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Longitudinally extensive transverse myelitis (LETM) is an infrequent subtype of acute transverse myelitis, which presents with sensory, motor and autonomic dysfunction after a focal or widespread inflammation of the spinal cord due to either direct infection or an autoimmune response. We present case reports of three females who developed LETM following COVID-19 vaccination. Their clinical presentation, deficits and rehabilitation outcome at discharge and at 8 months follow-up have been briefly described.
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Objective: SARS-CoV-2 (COVID-19) omicron variant emerged as the third wave of concern for the entire world. In this study, we aimed to study the level of the understanding, awareness and perception of Parkinson's disease (PD) patients and their caregivers (CG) regarding the Omicron variant of COVID-19 disease using a self-reported survey questionnaire. Background(s): The Omicron variant of SARS-CoV-2 was reported after almost 2 years of COVID-19 emergence. Attempts to control COVID-19 infection have resulted in countries being placed under lockdown, with a focus on self-isolation. These factors have complicated the situation of patients with serious chronic conditions like Parkinson's disease, which are dependent on their caregivers and doctors for their checkups, activities of daily living and and drug administrations & dose adjustments. Further patients of PD with cognitive impairment, are particularly vulnerable to these social restrictions and potential loss of access to usual support systems. Method(s): We conducted a prospective study using a structured questionnaire involving patients with Parkinson's disease who visited and following treatment in our outpatient department of Neurology before and during the COVID-19 pandemic. Research was conducted from February 2022 to August 2022. Result(s): A total of 134 patients with the disease and 114 caregivers were assessed. Approximately, 4.5% of the patients and 1.8% of the CG got infected with Omicron-Covid 19. Almost 77% of the patients and CG were having knowledge about the omicron variant but nearly half (59.7%) of them did now knew the symptoms. Approximately, 95% of the patients did not experienced worsening of their symptoms after Covid vaccination. Majority of patients (95.5%) and their CG (98.2%) neither got any symptoms suggestive of Omicron, nor opted for testing. Approximately, 95% of patients opted physical medicine as preferable choice for consultation, and accuracy of assessment and treatment/ medicines were the reasons behind. Conclusion(s): Omicron variant came and went unknown to many people. According to the current observations from this study, no strong relation between the Covid vaccination, pandemic, omicron variant infection and symptoms of PD could be established. Further research on large number of patients should be planned and executed.
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Objective The objective of this study was to assess whether the National Football League (NFL) players with probable coronavirus disease 2019 (COVID-19) during the 2020 season experienced a decline in athletic performance and endurance. Methods All players who were listed on the NFL's COVID-19 Injury Reserve (COVID-IR) list were screened for inclusion. Players were included in the study if they had spent ≥10 days on the COVID-19 IR list (which indicated a positive PCR test based on the NFL COVID-19 policies), had played in at least two games before and after going on the IR list, and primarily played an offensive or defensive position. The mean number of snaps played per game and Pro Football Focus (PFF) score per game were collected for each athlete, which served as surrogate measures of endurance and performance, respectively. The results were analyzed with players grouped by position, and then all players grouped as a whole. Within-group comparisons were performed via t-tests. Results A total of 78 players met the criteria for inclusion in the study. The overall mean PFF score pre-COVID-19 infection was 62.15 (SD: 6.93), while it was 61.73 (SD: 7.42) post-COVID-19 infection, showing a decrease of 0.42 after infection (n=78, p=0.33). The mean number of snaps played per game pre-COVID-19 infection was 38.99 (SD: 16.46) while it was 38.10 (SD: 17.05) post-COVID-19 infection, showing a decrease of 0.89 after infection (n=78, p=0.30). When grouped by position, statistically significant differences were seen with Defensive Backs' mean snaps played per game decreasing by 18.30 (n=6, p=0.03) and Defensive Linemen's mean PFF score decreasing by 3.77 points (n=21, p=0.03). Conclusion Based on our findings, COVID-19 infection negatively impacted endurance in Defensive Backs, and performance in Defensive Linemen. However, there was inconclusive evidence to show whether COVID-19 infection negatively impacted other positions when analyzed separately or all positions when analyzed together. Further studies with more participants are needed to fully assess the effects of COVID-19 on performance and endurance in elite athletes.
