf-design-and-machine-learning/dhanalakshmi-d
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
The Art Pastor's Guide to Sabbath | Steve Thomason
Comparison between Effectiveness of Hand Arm Bimanual Intensive Training and Repetitive Facilitation Exercises on Upper Limb Functions In Post Stroke Hemiparetic Patients
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ISSN No: 2456 - 6470 | www.ijtsrd.com | Volume - 1 | Issue – 5
International Journal of Trend in Scientific
Research and Development (IJTSRD)
International Open Access Journal
Comparison between Effectiveness of Hand Arm Bimanual Intensive
Training and Repetitive Facilitation Exercises on Upper Limb
Functions In Post Stroke Hemiparetic Patients
Dr. Shilpy Jetly
Associate Professor, DAV Institute
of Physiotherapy and
Rehabilitation, Jalandhar, Punjab
Sukhwinder Kaur
MPT Student, DAV Institute of
Physiotherapy and Rehabilitation,
Jalandhar, Punjab
Dr. Jaspinder Kaur
Associate Professor, DAV Institute
of Physiotherapy and
Rehabilitation, Jalandhar, Punjab
ABSTRACT
Background and Objective: According to world
Health Organization (WHO) stroke is defined as
“rapidly developing clinical sign of focal (or global)
disturbance of cerebral function lasting more than 24
hours or leading to death, with no apparent cause
other than vascular origin.1
Focal neurological deficits
must persists for at least 24 hours, motor deficits are
characterized by paralysis (hemiplegia) or weakness
(hemiparesis), typically on the side of the body
opposite site of lesion.
Materials and Methods: The study was performed
among 30 patients of both genders, aged 45-60 years.
Subjects were selected on the basis of inclusion
criteria and randomly divided into two groups by
convenience sampling and allocating alternate patient
group A and group B, 15 in each group. Group A was
treated with Repetitive Facilitation Exercises (RFE),
Group B was treated with Hand Arm Bimanual
Intensive Training (HABIT). Baseline assessments
were taken using WMFT and FMA and data was
analyzed.
Results: The groups showed significant differences in
WMFT and FMA variables. But on comparing the
mean of both the groups: there was no significant
difference between both the groups.
Conclusion: This study concluded that RFE and
HABIT both are effective in treatment of patients with
hemiparesis.
Keywords: Hemiparesis, RFE, HABIT, WMFT, FMA
INTRODUCTION
According to world Health Organization (WHO)
stroke is defined as “rapidly developing clinical sign
of focal (or global) disturbance of cerebral function
lasting more than 24 hours or leading to death, with
no apparent cause other than vascular origin.1
Focal
neurological deficits must persists for at least 24
hours, motor deficits are characterized by paralysis
(hemiplegia) or weakness (hemiparesis), typically on
the side of the body opposite site of lesion. Strokes
can be classified into two major categories: ischemic
or hemorrhagic.2
Stroke is the most common cause of
disability of survivors, an estimated one third will be
functionally dependent after one year experiencing
with difficulty of activities of daily living, ambulation
and speech, with 30% to 66% of individuals lose
functional ability in more affected arm and hand.3
Functional recovery of the paretic upper extremity
post stroke continue to be the one of the greatest
challenges faced by the rehabilitation professionals,
although most of the patients gain walking ability but
fail to gain functional use of their arms and hands.4
Upper extremity rehabilitation protocol for stroke
hemiparesis have traditionally primary on the paretic
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limb with unilateral strengthening exercise,
neuromuscular re-education and functional training.
Upper extremity paresis is leading cause of function
disability after stroke (self-care, feeding & dressing).5
A number of instruments have been developed to
evaluate functional recovery after stroke. Some
examples of instruments for determining upper-
extremity functional ability are the Chedokee-
McMaster (CM) assessment, the Fugl-Meyer (FMA)
assessment and the Wolf Motor Function Test
(WMFT) assessment.6
It has been seen that the recovery in lower limbs is
better than upper limb in post stroke patients. It is
because both lower extremities are equally required
for normal gait, by adopting compensatory gait
strategies; patients can perform his activities to some
extent. Patient prefers to use unaffected hand to
complete the tasks and neglect the use of affected
upper limb. Previous studies have shown the
effectiveness of Repetitive facilitation exercises
(RFEs) and Hand arm bimanual intensive training
(HABIT) in improvement of upper extremity in post
stroke hemiparetic patients. This study explored the
effectiveness of Repetitive facilitation exercises
(RFEs) and Hand arm bimanual intensive training
(HABIT).
