The purpose of study is to describe the effects of standing to improve balance and gait of children with spastic diaplegic cerebral palsy CP . The aim was to find out effects of standing to improve Balance and Gait.Methods subjective prospective cross sectional quasi experimental flexible design was used. By using Convenient sampling method 30 numbers of spastic diaplesic cerebral palsy subject was selected in the study. Age group was 2 to 5 years mean age 3.5 both the male and female. Screening was done by the screening tool Gross Motor Function Classification System GMFCS . The outcome of Motor function was measured with the Gross Motor Function Measure GMFM and standing balance was measured by the instrument Pediatric Balance Scale PBS . Intervention was done for 4 weeks 3 sessions per week 45 minute with wooden standing frame. Screened Child was placed in the Standing Unit in vertical or inclined plane depending on their functional abilities and Standing tolerance. Based on the statistic analysis software Statistical Package for the Social Science SPSS 25 compare the effect pre test data by screening tool and the post test data out come measure GMFM=0.00, PBS=0.00, paired t test differences was GMFM pre post and PBS pre post .00 and .05 respectively. Conclusion On this study it is concluded that there is positive effect of prolong Standing to improve Balance and Gait. And it’s also important to provide appropriate plane and positioning in the device for improvement. Hence these findings should be used in caution when treating the patients with Cerebral Palsy. Jyotiranjan Sahoo | Mr Subrata Kumar Halder | Mr Manoj Kumar Sethy "Effect of Standing to Improve Balance and Gait of Children with Cerebral Palsy" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd37985.pdf Paper URL : https://www.ijtsrd.com/medicine/other/37985/effect-of-standing-to-improve-balance-and-gait-of-children-with-cerebral-palsy/jyotiranjan-sahoo
To Study the Efficacy of Electromyographic Biofeedback Training on Dynamic Eq...IOSR Journals
Abstract: Cerebral palsy (CP) is caused by static lesion to a developing nervous system that primarily affects
motor function. Spastic motor involvement is characteristic of most of these individual.Dynamicequinus is a
common deformity that worsens the ambulatory ability of both diplegic and hemiplegic conditions. The use of
electromyographic (EMG) biofeedback has been suggested as a training tool to improve the ability to increase
activation of weak and partially paralyzed muscles and to decrease the activation of muscles affected by spasm
or spasticity without regard to specific diagnosis. However, very few studies have reported the effects of EMG
biofeedback on ankle function among children with spastic cerebral palsy .Objectives of the study was to
increase the activation of tibialis anterior and to improve the functional ambulation.40 subjects were made part
of the study on the basis of inclusion and exclusion criteria divided into two groups group A and B.Group A
received traditional physical therapy exercises and electromypgraphic biofeedback and group B received only
exercise program.The treatment duration was for 4weeks 3 sessions a week.The results were analysed using
statistical tests that were paired and unpaired t-test and mannwhitneytest.The results showed significant
improvement in the pre and post treatment.The conclusion of the study lended a favourable outlook to use
biofeedback training in treatment of CP children, to improve functional ambulation and gait. Keywords: Cerebral palsy, dynamic equinus deformity, gait, electromyography, biofeedback.
Effects of Virtual Reality with Cerebral Palsy Childrenspastudent
This document summarizes a study that investigated the effects of virtual reality (VR) physiotherapy on balance in children with cerebral palsy. The study hypothesized that VR would have no additional effects beyond conventional physiotherapy in improving balance. The study involved 12 children who received either conventional therapy alone or conventional therapy plus VR games for 6 weeks. Results found no significant differences in balance improvements between the two groups, supporting the hypothesis that VR provided no additional benefits beyond conventional therapy alone for balance in children with cerebral palsy.
68 trends in neuropediatric physical therapy - publicadoNathanael Amparo
The document summarizes trends in physical therapy protocols for children with neuromotor deficits such as cerebral palsy. It describes intensive therapy programs using special suits with elastic cords that position the child's body correctly and allow them to perform activities. These programs, involving 3-4 hours of therapy per day for 4-5 weeks, have shown significant rehabilitation results. Objective assessment tools are also increasingly used to precisely plan and monitor treatment. While more research is still needed, intensive physical therapy protocols combined with special suits and functional assessments are becoming standard practice for rehabilitating children with neuromotor impairments.
Effects of Wii versus traditional supervised exercise on the functional fitne...spastudent
Effects of Wii versus traditional supervised exercise on the functional fitness of moderately frail Chinese population- A Pilot Study
Nanyang Polytechnic
Physiotherapy
To Study the Efficacy of Electromyographic Biofeedback Training on Dynamic Eq...IOSR Journals
Abstract: Cerebral palsy (CP) is caused by static lesion to a developing nervous system that primarily affects
motor function. Spastic motor involvement is characteristic of most of these individual.Dynamicequinus is a
common deformity that worsens the ambulatory ability of both diplegic and hemiplegic conditions. The use of
electromyographic (EMG) biofeedback has been suggested as a training tool to improve the ability to increase
activation of weak and partially paralyzed muscles and to decrease the activation of muscles affected by spasm
or spasticity without regard to specific diagnosis. However, very few studies have reported the effects of EMG
biofeedback on ankle function among children with spastic cerebral palsy .Objectives of the study was to
increase the activation of tibialis anterior and to improve the functional ambulation.40 subjects were made part
of the study on the basis of inclusion and exclusion criteria divided into two groups group A and B.Group A
received traditional physical therapy exercises and electromypgraphic biofeedback and group B received only
exercise program.The treatment duration was for 4weeks 3 sessions a week.The results were analysed using
statistical tests that were paired and unpaired t-test and mannwhitneytest.The results showed significant
improvement in the pre and post treatment.The conclusion of the study lended a favourable outlook to use
biofeedback training in treatment of CP children, to improve functional ambulation and gait. Keywords: Cerebral palsy, dynamic equinus deformity, gait, electromyography, biofeedback.
Effects of Virtual Reality with Cerebral Palsy Childrenspastudent
This document summarizes a study that investigated the effects of virtual reality (VR) physiotherapy on balance in children with cerebral palsy. The study hypothesized that VR would have no additional effects beyond conventional physiotherapy in improving balance. The study involved 12 children who received either conventional therapy alone or conventional therapy plus VR games for 6 weeks. Results found no significant differences in balance improvements between the two groups, supporting the hypothesis that VR provided no additional benefits beyond conventional therapy alone for balance in children with cerebral palsy.
68 trends in neuropediatric physical therapy - publicadoNathanael Amparo
The document summarizes trends in physical therapy protocols for children with neuromotor deficits such as cerebral palsy. It describes intensive therapy programs using special suits with elastic cords that position the child's body correctly and allow them to perform activities. These programs, involving 3-4 hours of therapy per day for 4-5 weeks, have shown significant rehabilitation results. Objective assessment tools are also increasingly used to precisely plan and monitor treatment. While more research is still needed, intensive physical therapy protocols combined with special suits and functional assessments are becoming standard practice for rehabilitating children with neuromotor impairments.
Effects of Wii versus traditional supervised exercise on the functional fitne...spastudent
Effects of Wii versus traditional supervised exercise on the functional fitness of moderately frail Chinese population- A Pilot Study
Nanyang Polytechnic
Physiotherapy
Interactive Games as a Rehabilitation Tool for Elderly with Dementia: A Pilot...spastudent
The study aimed to investigate the effects of Wii Bowling on selective attention, simple reaction time, and quality of life in elderly with dementia. Twenty elderly with mild dementia were recruited and randomly assigned to an intervention or control group. The intervention group played Wii Bowling twice a week for 4 weeks, while the control group received usual day care activities. Results showed improvements in quality of life domains of family and self as a whole for the intervention group. The study provides preliminary evidence that interactive games like Wii Bowling may benefit elderly with dementia.