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Purpose: To compare functional capacity and peak expiratory flow rate in COVID-19 survivors and healthy individuals.Relevance of study: COVID 19 has shown to affect the lung parenchyma. For physiotherapists, as they deal with maximising functional potential of patients, knowing status of functional capacity and lung function of COVID-19 survivors may help in understanding patients' problem more effectively and also in making appropriate clinical decisions. Participants: Fifty participants from community of Ahmedabad, males and females of age group 50–65 years, with (group A) & without (group B) history of COVID-19 in the past 12 months, will be included in the study by convenience sampling. Patients with severe musculoskeletal, neurological & cardiac problems, recent injury, fever, cough & cold are excluded. Method: Observational analytical study was conducted. 6minute walk distance for functional capacity and peak expiratory flow rate with a peak flow meter, was obtained. Analysis: Data analysis for 14 participants was done using SPSS version 16 and Microsoft excel 2019. Data was screened for normality using Levene's test. Between group comparison for 6MWD and PEFR was done using Mann-Whitney U test. Level of significance kept at 5%. Results: Mean age in group A was (58.0 + 4.47) years, and in group B was (59.2 + 5.49)years. Difference in mean+SD for PEFR in L/min for group A (414.29 + 186.44) and Group B (344.29 + 66.29) was not significant (U=20, p=0.562). Difference in mean + SD for 6MWD group A (414.76 + 101.99), Group B (481.69 + 90.24) was not significant (U= 13.5, p=0.15). Conclusion: Study is still going. Implications: If the peak expiratory flow rate and functional capacity are reduced post COVID, there will be a need to manage the same.
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Purpose: To emphasize the importance of Balance assessment as integral part of SARS SARS-CoV-2 rehabilitation so that a ‘'future pandemic” of falls can be prevented. Relevance: Balance assessment in acute-care setting can help prevent falls and subsequent consequences complication during the course of rehabilitation. Participants: SARS –CoV-2 recovered survivors (n=130), who were admitted for a minimum of 7 days and on O2 support. Methods: Institutional Ethic committee approval was obtained. Patients admitted to the hospital with a confirmed diagnosis of SARS-CoV-2 who were on O2 support and minimum duration of hospital stay>7 days were recruited for the study. Balance impairment was assessed using Tinette POMA and the obtained data was analyzed. Analysis: DescriptiveResults: A total of (n=130) patients were identified, 54 patients were at risk of falls, 36 were at high risk and 18 were at moderate risk of fall. In the results, there is a significant balance impairment in O2 dependent SARS-CoV-2 survivors. Conclusion: Balance Assessment should be included in SARS-CoV-2 survivors so that a tailored exercise prescription can be formulated that will not only enhance their functional activities but also reduce the risk of falls and may prevent further complications. Implications: Balance Assessment will help to identify the patient who are at high risk of falls and effective rehabilitation can be planned. Early detection of fall risk through balance assessment paves way for targeted, integrated intervention through a tailored exercise program based on the findings thus, reducing the burden of the patient and healthcare system in general.