Wolf motor function test was designed to assess the
motor ability of patients with moderate to severe
upper extremity motor deficits in the laboratory and
clinic.7
The upper-extremity section of Fugl-Meyer (FMA)
scale was designed to assess the motor ability of
patients. It includes 27 grades motor function on the
ICF level of body functions (muscle and movement
functions). A 3-point ordinal scale is used to score 33
items, with a maximum score of 66. Good reliability
and validity have been reported.8
Kazumi Kawahira et al (2010) conducted a study to
evaluate the effects on the hemiplegic upper limb of
repetitive facilitation exercise (RFEs) using a novel
facilitation technique, in which the patient’s intention
to move the hemiplegic upper limb or finger was
followed by realization of the movement using
multiple sensory stimulations. 23 stroke patients were
enrolled in which 2- week RFE sessions (100
repetitions each of 5-8 types of facilitation exercise
per day) were altered with 2-week conventional
rehabilitation (CR) sessions, for a total of four
sessions, for a total of four sessions. The simple test
for Evaluating hand function (STEF) score, which
evaluates the ability of manipulating objects, in both
groups improved during both sessions. After the
second week RFE and CR sessions, both groups
showed little further improvement except in the STEF
score.9
Jill Whitall et al (2000) investigated the result of
bilateral arm training with rhythmic auditory cueing
will improve motor function in the hemiparetic arm of
stroke patients. They determined the effects of 6
weeks of BATRAC on 14 patients with chronic
hemiparetic stroke immediately after training and at 2
months after training. Four 5- minute periods per
session (3 times per week) of BATRAC were
performed with the use of a custom designed arm
training machine. At last, they concluded that with six
weeks of bilateral arm training with rhythmic auditory
cueing (BATRAC) improves functional motor
performance of the paretic upper extremity as well as
a few changes in isometric strength and range of
motion. These benefits are largely sustained at weeks
after training cessation.10
Methodology
The study design was quasi experimental and
comparative in nature. 30 hemiparetic subjects aged
between 45-60 years were included on the basis of
inclusion criteria: Sub acute stroke patients (30 days -
6 months), both male and female subjects, patients
with hemorrhagic and ischemic stroke, patients
having minimum 10 degree wrist extension and finger
extension actively for habit group, patients with mini
mental state examination score of 24 or more, patients
demonstrate independent full range of motor of upper
limb passively, patient is able to maintain sitting
balance. Patients were excluded from the study on the
basis of exclusion criteria: visual-perceptual
problems, participating in any experimental study
which include upper limb treatment, communication
barrier, patients with behavioural disturbances and
psychologically non cooperative, shoulder pain
insensitive to standard therapy, hand swelling
sufficient to prevent fist formation, painful arthritis of
the shoulder or wrist and finger joint, excessive
spasticity, defined as having a score of 3 on the
Modified Ashworth Spasticity Scale, participating in
any experimental rehabilitation or drug studies, severe
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sensory disturbance of affected upper limb, dementia,
patients with history of upper limb surgery.
Sampling method was convenient sampling. A written
consent was taken from the patients. Patients were
divided into 2 groups:- Group A:Repetitive
Facilitation Exercises (RFE) and Group B: Hand Arm
Bimanual Intensive Training (HABIT). In the study,
assessment of patient was done by Wolf motor
function test (WMFT) and Fugl – Mayer assessment
for upper limb (FMA-UE).
Subjects received the treatment for 5 session/week for
consecutive 2 weeks (total 10 sessions). Post reading
was taken at 2 weeks (after 10 sessions).
Group A:
The RFE session consisted of stretch reflex by rapid
passive stretching of the muscles and the skin-muscle
reflex which is induced by tapping or rubbing on the
muscles in a specific posture that maintained the
tension in the targeted muscles. Each repetitive
exercise was given for 100 repetitions per session for
2 weeks.
Group B:
The activities were divided into five movement
categories that focus on the distal extremity. Total
time for each set of movements was 10 minutes and
rest for 2 minutes. The total treatment time was 1-
hours.
Statistical Analysis
Unpaired t-test was used to compare the scores of
baseline assessments between the two groups to find
out whether the two groups were comparable or not.
The groups have p>0.05 are comparable. Paired t-test
was used to compare the variables within the groups.
Unpaired t-test was used to compare the variables
between the groups.
INTERPRETATION
Table1: Mean and SD of age of the subjects for the Group A and Group B
Age Mean + SD t- Value Level of Significance
Group A
51.27 + 4.95
0.206 0.837
NSGroup B
51.67 + 5.64
0
10
20
30
40
50
60
Values
Comparison of Mean and SD of Age between
Group A and Group B
Mean
SD
Group A Group B
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Table2: WMFT within group A
WMFT Mean + SD t-value Level of
Sig.
Group A
Pre Value 162 + 6.15
15.80
0.0001
S
Post Value 140.9 + 5.26
Table 3: WMFT within group B
WMFT Mean + SD t-value Level of
Sig.