This study compared the incidence of neurobehavioral side effects of levetiracetam versus phenytoin in patients with traumatic brain injury (TBI). In a prospective observational study of 100 TBI patients treated with either levetiracetam or phenytoin, researchers found:
1. Levetiracetam was associated with significantly fewer neurobehavioral side effects than phenytoin, including less irritability, aggression, and confusion.
2. Phenytoin treatment resulted in nearly double the incidence of neurobehavioral side effects compared to levetiracetam.
3. Levetiracetam appears to be a better-tolerated antiepileptic drug for
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.
An accessible training_device_for_children_with_cerebral_palsySachinAthiKvr
This study developed and tested two types of pedal switches integrated with rehabilitation devices to improve balance and walking in children with cerebral palsy. One type connected to web games and the other to home appliances. Children used their feet to operate the devices for 15 weeks. Those using the web game device showed significantly greater improvements in sway patterns and balance/walking scores compared to the home appliance device, suggesting web games better motivate rehabilitation adherence. Maintaining motivation is important for rehabilitation success in children with cerebral palsy.
The document reviews studies that examined the effects of progressive resistance training (PRT) on gait parameters in children with cerebral palsy, finding that while PRT improved muscle strength and increased gait velocity slightly compared to control groups, more research is needed to determine how to best address muscle weaknesses and compensation patterns through resistance training to maximize its effects on gait.
The Beighton score is a valid measure for generalized hypermobility in children ages 6 to 12 based on this study of 551 Dutch children. More than 35% of children scored above the cutoff of 5/9 on the Beighton scale, indicating increased joint mobility. Children with higher Beighton scores showed increased range of motion in other joints measured as well. There were no significant differences in prevalence of joint pain or pain after exercise between groups with different Beighton scores. The Beighton score effectively measured generalized joint mobility in this population of school-aged children.
The document provides an overview of common balance tests and measures used in physical therapy, including functional scales like the Four Square Step Test (FSST) and Timed Up & Go (TUG), as well as subjective scales like the Activities-specific Balance Confidence Scale (ABC) and Dizziness Handicap Inventory (DHI). It discusses what components of balance the different tests measure, such as control of dynamics, static stability, and sensory integration. Cut-off scores and psychometric properties like reliability and validity are provided for each measure. The summary emphasizes selecting the best test based on the patient and condition, and tailoring interventions to the specific balance impairments measured.
The document discusses the benefits of physical exercise on cognitive function in older adults and patients with Alzheimer's disease or mild cognitive impairment. It provides evidence from multiple reviews and studies that both aerobic and resistance training can improve executive function and delay cognitive decline. The document also describes results from trials conducted by the author showing that regular physical exercise interventions led to sustained or improved cognitive performance and functional abilities in MCI patients and helped maintain cognitive skills longer in Alzheimer's patients compared to control groups without exercise.
1) The study compared the effects of three Pilates regimes on chronic low back pain symptoms and load transfer through the pelvis.
2) All groups experienced statistically significant reductions in frequency, intensity, and duration of low back pain after exercising, but there were no significant differences between groups.
3) Load transfer through the pelvis, as measured by the Stork test, did not significantly improve for any group after the Pilates program.
This document contains summaries of several research articles on various topics related to physiotherapy and physical therapy. The articles discuss the effects of home exercise programs for older adults, interval bicycling interventions for Parkinson's disease, exergaming and treadmill training for Parkinson's disease, predictors of walking speed after stroke, reliability of chest x-ray interpretation by physiotherapy students, effects of home rehabilitation on activities of daily living and gait for older adults with heart failure, a model for teaching ethical reflection in service learning, and several other topics related to physiotherapy treatments and interventions.
The factorial validity of imagery scaleMalika Sharma
This document describes the development and validation of an imagery scale for Indian artistic gymnasts. It involved a multi-step process including: 1) developing statements based on literature, 2) administering the scale to 120 gymnasts, 3) conducting exploratory factor analysis which supported a 2-factor model explaining 45.28% of variance, 4) refining the scale, 5) administering to 65 gymnasts where a 1-factor model explained 50.046% of variance. The validated 4-item imagery scale can now be used to assess gymnasts' imagery abilities.
Effects of Learning by Video Modeling on Gymnastic Performances among Tunisia...IOSR Journals
The document summarizes a study that analyzed the effects of learning gymnastic skills through video modeling combined with physical education sessions among Tunisian secondary school students. 103 students were divided into an experimental group that received video modeling lessons and a control group. Measures were taken before and after. The results showed that the experimental group improved gymnastic performance significantly more than the control group. Specifically, the progression of performance was higher for girls compared to boys in the experimental group. The study demonstrates that learning through video modeling can effectively help students acquire and improve gymnastic skills.
Atraumatic/MDI - Physiotherapy Principles and ManagementThe Arm Clinic
Physiotherapy management of multidirectional instability (MDI) of the shoulder is complex due to various drivers of the condition. Research on MDI has been difficult to interpret due to inconsistent definitions, heterogeneous populations, lack of standardization, and insensitive outcome measures across studies. Physiotherapy aims to address drivers both local to the shoulder like atypical muscle activation patterns and scapular kinematics, as well as central nervous system drivers involving cortical reorganization. Rehabilitation focuses on normalizing range of motion, improving neuromuscular control, and training into positions of vulnerability using modalities that target specific muscles individually and create synergies between muscles.
1) This study examined fear of falling and functional ability in older adults undergoing hip surgery in Thailand.
2) A total of 33 older adult participants undergoing hip surgery were included in the study.
3) Baseline characteristics of participants showed that most were female, widowed, with comorbidities like hypertension and diabetes. The main cause of hip fracture was falls during daily activities.
This study examined the effects of glucosamine supplementation on individuals experiencing regular knee pain. Subjects were randomly assigned to receive either glucosamine or placebo supplementation daily for 12 weeks. Outcomes were assessed using clinical tests, questionnaires, and participant evaluations at baseline and weeks 4, 8, and 12. The glucosamine group reported significantly less knee pain and better quality of life scores on questionnaires at weeks 8 and 12 compared to the placebo group. Additionally, 88% of the glucosamine group reported an improvement in knee pain over the study period versus only 17% in the placebo group. The results suggest glucosamine supplementation can provide pain relief and improved function for those with regular knee pain.
The document discusses neuro-developmental physiotherapy (NDT) offered at King Edward Preparatory for children with low muscle tone (LMT). NDT is an advanced hands-on physiotherapy approach used to address challenges with posture, movement, motor skills, muscle weakness and coordination. Children with LMT may exhibit poor posture, delayed motor skills, difficulty remaining upright, restlessness, tiring easily and avoiding physical activity. The physiotherapist works with the child, family, physicians and teachers to develop a comprehensive treatment program involving weekly sessions for 6 months to strengthen muscles and improve stability, movement and performance.