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Purpose: To evaluate the effect of tele-rehabilitation on balance and coordination training in cerebral palsy children. Relevance: COVID-19 pandemic had significant impact on children with disability due to prolonged confinement at home which influenced negative physical status of children. Tele-rehabilitation can play a major role in the maintenance of function, prevention of worsening disability, and follow up of patient. It can proves beneficial to the family by decreasing time and costs related to travelling, family centered service, home based model of delivery of care which leads to being less prone to infection. Participants: 9 Children with cerebral palsy in the age group of 6–12 years with GMFCS level I and II were recruited from the paediatric out-patient department and child developmental centre of a tertiary care hospital and special schools in Belagavi. Methods: In this pre-post pilot study, pre-treatment and post-treatment outcomes were taken by using balance and bilateral coordination subtest of Bruininks Oseretsky Test of motor proficiency 2 (BOT2). The physiotherapy treatment consisted of conventional balance training exercise via tele-rehabilitation through Whats App video call. The intervention was carried out thrice a week for 4 weeks for one hour which was monitored by the therapist and assistance was provided by the parent. Statistical Analysis: The data was analysed using paired t test. Results: The results indicated a significant improvement in balance (P =0.042) with mean difference-4.25 ± 3.20 and coordination with mean difference-4.25 ± 1.50 (P=0.011). Conclusion: This study showed that tele-rehabilitation as a mode of treatment for children with cerebral palsy is useful for training balance and coordination. Implications: Tele-rehabilitation can be considered as an effective mode of delivering rehabilitation for children with cerebral palsy and that the effect must be studied in a larger sample size.
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Background: COVID-19 is an infectious disease caused by novel coronavirus (SARS CoV-2). The mode of spread of the infection is through droplets and also through direct contact of contaminated surfaces. Measures such as social distancing and use of protective equipment are required to prevent the spread of infection. This study was designed to assess the awareness about COVID-19 among physiotherapists, during the two phases of lockdown. Materials and Methods: An online survey was conducted in two phases among 110 physiotherapists to assess their awareness and knowledge about the disease. The first phase of the study was done during the first COVID-19 wave in India between 25th and 30th of March 2020, and the second phase was conducted between 7th and 12th of May 2021 when the second wave of COVID-19 in India was at its peak. Results: It is essential for physiotherapists to understand COVID-19 as a disease and to know its mode of spread in order to take necessary precautions and measures within their working environment to prevent the spread of the disease. With the first phase of the study, we identified a need for educational and awareness programs in therapists and need of guidelines in order to implement effective and safe strategies in dealing with the patients during this pandemic. The second phase identified that better understanding existed in physiotherapists about the disease, with precautions taken at their workplace to prevent the spread of COVID-19. Conclusion: A better knowledge about COVID-19 was reflected among physiotherapists at the second lockdown phase than during the first lockdown.
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Purpose: To review and understand the impact of COVID-19 on Pregnant mothers and its effect on Infant's development. Relevance: Postpartum health of the mother is affected in terms of their mental well-being, separation period and stress which may lead to indirect effect on infant's brain development. Therefore an appropriate developmental screening must be done to these infants so that early intervention plan can be done if required. Participants: Studies reporting about pregnant women infected with COVID-19 and their infant were included and women not tested positive for COVID-19 were excluded. Methodology: Comprehensive literature search was performed using the search engines PubMed, Google scholar. Search strategy was devised, articles were selected based on the Inclusion and Exclusion criteria. Analysis: 81 articles were screened and 8 were included in the review. 2 were Observational Studies, 4 were reviews,1 was cohort study and other was longitudinal study. Results: Majority of the studies reported delivery occurred in isolation room with 14 days separation period, Postpartum practices like breastfeeding, KMC are safe to be practiced with appropriate precautions. Longitudinal study in China found negative association after evaluating the impact of COVID-19 on mother's psychological status and infant's early development, by using ASQ Questionnaire upto 3 months. Conclusion: Many articles spoke about the postpartum health of the mother being affected following COVID-19, not much emphasis was given on infant's development. Implications: Since adversity and stress during prenatal period are associated with later impairments in the infant, long term impact of COVID-19 during pregnancy on infant's development is an important area for further studies.