Group B
Pre Value 160.6 + 4.15
11.84
0.0001
S
Post Value 137.8 + 8.08
0
20
40
60
80
100
120
140
160
180
Values
Comparison of Mean and SD of variable
WMFT within group A
Mean
SD
Pre Value Post Value
0
20
40
60
80
100
120
140
160
180
Values
Comparison of Mean and SD of variable
WMFT within group B
Mean
SD
Pre Value Post Value
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Table 4: FMA - UE within group A
FMA – UE Mean + SD t-value Level of
Sig.
Group A
Pre Value 35.73 + 5.48
11.14
0.0001
S
Post Value 47.33 + 5.07
Table5: FMA - UE within group B
FMA – UE Mean + SD t-value Level of
Sig.
Group B Pre Value 36.80 + 5.62 11.01 0.0001
S
0
10
20
30
40
50
60
Values
Comparison of Mean and SD of variable
FMA - UE within group A
Mean
SD
Pre Value Post Value
0
10
20
30
40
50
60
Values
Comparison of Mean and SD of variable
FMA - UE within group B
Mean
SD
Pre Value Post Value
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Table 6: WMFT between group A and group B
WMFT Mean + SD t-value
Level of
Sig.
Pre Test
( 0 Day)
Group A 162 + 6.15
0.695
0.492
NS
Group B 160.6. + 4.15
Post Test
(2 Weeks)
Group A 140.9 + 5.26
1.232
0.228
NSGroup B 137.8 + 8.08
Table 7: FMA - UE between group A and group B
FMA - UE Mean + SD t-value Level of
Sig.
Pre Test
( 0 Day)
Group A 35.73 + 5.48
0.526
0.603
NS
Group B 36.80. + 5.62
Post Test
(2 Weeks)
Group A 47.33 + 5.07
0.519
0.607
NS
0
20
40
60
80
100
120
140
160
180
Values
Comparison of Mean and SD of variable
WMFT between Group A and Group B
Mean
SD
A B A B
Pre Value Post Value
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Table 1 showed that there was no significant
difference in the age group. So, the groups were
comparable. Table 2 showed that there were
significant changes of WMFT variable within the
group A. Table 3 showed that there were significant
changes of WMFT variable within the group B. Table
4 showed that there were significant changes of FMA
variable within the group A. Table 5 showed that
there were significant changes of FMA variable
within the group B. Table 6 showed that there were
not significant changes of WMFT variable between
the groups. Table 7 showed that there were not
significant changes of FMA variable between the
groups.
DISCUSSION
The study was done to evaluate the effect of repetitive
facilitation exercises and hand arm bimanual intensive
training on wolf motor function test and fugl-meyer
for upper extremity in post stroke hemiparetic
patients. The hypothesis was that the significant
change in the effectiveness between Repetitive
facilitation exercises (RFEs) and Hand arm bimanual
intensive training (HABIT) on upper limb functions in
post stroke hemiparetic patients.
It is necessary to know that the functional recovery of
the paretic Upper extremity continues to be the one of
greatest challenge. Patient with history of stroke can
gain walking ability but fail to use of their upper
extremity function.11
The massed practice design used
to improve the function of individual with
hemiparesis by constraining the less affected arm.12
The effects of the RFEs used in the novel facilitation
technique that was developed on the isolation from
synergy and the manipulation of objects of the
hemiplegic upper limb. The novel facilitation methods
used in previous studies were designed to give
focused sufficient physical stimulation to realize the
patient’s intended movements. These physical
stimulation were the stretch reflex, skin–muscle
reflex, and alpha and gamma linkage, which were
induced by tapping or rubbing the muscles, rapid
passive stretching of the muscle or slight resistance
against the intended movements. In the present study
we were followed the same repetitive facilitation
exercises regimen with 5 movements rather than 8
movements.13
In any case, motor functional recovery of a
hemiplegic finger requires more repetitive voluntary
upper limb and finger movements that are isolated
from synergy by facilitation techniques, because it is
difficult for patients to move the hemiplegic upper
limb alone, especially the fingers. RFEs for the
hemiplegic upper limb improved the functional
recovery when voluntary movements were elicited by
the novel facilitation technique, although patients who
did not show the effects of this facilitation might gain
little from RFEs. Recent studies have shown that
brain plasticity contributes to functional recovery
from paralysis. Forced use of the hemiplegic hand
after brain damage in adult primates and finger
tracking training in adult humans who suffered a
stroke led to changes in motor representation in the
primary motor cortex.14
0
10
20
30
40
50
60
Values
Comparison of Mean and SD of variable
FMA - UE between Group A and Group B
A B A B
Pre Value Post Value
Mean
SD
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Regarding the activities in bimanual training, Larisa
R. Hoffman et al(2007) gave bimanual training to
cervical spinal cord injury patient who had complete
motor spinal cord injury at the level of C6 .The
training include five activities –Grasp, Grasp with
rotation, finger isolation, pinch and pinch with
rotation. There is significant improvement seen in
both the upper limbs in the present study, same
activities were taken to see the improvement in hand
function.15
One of the previous study on hand arm bimanual
intensive training was conducted by Jeanne Charles,
Andrew M Gordon et al(2006)16
found that it is
becoming increasingly clear that the key to eliciting
improvement in function is to provide sufficient
practice. However, rather than just focusing on
repetition, the practice must be structured, based on
how the central nervous system responds during
learning; i.e. optimal responses with increasing
movement complexity and provision of motivation
and reward.17
Thus, appropriate intensity must be
provided with these guidelines in mind. There is rapid
development of ipsilateral and contralateral
corticospinal projections from the undamaged
hemispheres.