Efficacy of PNF Training Vs Agility Training on Mobility and Balance in Unila...ijtsrd
This study compared the effects of proprioceptive neuromuscular facilitation (PNF) training and agility training on mobility and balance in 15 unilateral transtibial amputees each. Both groups received their respective training (PNF or agility) in addition to conventional occupational therapy, three times per week for four weeks. Outcome measures of Berg Balance Scale and Amputee Mobility Predictor showed significant improvements within each group after the intervention. When comparing the groups, there was no significant difference in balance improvement but agility training led to significantly greater gains in mobility. Thus, the study concluded that agility training may be more effective than PNF training at improving mobility in unilateral transtibial ampute
This document summarizes and discusses several articles on physical medicine and rehabilitation (PMR) topics that were published in recent issues of various journals. The articles cover a range of topics including the treatment of 12th rib syndrome, the use of the tourniquet ischemia test to diagnose complex regional pain syndrome, physiotherapy interventions for treating spasticity, a telehealth intervention to increase fitness for those with spinal cord injuries, spinal cord involvement in COVID-19, the use of local anesthetic injections in athletes, and a comparison of video-based and text-based physical activity interventions. The document also provides an introduction and welcome from the editor as well as information about new contributors.
Management of gait problems in children with spastic hemiplegic cerebral palsy involves several treatment approaches. Physiotherapists utilize strengthening exercises, stretching exercises, balance training, gait training accompanied by ankle foot orthoses, endurance training, task-oriented techniques, proprioceptive neuromuscular facilitation exercises, and neurodevelopmental treatment. These therapeutic approaches have all demonstrated efficacy in improving gait deviations and lower extremity function for children with the four types of hemiplegic gait patterns. Gait problems are considered one of the most challenging issues associated with cerebral palsy, particularly spastic hemiplegia and diplegia.
This study examined bone mineral density (BMD) in 54 children and adolescents with juvenile idiopathic arthritis before and after a 12-week exercise program. The participants were randomly assigned to an exercise group or control group. The exercise group performed 100 two-footed jumps with a rope and muscle strength exercises 3 times per week. BMD was measured at the start, after 3 months, and after 6 months using dual-energy x-ray absorptiometry. The results showed that BMD values in the total body increased significantly in the exercise group after the program, while BMD measurements remained stable in the control group and for all participants remained within the normal reference range compared to other children. Thus, a short-
Interactive Games as a Rehabilitation Tool for Elderly with Dementia: A Pilot...spastudent
The study aimed to investigate the effects of Wii Bowling on selective attention, simple reaction time, and quality of life in elderly with dementia. Twenty elderly with mild dementia were recruited and randomly assigned to an intervention or control group. The intervention group played Wii Bowling twice a week for 4 weeks, while the control group received usual day care activities. Results showed improvements in quality of life domains of family and self as a whole for the intervention group. The study provides preliminary evidence that interactive games like Wii Bowling may benefit elderly with dementia.
This study compared the incidence of neurobehavioral side effects of levetiracetam versus phenytoin in patients with traumatic brain injury (TBI). In a prospective observational study of 100 TBI patients treated with either levetiracetam or phenytoin, researchers found:
1. Levetiracetam was associated with significantly fewer neurobehavioral side effects than phenytoin, including less irritability, aggression, and confusion.
2. Phenytoin treatment resulted in nearly double the incidence of neurobehavioral side effects compared to levetiracetam.
3. Levetiracetam appears to be a better-tolerated antiepileptic drug for
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.
An accessible training_device_for_children_with_cerebral_palsySachinAthiKvr
This study developed and tested two types of pedal switches integrated with rehabilitation devices to improve balance and walking in children with cerebral palsy. One type connected to web games and the other to home appliances. Children used their feet to operate the devices for 15 weeks. Those using the web game device showed significantly greater improvements in sway patterns and balance/walking scores compared to the home appliance device, suggesting web games better motivate rehabilitation adherence. Maintaining motivation is important for rehabilitation success in children with cerebral palsy.
The document reviews studies that examined the effects of progressive resistance training (PRT) on gait parameters in children with cerebral palsy, finding that while PRT improved muscle strength and increased gait velocity slightly compared to control groups, more research is needed to determine how to best address muscle weaknesses and compensation patterns through resistance training to maximize its effects on gait.
The Beighton score is a valid measure for generalized hypermobility in children ages 6 to 12 based on this study of 551 Dutch children. More than 35% of children scored above the cutoff of 5/9 on the Beighton scale, indicating increased joint mobility. Children with higher Beighton scores showed increased range of motion in other joints measured as well. There were no significant differences in prevalence of joint pain or pain after exercise between groups with different Beighton scores. The Beighton score effectively measured generalized joint mobility in this population of school-aged children.
The document provides an overview of common balance tests and measures used in physical therapy, including functional scales like the Four Square Step Test (FSST) and Timed Up & Go (TUG), as well as subjective scales like the Activities-specific Balance Confidence Scale (ABC) and Dizziness Handicap Inventory (DHI). It discusses what components of balance the different tests measure, such as control of dynamics, static stability, and sensory integration. Cut-off scores and psychometric properties like reliability and validity are provided for each measure. The summary emphasizes selecting the best test based on the patient and condition, and tailoring interventions to the specific balance impairments measured.
The document discusses the benefits of physical exercise on cognitive function in older adults and patients with Alzheimer's disease or mild cognitive impairment. It provides evidence from multiple reviews and studies that both aerobic and resistance training can improve executive function and delay cognitive decline. The document also describes results from trials conducted by the author showing that regular physical exercise interventions led to sustained or improved cognitive performance and functional abilities in MCI patients and helped maintain cognitive skills longer in Alzheimer's patients compared to control groups without exercise.
1) The study compared the effects of three Pilates regimes on chronic low back pain symptoms and load transfer through the pelvis.
2) All groups experienced statistically significant reductions in frequency, intensity, and duration of low back pain after exercising, but there were no significant differences between groups.
3) Load transfer through the pelvis, as measured by the Stork test, did not significantly improve for any group after the Pilates program.
This document contains summaries of several research articles on various topics related to physiotherapy and physical therapy. The articles discuss the effects of home exercise programs for older adults, interval bicycling interventions for Parkinson's disease, exergaming and treadmill training for Parkinson's disease, predictors of walking speed after stroke, reliability of chest x-ray interpretation by physiotherapy students, effects of home rehabilitation on activities of daily living and gait for older adults with heart failure, a model for teaching ethical reflection in service learning, and several other topics related to physiotherapy treatments and interventions.
The factorial validity of imagery scaleMalika Sharma
This document describes the development and validation of an imagery scale for Indian artistic gymnasts. It involved a multi-step process including: 1) developing statements based on literature, 2) administering the scale to 120 gymnasts, 3) conducting exploratory factor analysis which supported a 2-factor model explaining 45.28% of variance, 4) refining the scale, 5) administering to 65 gymnasts where a 1-factor model explained 50.046% of variance. The validated 4-item imagery scale can now be used to assess gymnasts' imagery abilities.
Effects of Learning by Video Modeling on Gymnastic Performances among Tunisia...IOSR Journals
The document summarizes a study that analyzed the effects of learning gymnastic skills through video modeling combined with physical education sessions among Tunisian secondary school students. 103 students were divided into an experimental group that received video modeling lessons and a control group. Measures were taken before and after. The results showed that the experimental group improved gymnastic performance significantly more than the control group. Specifically, the progression of performance was higher for girls compared to boys in the experimental group. The study demonstrates that learning through video modeling can effectively help students acquire and improve gymnastic skills.
Atraumatic/MDI - Physiotherapy Principles and ManagementThe Arm Clinic
Physiotherapy management of multidirectional instability (MDI) of the shoulder is complex due to various drivers of the condition. Research on MDI has been difficult to interpret due to inconsistent definitions, heterogeneous populations, lack of standardization, and insensitive outcome measures across studies. Physiotherapy aims to address drivers both local to the shoulder like atypical muscle activation patterns and scapular kinematics, as well as central nervous system drivers involving cortical reorganization. Rehabilitation focuses on normalizing range of motion, improving neuromuscular control, and training into positions of vulnerability using modalities that target specific muscles individually and create synergies between muscles.