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Background: Since the use of smart phones, laptops etc. has increased recently, their impact on people individual's health is not well established. Smartphone use had been remarkably increased during the COVID-19 lockdown due to different unexplained reasons.It is important and critical to examine and rule out the presence, absence or the magnitude of this impact, especially among young people and adolescents. Relevance: To find out the prevalence of neck pain among adolescents and young adults and its correlation with the duration of screen use. Study Design: A descriptive, cross sectional study. Settings: online platformMethods: This cross-sectional study was conducted using an online google survey form, which was distributed through social media to 300 participants to find out the prevalence of neck pain among younger population and its relationship with screen use. Results: Our study showed that the mean age of the study population having neck pain associated with screen use is 24 year. More of the female than male subjects reported neck pain.The prevalence of pain increased with increase in duration of screen use. Conclusion: The research sample reported that people use of electronic devices showed a close association with neck pain and the more the people spends time using an electronic device the greater is the complaint of neck pain. We found that there is a positive correlation between long time screen use and neck pain.
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Background: Ergonomics is the scientific study of human work. The objective of ergonomics is to obtain an effective match between the user and workstation to improve working efficiency, health, safety, comfort, and ease of use. Aim: The aim of this article is to assess ergonomic awareness among information technology (IT) professionals who are working remotely. Materials and Methods: A cross-sectional survey was conducted among IT professionals through a self-administered questionnaire. A total of 150 subjects were recruited in the study. The results were summarized using descriptive statistics. Results: Majority (75%) of the total subjects work for 7–9 h in a day for 6 days in a week without taking breaks at regular interval. Only 7% of the total participants utilized break for stretches and 21% participants walk around during break. The distance of monitor from the eyes of 18.66% of the participants was between 21 and 30 inches and for 2% of the participants it was greater than or equal to 31 inches;this shows that the majority of the participants did not place their monitor at appropriate distance. The study showed that there is lack of knowledge of sitting posture among the IT professionals working from home: 9% of the participants were lying on bed, 16% were seated on sofa, and 17% were sitting on bed. Chairs used by the participants in the study were 15.33% wooden, 19.33% plastic, and 13.33% other types. Conclusion: It was found that those majorities of the participants were unaware about the correct ergonomics and were unable to make modifications in their workstation.
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Purpose: To assess the knowledge, attitude and practice of parents towards prevention of COVID-19 in children with special needs. Relevance: The coronavirus disease 2019 (COVID-19) has had a rapid global spread. Children with special need are more susceptible to viral infection. Participants: All parents of children with special needs visiting Paediatric Department in tertiary care hospital, Belgavi. Method: An institution based study for sample of 450 participants. Data collection was based on direct interview using a structured questionnaire consisting Knowledge (10 questions), attitude (6 questions), and practice (5 questions). Analysis: Standard descriptive statistics were used for the data, mean and standard deviation for continuous variables whereas frequencies and percentages for categorical variables. Result: Almost all the participant (100%) knew about the present scenario of COVID-19. Majority of the participants were about how COVID-19 spreads and its preventive measures. Most of the parents (72.4%) knew that the children with special needs are more risk of infection. Almost all of the participants (95.8%) knew that their child must wear a mask in public places. Most of the participants (64.9%) did not know that mask should not be worn by children less than two years. Almost 242 parents practiced the all preventive measures for COVID-19. Conclusion: The parents of children with special needs have good knowledge, attitude and practice regarding the prevention of COVID-19 in children with special needs. Implication: Knowledge, attitude and practice of parents will help control epidemic in children.