The corticospinal system underlying
skilled manipulative control is capable of
reorganization after damage, probably underlying
recovery of function.18
Ipsilateral pathways have been
shown to be implicated in the recovery of function
after stroke. Thus, tasks recruiting the ipsilateral
pathways such as symmetrical bilateral movements
may be beneficial.19
Wolf motor Function Test (WMFT)
There were significant changes in the effectiveness of
different treatments given by repetitive facilitation
exercises and hand arm bimanual training on wolf
motor function test (WFMT) on post stroke
hemiparetic patients. All subjects treated with 60
minutes RFE showed decreased WMFT score (140.9
+ 5.26) after 2 weeks, which were statistically
significant from baseline. On the other hand, all
subjects who received 60 minutes hand arm bimanual
intensive training (HABIT) protocol also showed
decreased WMFT score (137.8 + 8.08) after 2 weeks
treatment, which were statistically significant from
baseline. When compared both the groups, both the
treatments were equally effective in context of wolf
motor function test (WMFT). The result of this study
was supported by Kawahira K. and Shimodozono
M et al (2010)9
who demonstrated the use of RFEs
that might have played a role in promoting motor
functional improvement is the elicitation of voluntary
movements of the hemiplegic limb.
The results of this study were in concordance with the
results of Kumar A,Singh P. et al (2011) 20
who
demonstrated significant improvement in WMFT
within the group comparison. The study found that
when one limb must move further or aimed towards a
smaller target compared to the other, the behaviour of
one hand is affected by the task requirement of
contralateral hand. This is known as assimilation
effect. Assimilation effect are usually asymmetric in
nature such that the limb performing more difficult
task impacts the limb performing a easier task to a
greater extent than the converse.
Fugl Meyer Assessment for Upper Extremity
(FMA – UE)
There were significant changes in the effectiveness of
both the techniques on Fugl Meyer Assessment for
Upper Extremity (FMA – UE) on post stroke
hemiparetic patients. All subjects treated with 60
minutes RFE showed decreased FMA - UE score
(47.33 + 5.07) after 2 weeks, which were statistically
significant from baseline. On the other hand, all
subjects who received 60 minutes hand arm bimanual
intensive training (HABIT) protocol also showed
decreased FMA - UE score (48.27 + 4.77) after 2
weeks treatment, which were statistically significant
from baseline. When compared both the groups, both
the treatments were equally effective in context of
Fugl Meyer Assessment for Upper Extremity (FMA –
UE). The result of this study was also supported by
John Chae et al. (1998)21
whoanalysedthe score of
fugl-meyer revealed significantly greater motor
improvement for the neuromuscular stimulation group
at 4 weeks after treatment and at 12 weeks after
treatment.The result of this study was also supported
by Jill Whital et al (2000 )22
whoconducted a study
on bilateral movements and concluded that practicing
bilateral movement in synchrony may result in
facilitation effect from non paretic arm to paretic arm,
when bimanual movements are initiated
simultaneously. Both arms act as unit that supercedes
the individual arm action, indicating that both arms
are linked as a co-ordinate unit in the brain.23
CONCLUSION
Based on the data analysis it can be interpreted that
Repetitive facilitation Exercises and Hand Arm
Bimanual Intensive Training are equally effective on
9. International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470
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outcome parameters in patients with hemiparesis.
Therapist can choose any of the treatment technique
for the betterment of the hemiparesis patients in
context of upper limb recovery.
Limitations
➢ Small sample size
➢ Absence of randomization of sampling and
appropriate control group
➢ Follow Up
Recommendations
➢ Random sampling should be there.
➢ This study can be done on larger sample size.
➢ This study can also be done on younger age group.
➢ Gender specific study can also be done.
➢ This study can be done in different phases of
stroke (Acute and chronic)
Ethical clearance
No ethical clearance required.
Source of funding
No funding was required to carry out this work.
Acknowledgement
We are thankful to Dr Jitendra Shrama, Principle,
DAV Institute of Physiotherapy and Rehabilitation,
Jalandhar, Punjab-144008.
Conflicts of Interest
Authors declare that there is no conflict of interest.
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