1) This study examined fear of falling and functional ability in older adults undergoing hip surgery in Thailand.
2) A total of 33 older adult participants undergoing hip surgery were included in the study.
3) Baseline characteristics of participants showed that most were female, widowed, with comorbidities like hypertension and diabetes. The main cause of hip fracture was falls during daily activities.
This study examined the effects of glucosamine supplementation on individuals experiencing regular knee pain. Subjects were randomly assigned to receive either glucosamine or placebo supplementation daily for 12 weeks. Outcomes were assessed using clinical tests, questionnaires, and participant evaluations at baseline and weeks 4, 8, and 12. The glucosamine group reported significantly less knee pain and better quality of life scores on questionnaires at weeks 8 and 12 compared to the placebo group. Additionally, 88% of the glucosamine group reported an improvement in knee pain over the study period versus only 17% in the placebo group. The results suggest glucosamine supplementation can provide pain relief and improved function for those with regular knee pain.
The document discusses neuro-developmental physiotherapy (NDT) offered at King Edward Preparatory for children with low muscle tone (LMT). NDT is an advanced hands-on physiotherapy approach used to address challenges with posture, movement, motor skills, muscle weakness and coordination. Children with LMT may exhibit poor posture, delayed motor skills, difficulty remaining upright, restlessness, tiring easily and avoiding physical activity. The physiotherapist works with the child, family, physicians and teachers to develop a comprehensive treatment program involving weekly sessions for 6 months to strengthen muscles and improve stability, movement and performance.
Efficacy of PNF Training Vs Agility Training on Mobility and Balance in Unila...ijtsrd
This study compared the effects of proprioceptive neuromuscular facilitation (PNF) training and agility training on mobility and balance in 15 unilateral transtibial amputees each. Both groups received their respective training (PNF or agility) in addition to conventional occupational therapy, three times per week for four weeks. Outcome measures of Berg Balance Scale and Amputee Mobility Predictor showed significant improvements within each group after the intervention. When comparing the groups, there was no significant difference in balance improvement but agility training led to significantly greater gains in mobility. Thus, the study concluded that agility training may be more effective than PNF training at improving mobility in unilateral transtibial ampute
This document summarizes and discusses several articles on physical medicine and rehabilitation (PMR) topics that were published in recent issues of various journals. The articles cover a range of topics including the treatment of 12th rib syndrome, the use of the tourniquet ischemia test to diagnose complex regional pain syndrome, physiotherapy interventions for treating spasticity, a telehealth intervention to increase fitness for those with spinal cord injuries, spinal cord involvement in COVID-19, the use of local anesthetic injections in athletes, and a comparison of video-based and text-based physical activity interventions. The document also provides an introduction and welcome from the editor as well as information about new contributors.
Management of gait problems in children with spastic hemiplegic cerebral palsy involves several treatment approaches. Physiotherapists utilize strengthening exercises, stretching exercises, balance training, gait training accompanied by ankle foot orthoses, endurance training, task-oriented techniques, proprioceptive neuromuscular facilitation exercises, and neurodevelopmental treatment. These therapeutic approaches have all demonstrated efficacy in improving gait deviations and lower extremity function for children with the four types of hemiplegic gait patterns. Gait problems are considered one of the most challenging issues associated with cerebral palsy, particularly spastic hemiplegia and diplegia.
This study examined bone mineral density (BMD) in 54 children and adolescents with juvenile idiopathic arthritis before and after a 12-week exercise program. The participants were randomly assigned to an exercise group or control group. The exercise group performed 100 two-footed jumps with a rope and muscle strength exercises 3 times per week. BMD was measured at the start, after 3 months, and after 6 months using dual-energy x-ray absorptiometry. The results showed that BMD values in the total body increased significantly in the exercise group after the program, while BMD measurements remained stable in the control group and for all participants remained within the normal reference range compared to other children. Thus, a short-
This study examined the effects of kinesio taping in addition to physical therapy on seated postural control in 30 children with spastic diplegic cerebral palsy between 10-16 months of age. The children were randomly assigned to a study group that received kinesio taping applied to paraspinal muscles in addition to physical therapy, or a control group that received only physical therapy. Both groups showed improvements in kyphotic angle, Cobb's angle, and GMFM seated scores after treatment, but the study group showed significantly greater improvements, suggesting kinesio taping is a beneficial addition to physical therapy for improving seated posture and trunk control in children with spastic diplegic cerebral palsy.
EFFECTIVENESS OF TREADMILL TRAINING ON GAIT FUNCTION IN.pptxNicholas Redly
This meta-analysis investigated the effects of treadmill training on gait function in children with cerebral palsy. Eight studies with a total of 179 participants were included. Treadmill training had a moderate effect on overall gait function. It had a large effect on gait endurance, and moderate effects on gait speed and limb support time. However, treadmill training had small, insignificant effects on cadence and step length. These findings suggest that treadmill training can effectively improve certain aspects of gait function in children with cerebral palsy.
This study examined the active self-correction of spinal curvatures in 249 children (136 females, 113 males aged 10-14 years) in response to the command "straighten your back". Spinal angles were measured in standing and sitting positions both spontaneously and after the command. In standing, the command significantly increased sacral slope and decreased lumbar lordosis, thoracic kyphosis, and lower and upper thoracic kyphosis. In sitting, the command significantly changed sacral slope and lumbar lordosis from kyphotic to lordotic and significantly reduced thoracic kyphosis and flattened lower thoracic kyphosis. There were some gender differences in self-correction of lumbar lordosis and upper thoracic kyphosis
This document summarizes research on the effects of hippotherapy on several disorders. It discusses studies that found hippotherapy improved outcomes for children with cerebral palsy, autism spectrum disorder, and attention deficit hyperactivity disorder. For cerebral palsy, hippotherapy reduced spasticity, improved gross motor functions and muscle activity. For autism, it increased engagement, social behaviors and self-regulation. For ADHD, hippotherapy improved executive functioning. The document reviews participant characteristics, assessment scales, and results from multiple clinical studies on hippotherapy for each of these disorders.
This document summarizes gait abnormalities in children with cerebral palsy. It begins by defining cerebral palsy and describing the three main types: spastic, dyskinetic, and ataxic. For each type, it outlines the characteristic neuromuscular deficits that affect gait. It then describes normal gait cycle and determinants. Key factors that influence gait in CP are weaknesses, shortened muscles, spasticity, and bone deformities from altered forces. Gait abnormalities range from mild toe-walking to severe crouched gait. Prognosis for walking depends on CP type, severity, and age of independent walking. Over time, walking ability tends to decline in adolescents and adults with CP
Depression in Mothers of Children with Cerebral Palsy and Its Relation with C...ijtsrd
Introduction Cerebral palsy is a condition caused by an abnormality in the brain causing difficulties in movement and coordination, with an onset in the developmental period of childhood. Cerebral palsy can include cerebral malformation arising in the gestational period, a destructive process in the antenatal, prenatal or early postnatal periods, or by various processes acting together. Objective To evaluate the depression level in mothers of children with cerebral palsy and its relation with the current functional status of the children and establish To determine the correlation of functional ability of children with cerebral palsy and depression levels in their mother.Hypothesis There is inversely proportional relationship of depression of mother of children with cerebral palsy with current functional status of their children. There is directly proportional relationship of depression of mother of children with cerebral palsy with current functional status of their children.Design Pre test and post test experimental correlation study. Participants Mother of both male and female children with a documented diagnosis of Cerebral palsy in the age group of 6 months to 3 years. The children in group a received one hour of occupational therapy based on neurodevelopment therapy. Therapy was individualized for each child’s condition and was dictated by the child’s unique clinical needs. The goal of therapy was to improve postural and functional abilities in different developmental position.Each activity was given for 10 15 minutes depending on child’s interest, attention and interaction with the environment. Each session started from the weight bearing activity and gradually followed by performance of the movement within the developmental context.Main Outcome Measures Beck depression inventory Gross motor functional measure Results Table 6 shows that there is a significant difference p 0.05 e in both GMFM AND BDI scores since the p value are 0.000, which is less than the acceptable level of significance of 0.05. Table 7 shows that there is a negative relationship p 0.05 between children current functional level and mother’s depression level.Conclusions From this study it is concluded that there is p 0.05 negative relationship between BDI score and GMFM score. Hence these findings should be used in caution when treating the patients with cerebral palsy. Balvant Kumar Meena | Mr. Subrata Kumar Halder | Ms Smita Jayavant "Depression in Mothers of Children with Cerebral Palsy and Its Relation with Current Functional Status of The Children" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd37912.pdf Paper URL : https://www.ijtsrd.com/medicine/other/37912/depression-in-mothers-of-children-with-cerebral-palsy-and-its-relation-with-current-functional-status-of-the-children/balvant-kumar-meena
This systematic review and meta-analysis examined the effects of suit therapy on functioning in children and adolescents with cerebral palsy (CP). Four randomized controlled trials met the inclusion criteria and were included in the meta-analysis. Small effect sizes were found for improvements in gross motor function immediately after treatment and at follow-up. However, the small number of included studies, variability between studies, and low sample sizes limit the strength of the findings. More high-quality research is needed to better understand the impacts of suit therapy.
pediatric electrodiagnostic for cerebral palsy,
A diagnosis of CP is often made based on MRI, delay of motor milestones and the presence of gait abnormalities in young children
Although the initial brain injury is non-progressive, the musculoskeletal impairments and functional limitations associated with CP are progressive
Three main classes of CP include spastic, dyskinetic and ataxic
Unimanual and bimanual intensive training Irfan iftekhar
Use of Constraint Induced Movement Therapy (CIMT) as an intervention for hemiparesis has demonstrated favorable results in recent literature. CIMT is a common neurological intervention which has been used to treat individuals who have experienced unilateral hemiparesis, or weakness of one arm due to some sort of neurological condition or trauma.
The effect of instability training on knee joint proprioception and core stre...Fernando Farias
A general 10-week IT program utilizing Swiss balls and body mass as a resistance proved effective for improving knee proprioception as well as trunk flexion and extension strength in previously inactive individuals. The present study demonstrates that the use of body weight as a resis- tance under unstable conditions can provide significant improvements in knee proprioception (for as long as 9 months after training) and trunk strength for the untrained population that should contribute to general health and functionality.
این پاورپوینت در کارگاه ارزیابی و توانبخشی مشکلات راه رفتن در کودکان فلج مغزی توسط دکتر محمد خیاط زاده ارائه شده است.
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Eight weeks of aerobic exercises improved several physical fitness components in children with Autism Spectrum Disorders. The study examined the effects of an eight-week aerobic exercise program involving brisk walking, aerobic dancing, and jumping rope on the static balance, muscular strength, flexibility, body composition, neuromuscular coordination and reaction time of children with ASD aged 9-20. Statistical analysis revealed that the aerobic exercises significantly improved all components measured. The study concluded that incorporating appropriate physical activity can enhance the well-being of children with ASD and help reduce atypical behaviors.
This document discusses motor, cognitive, emotional, and psychosocial development from infancy to childhood. It describes typical motor development milestones including reflexes that are present at birth and disappear at certain ages as voluntary control increases. Motor skills progress from head to toe and develop in a predictable sequence, though rates vary between children. Development is influenced both by genetic factors that determine potential and environmental factors like parenting, family dynamics, and socioeconomic status.
The document discusses the history and development of suit therapy. It began with the development of the Penguin suit in Russia's space program to counter the harmful effects of weightlessness on the body during space flights. Suit therapy aims to normalize sensory and motor inputs, bone density, muscle strength, balance, and body fluid balance that are impacted by reduced weight bearing.
The Adeli suit, developed by the Russian Academy of Sciences, showed successful results in treating cerebral palsy and other neurological disorders, opening the door for suit therapy as a new treatment method. The modified TheraSuit was designed by Polish therapists Richard and Izabela Koscielny for intensive suit therapy in the US and abroad. Research shows TheraSuit can
This document provides information on cerebral palsy, including its causes, types, clinical manifestations, diagnostic evaluation, and management. Cerebral palsy is a group of disorders that affect movement and posture, caused by non-progressive brain damage early in development. It involves motor impairments as well as disturbances of sensation, perception, communication, cognition, and behavior. Common types include spastic, dyskinetic, and ataxic cerebral palsy. Treatment is multidisciplinary and focuses on medical management, therapies, surgery, and nursing care to improve symptoms and quality of life.
Miguel JuncoReferences PathophysiologyBohannon, R. W. (1983). .docxendawalling
Miguel Junco
References Pathophysiology
Bohannon, R. W. (1983). Results of Resistance Exercise on a Patient with Amyotrophic Lateral Sclerosis. Phys. Ther, 63(6), 965–968. doi: 10.1093/ptj/63.6.965
Goodman, C. C., & Marshall, C. (2017). Pathology for the physical therapist assistant. Philadelphia: Saunders.
Jette, D. U., Slavin, M. D., Andres, P. L., & Munsat, T. L. (1999). The Relationship of Lower-Limb Muscle Force to Walking Ability in Patients with Amyotrophic Lateral Sclerosis. Phys Ther, 79(7), 672–681. doi: 10.1093/ptj/79.7.672
Martin, S., & Kessler, M. (2016). Neurologic interventions for physical therapy. St. Louis: Elsevier Saunders.
Bello-Haas, V. D., Kloos, A. D., & Mitsumoto, H. (1998). Physical Therapy for a Patient Through Six Stages of Amyotrophic Lateral Sclerosis. Phys. Ther, 78(12), 1312–1324. doi: 10.1093/ptj/78.12.1312
The Relationship of Lower-Limb
Muscle Force to Walking Ability in
Patients With Amyotrophic
Lateral Sclerosis
Background and Purpose. The purpose of this study was to determine
the level of muscle force associated with ability to walk in the
community without assistance, in the community with assistance, or at
home only in individuals with amyotrophic lateral sclerosis (ALS).
Subjects and Methods. Percentage of predicted maximal muscle force
(%PMF) of lower-extremity muscles was determined, and walking
ability was categorized in 118 patients with ALS during periodic visits to
the Neuromuscular Research Unit. Data were derived from consecu-
tive visits in which subjects demonstrated declines in walking ability.
Means for %PMF of each muscle group and a limb average were
calculated at each consecutive visit. Results. The mean lower-extremity
average %PMF was: (1) 54.01% (SD512.76%) for subjects who walked
independently in the community and 50.19% (SD514.38%) during
the next visit when these same subjects required assistance in the
community (difference53.82%, 95% confidence interval [CI]5
2.4525.19);(2) 37.52% (SD515.17%) during the last visit that subjects
walked with assistance in the community and 32.18% (SD513.83%)
during the next visit when they walked only at home (differ-
ence55.33%, 95% CI53.61–7.06); and (3) 19.12% (SD59.08%) dur-
ing the visit when subjects were last able to ambulate at home versus
13.70% (SD57.36%) when they became unable to walk (differ-
ence55.42%, 95% CI52.9727.96). Conclusion and Discussion. The
findings suggest there are required levels of lower-extremity muscle
force for various categories of walking ability. Variations in forces
within and between categories of walking ability, however, indicate the
complexity of this relationship. [Jette DU, Slavin MD, Andres PL,
Munsat TL. The relationship of lower-limb muscle force to walking
ability in patients with amyotrophic lateral sclerosis. Phys Ther.
1999;79:672– 681.]
Key Words: Gait; Muscle performance, lower extremity; Neuromuscular disorders, general.
672 Physical Therapy . Volume 79 . Number 7 . July 1999
Re
se
ar.
Similar to Effect of Standing to Improve Balance and Gait of Children with Cerebral Palsy (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
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
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You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
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Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
2. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD37985 | Volume – 5 | Issue – 1 | November-December 2020 Page 399
Decreasing spasticity may enable the child to utilize their
selective control more effectively and functionally (Flett,
2003)11. The reduction ofspasticitymayaltertheconstraints
on ankle dorsiflexion during walking. Improvement inankle
kinematics during walking may allow the foot to accept
weight during stance and allow proper foot positioning
during stance thusallowingforwardprogressionforefficient
ambulation.
These problems can be minimized by prolonged Standing
and used widely in clinical practice.
STANDING:
The children who stood unsupported – both the Typically
Developing (TD) children and the children in CP fulfilled the
requirements for postural orientationduringStanding.They
thereby had the ability to align and maintain their body
position with respect to both gravityandthe environment 12.
The basic function of maintaining a Standing position
opposing gravity is derived from a complex interaction
between both sensory and motor systems. For the motor
task of Standing without support, posture and Balance –
postural control – are central. Postural control involves
controlling the body position in space for stability and
orientation13, 14.
The children’s difficulties to stand still relative to gravity in
CP, indicate proprioception disturbances with difficulties to
sense movements of the limbs, bothinand betweenthebody
segments, and the relative position of the body segments in
space. Disturbed proprioception has been previously
reported in children with CP in a study by Wingert et al.
(2009)14. Moreover, Damiano et al. (2013) reported that
proprioceptive deficitswere relatedtoinstabilityinStanding
and to decreased walking speed in children with mild CP,
and Bartonek et al. (2016) suggested that disturbed sensory
information from the lower limbs contributed to decreased
walking velocity in children with CP.17, 18
Proprioceptive deficits including disturbances with both
position sense and sense of limb movement in the lower
limbs have been recognized in children with CP.19, 20
Moreover, proprioceptive deficits have been related to
instability during Standingin childrenwithCPwhocould not
stand unsupported.21
Locomotion is characterisedbythree essential requirements
progression, postural control and adaptation. Progressionis
ensured through a basic locomotors pattern that produces
and coordinates rhythmical patterns of muscle activation of
the leg and trunk that successful moves the body in
despaired direction. Postural control reflect the need to
established and maintain an appropriate posture for
locomotion, and for demand for the dynamic stability of the
moving body.24
Prolonged Standing programs are used for children with
Cerebral Palsy (CP) and have been shown to have wide-
ranging positive effects in these children. Standing frames
are recommended for children with limited mobility in the
upright posture, including children with CP, to encourage
proper alignment and weight bearing on the lower
extremities (Gudjonsdottir& Mercer, 2002; Stuberg, 1992).
Standing programs have been shown to increase range of
motion (Baker, Cassidy, & Rone-Adams, 2007; Richardson,
1991; Tsai, Yeh, Chang,&Chen, 2001), improve muscle tone
(Bohannon, 1993; Eng et al., 2001; Fefr, Fisher, & Langbein,
1994, 1996; Odeen & Knutson, 1981; Pin, 2007; Shields &
Dudley-Javoroski, 2005; Tremblay, Malouin, Richards, &
Dumas, 1990; Tsai et al., 2001), improve bone growth, and
increase bone mineral density (Caulton et al., 2004;
Gudjonsdottir & Mercer, 2002; Gudjonsdottir & Stemmons,
1997; Stuberg, 1992; Wilmshurst, Ward, Adams, Langton, &
Mughal, 1996), and are assumed to prevent or reduce
secondary impairments by maintainingmuscleextensibility,
preventing muscle and soft tissue contracture, and
promoting optimal musculoskeletal development (Stuberg,
1992).27
Despite widespread use, the clinical effectiveness of
supported Standing in improving Gait measures in children
with CP has yet to be established. The purpose of this study
was to determine the effects of prolonged Standing to
improve Balance and Gait of the children with spastic
diplegic Cerebral Palsy. There ispaucityofstudyonStanding
and Gait.
Therefore attempt has been taken to known the effect of
prolong Standing to improve Balance and Gait.Therefore
intent of the study is to understand the effects of standing to
improve Balance and Gait for children with Cerebral Palsy.
AIMS OF STUDY:
Find out effects of standing to improve Balance and Gait.
HYPOTHESIS:
There is a positive effect of standing to improve Balance and
Gait
NULLHYPOTHESIS:
There is no effects on the Standing to improve Balance and
Gait.
METHODOLOGY
Design:
A different subjective prospective cross sectional quasi
experimental flexible design was used for proposes of the
study this deal with the details description of the subject.
Design of the study is A-B-A.
Subject:
Convenience sampling was used. Total 30 numbers of
subjects with spastic diaplesic Cerebral Palsy were selected
for the experiment. Age group was 2- 5 years; mean age 3.5
both the male and female. All subjects were selected from
the pediatric section of department of occupational therapy
SVNIRTAR, Cuttack over the period of one year. All the
subjects were diagnosed spastic CP and all were routinely
tested during the initial assessment. Those who were
participated in the study had followed the instruction
adequately. And they were granted inform consent before
testing.
Inclusion criteria:
Subject was diagnosed as spastic diplegic CP.
Age group was 2 to 5 years.
Both male and female were included.
Ability to follow the command
Gross motor Function Classification System (GMFCS)
level- 2 to3
3. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD37985 | Volume – 5 | Issue – 1 | November-December 2020 Page 400
MAS grade 1 or 2.
Exclusion Criteria:
Children with Mental retardation were excluded.
Cerebral Palsy with mental retardation also excluded.
Acute orthopaedic disorder.
Post operative condition.
Any contracture or deformity.
INSTRUMENTATION:
Screening Tool:
Gross Motor Function Classification System (GMFCS):
This Scale is now widely used to classify the Gross Motor
Function of children with Cerebral Palsy. It is an instrument
which gives informationaboutprognosisofchildrenwith CP.
This gives out comes of motor disability of infant in large
population.
GMFCS is five level scale that rates the Childs Gross Motor
Function which emphasises movement initiation for
Standing Balance andGait.Level -1includes Walkingwithout
Limitation and level -5 is Transport on Manual Wheel Chair
depends on the age in the form of Birthday 75 (APPENDIX-
III).
Out Come Measure:
1. Gross Motor Function Measure (GMFM); - the scale
was developed for Evaluation and Assessment of motor
function in child with CP and by using this measure we
can observe motor behaviour by a standard score. It is
last type measure that required evaluating the
effectiveness motor intervention for children withCP.It
is consist of 88 item grouped in five dimensions lying &
rolling, sitting, crawling & kneeling, Standing, running
and jumping. The item score on 4 point ordinal scale,
score for each dimension expressedaspercentageofthe
maximum sore for that dimension. Total score is
obtained by adding the percentage score for dimension
and dividing by 5 from which I took only D and E which
is standing and running & jumping. And score was like
adding by both the scale divided by 2 which is goal total
score age group is 5 to 16 year76 (APPENDIX- IV).
2. Paediatric Balance Scale (PBS);- The instrument use
for measure for school age children with mild to
moderate motor impairment scalehaving14itemwhich
should be scored utilizing 0 to 4 scale. If the first trail a
child receives the maximal score of 4. Age group is
school age like 2 to 14 maximum score is 56 77
(APPENDIX- V).
INTERVENTION
The entire subject undergone a therapeutic intervention
aimed was to increase Postural control on staticBalanceand
Gait. Therapy was done for 4 weeks 3 sessions per week 45
minute duration by screening tool (GMFCS) and inclusion
and exclusion criteria had been screened out the subject for
therapy. After the intervention subject was measure the
through outcome measure PBS & GMFM to check out the
improvement.
Standing unit:
The screened Child was placed in the Standing Unit in
vertical or inclined plane depending on their functional
abilities and Standing tolerance. Straps (2 inch) were
attached around pelvis to stabilise andmaintainthepelvicin
straight. 2 inch straps also was used around hip that is mid
thigh to prevent sway and hip flexion. Itgivesstabilizationto
the hip joint and ankle to prevent involuntary movement.
Also it makes the lower extremity straight for properweight
bear on lower limb to maintain the normal anatomical
position as much as possible. Different size strapswereused
for Hip and Ankle to prevent involuntary movement. Child
was encouraged to play or leisure time activity by using
upper extremity while Standing. Activity like Peg Boards,
Rings, and Blocks were used while reaching out forward,
upward, and sideways unilaterally/bilaterally for weight
shifting on foot alternatively. Allowed and encouraged the
child to stand around 45 minutes in the Standing unit
maintaining the body in proper anatomical position byusing
toys as per their likes and interest.
PROCEDURE
FLOW CHART
Allocation of patient was by convenient sampling
method
30 patients were included in the study by the
inclusion criteria and consent form taken from
the subject.
Pre test data were taken from the entire patient
Intervention Prolong standing for 45 minute
Post test data were collected from all the patient
Data analysis was done by comparing of both pre
test and post data.
Result
4. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD37985 | Volume – 5 | Issue – 1 | November-December 2020 Page 401
DATA ANALYSIS
Total 30 number of subject was selected for the study from
the age group 2 to 5 with the mean age of ± 3.3were taken in
to analysis.
The SPSS 25 software was used for analysis the data.Subject
was being assessed beforetheinterventionandtwooutcome
measure instrument namely GMFM, PBS were used. Each
assessment was followed by reassessment by the same
investigator.
The GMFM pre test was compared with the post test by
Wilcoxon Signed Ranks Test for the significant difference in
mean scores. (Table-1)
The pre test data of PBS was compare with the post test data
by the test Wilcoxon Signed Ranks test for the significant
difference in mean score. (table-2)
The pair (T) test was used to compare the GMFM pre test-
post test and PBS pre test – post test the test value was
significant. (Table-3)
Finally the GMFM post test was compare with the PBS post
test score there is significant difference between the scores.
(Table-4)
DATA TABLE
TABLE-1
WILCOXON SIGNED RANKS TEST
N=30
PRE- TEST POST-TEST SIG. VALUE
GMFM
MEAN STD.DEVIATION STD.ERROR MEAN MEAN STD.DEVIATION STD.ERROR MEAN
0.00*
6.46 5.69 1.03 29.53 20.52 3.74
TABLE-2
PBS PRE TEST AND POST TEST
PAIRED SAMPLE T TEST
N=30
PRE- TEST POST-TEST SIG. VALUE
PBS
MEAN STD.DEVIATION STD.ERROR MEAN MEAN STD.DEVIATION STD.ERROR MEAN
0.005*
4.70 2.23 0.40 17.40 9.24 1.68
* INDICATE SIGNIFICANCE VALUE <.05
TABLE-3
PAIRED T-TEST
PAIRED DIFFERENCES
MEAN STD. DEVIATION STD.ERROR MEAN df Z SIG
PAIR 1 GMFM PRE-POST -23.07 16.87 3.08 29 -4.782 .00*
PAIR2 PBS PRE-POST -12.70 8.36 1.52 29 -4.785 .05*
* INDICATE SIGNIFICANCE VALUE <.05
TABLE- 4
PAIRED SAMPLE STATISTICS
N MEAN STD.DEVIATION STD.ERROR
PAIR 1 GMFM POST 30 29.53 20.52 3.74
PAIR2 PBS POST 30 17.40 9.24 1.68
RESULT
The table -1 shows the descriptive statistic, the Range for
GMFM-88 with the pre test mean score 6.46, standard
deviation 5.69, std. error 1.03, post test mean score was
mean value 29.33, std. deviation 20.52 and std. error 3.74.
The range of pre test PBS score was like mean 4.70, std.
deviation 2.23, std. error 0.40 post test mean score 17.40,
std. deviation 9.24 and std. error 1.68 in (table-2),linegraph
2 (A) and column graph 2(B).
There is significant difference between pre testandposttest
of GMFM with significance of p=0.00 in (table-1), line graph
1 (A) and column graph 1(B) When both pre test and post
test data was compare there is a significant difference found
among the scores.
There is significance difference in PBS first and final
evaluation in (table-2), line graph 2 (A) and column graph
2(B) with the p=0.005. When both pre test andposttestdata
was compare there is a significant difference found among
the score.
There is significant betweentheGMFMandPBSbothpretest
and post test ( table -3) mean score of GMFM 23.07, 12.70,
std. deviation 16.87,8.36, std. error- 3.08,1.52, Z value -
4.752,-4.785, p=0.00,0.005 respectively. When both are
compare there is significant score found and shows in the
line graph 3 (A) and column graph 3(B).
When compare post test of GMFM and PBS( table-4)there is
difference in mean score of GMFM 29.53 and PBS 17.40,
standard deviation 20.52, 09.24, sdt. Error 3.74,1.68
respectivly difference was found within the group and also
shows in line graph 4 (A) and column graph 4 (B).
5. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD37985 | Volume – 5 | Issue – 1 | November-December 2020 Page 402
DISCUSSION
The purpose of this study was to determine the effects of
Standing on Gait and Balance in children with CP.
Improvement was shown In this current study 1- On the
floor pull to stand on large bench, 2- stand: maintains arms
free 3 seconds, 3-stand: holding on to large bench with one
hand lifts right foot, 3 seconds, 4- stand: holding on to large
bench with one hand lifts left foot 3 seconds, 5- stand
maintain arm free for 20 second, 6-sit on small bench:
attains stand without using arms, 7-stand 2 hands held:
walks forward 10 steps, 8-stand 1 hand held: walks forward
10 steps, 9-stand: walks forward 10 steps of in the GMFM.
Result show with p= .00 are improve significantly. There
were significant changes in between the pre test and post
test score, significant changes in the item no. Sitting to
Standing, Standing to sitting “Sit down slowly without using
your hands”, Transfers, Standing unsupported, Sitting
unsupported “Sit with your arms folded on your chest for 30
seconds”, Standing with feet together,Standing withonefoot
in front, Standing on one foot, of PBS all items respectively
with p=0.005.
Item no. 1: on the floor: pulls to stand at large bench Sitting
to Standing which normally involved extension of the lower
limbs over a fixed base (on the feet) may be impossible
without extensive use of upper limb. The diplegic child may
be pull to stand with feet placed too far forward and planter
flexed. So as a result body mass is too far behind the base of
support and upper limb gross movementofhandhelpto pull
to get up and stand. Children underwenta speciallydesigned
program for core stability, as the core musclesareimportant
for moving in and out Standing position in children with CP.
Similarly, Dodd et al.(2002) reported that the core muscles
stabilize the central part of the body to allow controlled
movements of the upper and lower limbs. Thus, the core
stability program may be modified to enhance Balance in
children with CP 78.
Item no.2: Standing maintains, arms free 3 seconds; Before
intervention child was unable to maintain the unsupported
Standing position or Balance after weight bearing the both
group muscleagonistandantagonistworkedsymontaneouly
to maintain co contraction for smooth movement. The
results of the current study were reinforced byGillen,(2013)
who concluded that children with spastic CP have defects in
the timing of motor responses. To support surface
perturbations, such as delayed muscle activation onset,
which moves the centre of mass towards thelimitofstability
and leads to more proximal muscle activation before distal
muscle activation when responding to support surface
perturbations in the Standing position which is the opposite
to that observed in children with normal control. Finally
children with spasticity have postural adjustment deficits
associated with voluntary control in static and dynamic
activities. There was a significantimprovementinBalance79.
Item no.3: Holding one hand one leg Standing while child
wants to stand on one leg that means when he/ she will lift
her one leg, spastic diplegic subject normally unable to
maintain or difficult to maintain the position because of
narrow base of. support. To maintain the Balance on one leg
subject has to shift the body weight left/ right for better
control of Balance. When body weight had change position
the subject has to maintain the COG. Hessari et al. (2011)
who had reported that core stabilization training improved
the dynamic Balance in CP with mental retardation 81. Limb
protraction/retraction control was found to be dominant
during medial-lateral sway, whereas the estimated body
transverse rotationcontributionwassignificantforanterior-
posterior Balance. These are significance of body transverse
rotation control contribution in unsupported Standing82.
Item no.4: stand: holding on to large bench with one hand
lifts right foot 3 seconds:- subject stand on one leg with the
holding of one hand to the large bench, the base ofsupport is
decrease but shifting of body weight properly will help the
child to maintain the Balance with narrow base of support.
By holding the large bench will help the childtomaintainthe
Balance and the CG will passes through the hip and knee
joint of left to maintain the Balance. Hyper tonicity of
extensor synergy may interfere hip flexion, abduction and
dorsi flexion of foot. Children with CP cannot allocate their
body weight during static Balance and shift the body weight
from one limb to another during dynamic Balance 82.
Supported by the Sterba et al.(2002), who had reported that
postural and equilibrium reactions in children withCPcould
be improved by strengthening the core muscles in addition
to achievement of joint stability, co-contraction, and
mproved ability to shift weight 83.
Item no.5: stand: holding on to large bench with one hand
lifts left foot, 3 seconds as correlate in the study were
supported by the studies mentioned on item no 4.
Item no.6 : sit on small bench: attains stand without using
arms from sitting position to Standing on a small benchneed
to use the co contraction of both agonist and antagonist
muscle of hip joint because during sitting to Standing
isotonic contraction of quadricepsandisometriccontraction
of hamstring as a result smooth and coordinated movement
is possible. Baker MJ (1993) and Wilson (1997) studied on
sitting to stand Behaviour with Orthosis in CP children and
they found that orthosis improved upright trunk posture
which further confirms the co-activationofantagonistwhich
interfere the normal function Baker MJ 1993 SKH).
Item no.7: stand 2 hands on large bench: carries 5 steps to
right, stability is characterised by the ability to maintain the
stable posture. Children who demonstrate problem in
stability may be unable to hold the steady because of
increase tone O Sullivan (2001). Walk with less base of
support and less stability which is difficult for the CP with
spasticity. Mostafa S. Ali (2019) enabling smooth decided
movements and to improved upper- and lower-limb muscle
strength, which affects the spine through the length tension
relationship 84.
Item no.8: stand 1 hand held: walks forward 10 steps:-
According to the motor control child having problem in
continuous movement subject are unable to walk. Gentile in
1987 state that the weather the base of support is steady or
moving depends on that he conclude that base of support is
steady Stability is more and viscera likemobilitytask suchas
walking stability requirement lessdemandingsoforBalance
and to compromise fulfil his demand of stability child use
one hand held. The Core stabilityprogramimprovedBalance
as a result of better modification of load transfer and
efficient patterns of weight distribution 87. Thus core
exercises could improve Balance in our children with CP.
6. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD37985 | Volume – 5 | Issue – 1 | November-December 2020 Page 403
Item no.9: stand: walks forward 10 steps:- inter-limb
coordination along with walking, these results are reflective
of improvements in Gait pattern efficiency. The
Iimprovements in postural control and floor mobility is
reflects an increase in symmetry between right and left step
or stride lengths. Indicative of an increase in consistency in
measured Gait parameters. Denise M. Begnoche (2007)says
that it may also reflect improvements in dynamic postural
control during Gait . Although group significance was not
shown, all participants exhibited increases in speed of
walking 88. Proprioceptive reflex and counteract the
sensation of pain 89. TheWeightbearing exerciseisenhanced
neuromuscular activation 90. Weight bearing exercise is
affects muscle strength and increases the power to improve
Balance 91.
Paediatric Balance test was used to assess the Balance. The
standardized examination tool currently utilized by
paediatric physical therapist and Occupational Therapistfor
school age children with mild – moderatemotorimpairment
include Brouninsk’s Oseretsky test of motor proficiency,
Burn (1978). The pea body Developmentmotorscale(Folio)
Gross Motor Functional measure, Rusell (1993). In addition
clinicians have developed their own Non standardized
measure, Wescott (1995). The standardized and non
standardized measure that currently provide clinicianswith
valuable information but may not fully meet their need to
asses a Childs functional Balance ability is high base on
pediatric Balance scale has been selected.
Gross Motor Function Classification System was used to
classify the CP children. Methods of classification that had
been proposed are base on (1) pathophysiology (or)
neuroanatomical location of the lesion. Fay 1950) Perstein
(1952), Minear (1950) (3) part of body mustinvolved,Balf&
Ingram (1995) Menear (1956), (4) Ambulatory Status
Badell- Rebera (1985), Yoaochi et al (1993).
These methods of classification rely heavily on clinical
judgement and are primarily of a value for diagnosis. Their
reliability and validity have not been investigated. Base on
GMCS scale subject was selected. The reliability validity has
been studied by Ellen Wood (2000) and Amy Winter Bakin
(2003). They found that the GMFCS has very high reliability
and validity.
Modified Ashworth Scale was being used for selecting the
subject for assessing the muscle tone as muscle tone is
velocity dependent but it was not use in the statisticallyonly
for the assessment it had been used. The reliability validity
of modified ashworth scale is yet it is not confirm. By that
assessment investigator found that there is a changes in the
muscle tone before the intervention and after the
intervention. Nancy Clopton, et al (2005) concludes that as
appropriate reliability for clinical use. And no evidence was
found that training improves reliability 92 And also Akmer
Mutlu state that These scale is not very reliable and
assessments of spasticity using these scales should be
therefore interpreted with great caution 93.
CONCLUSION
On this study it is concluded that there is positive effect of
prolong Standing to improve Balance and Gait. And it is also
important to provide appropriate positioning device to
improve Gait and Balance. Hence these findings should be
used in caution when treating the patients with Cerebral
Palsy.
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