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BackgroundThe increasing demand for physical therapy services worldwide calls for innovations to be made to meet the challenges of service delivery. However, little is known about the knowledge, attitude, and practice (KAP) of digital physical therapy among Nigerian physiotherapists. Hence, this study aimed to evaluate the level of KAP of digital physical therapy among physiotherapists in Nigeria.MethodsThis cross-sectional study purposively recruited 150 Nigerian physiotherapists. Copies of modified and validated questionnaires on the KAP of digital physical therapy from a previous study were sent to registered and licensed physiotherapists via electronic survey to assess the KAP of digital physical therapy. Descriptive and inferential statistics were used to analyze the data. Alpha level was set at p < 0.05.ResultsThe mean age of the respondents was 29.76 ± 6.95 years. Most participants (81.3%) have a knowledge level above average, while 18.7% have below average. Furthermore, most (76.0%) of the respondents had a positive attitude toward digital physical therapy. In addition, more than two-thirds, 69.3% uses digital physical therapy platforms for physical therapy practice. Knowledge, attitude, and practice were not significantly associated with sociodemographic characteristics (p > 0.05). Furthermore, there was no significant association between knowledge, attitude, and practice (p > 0.05).ConclusionMany Nigerian physiotherapists demonstrated adequate knowledge, positive attitude, and good practice of digital physical therapy. However, knowledge, attitude, and practice of digital physical therapy were not influenced by sociodemographic characteristics.
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Purpose: To determine the impact of nomophobia on insomnia and physical activity (PA) levels among physiotherapy undergraduate students. Relevance: We are living through a period where technology is the only connection to normalcy. Reports indicate increased screen time during the COVID-19 pandemic, also due to significant disruption in routine, nocturnal media use has been increased leading to insomnia. As the total screen time increases, users have decreased physical activity, which can lead to sedentarism. Participants: All undergraduate physiotherapy students of Ramaiah Medical College (Department of Physiotherapy), Bengaluru, India were invited to participate in an online survey. 95 participants who gave the consent were enrolled. Methods: Nomophobia- questionnaire (NMP-Q), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Insomnia Severity Index (ISI) were distributed to the participants as Google forms via WhatsApp. The participant was asked to give the best response of his experience. Data collected was subjected to analysis. Analysis: Responses obtained via Google-forms were screened. The data was categorized and analyzed using Google spread- sheet and descriptive statistics using percentage and frequency distribution was performed. Results: 72(75.78%) students were categorized with moderate-severe nomophobia. 25(26.31%) students had moderate-severe nomophobia suffered from clinical insomnia. However, they demonstrated moderate-high PA level. 21(22.10%) students had mild nomophobia with subthreshold insomnia and low PA level. The results demonstrate significant impact of nomophobia on insomnia, however not on PA level among physiotherapy undergraduate students. Conclusion: The burden of nomophobia and impaired control that compromises the health and wellness were prevalent in physiotherapy undergraduate students. Measures need to be taken to address clinical insomnia in view of the current era of growing information technology. Implications: This study will pave a path for the need of exercises to improve the sleep quality and duration of students who have nomophobia.
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Background: During unprecedented times of COVID- 19, continuing Physiotherapy through conventional mode is tough and limited to certain extent. To overcome the current situation, WCPT has strongly suggested the implementation of Tele-physiotherapy. Many studies have proven efficiency of Tele-rehabilitation in delivering rehabilitative services;still its use is limited in India may be due to knowledge and attitude of physiotherapists. Currently, no valid tool is available for assessing the attitude, knowledge and barrier of tele physiotherapy among Indian physiotherapist. Thus, the aim of the current study is to develop, validate and establish internal consistency of the questionnaire for the same. Participants: 60 physiotherapists with minimum of 1 year of and those who were willing to participate were included. Non-Practicing Physiotherapist were excluded from the study. Method: Questionnaire was drafted on the basis of previous studies under 4 domains: Demographics, Knowledge, Attitude and Barrier. A panel of 5 experts was formulated. A Delphi process was carried out to validate the developed questionnaire. The content validity ratio (CVR) was calculated. The questionnaire was sent to physiotherapists electronically/ physically and data of 60 Physiotherapist was analysed for Cronbach alpha coefficient using SPSS version 20. Results: The content validity ratio for the complete questionnaire was 0.98. 66.7 % of our sample was between the age of 25–35 years with 82.2% Physiotherapists were postgraduate and 26.2% being experienced for more than 10 years. The Cronbach alpha coefficient for internal Consistency of the questionnaire was good (0.77). Conclusion: The questionnaire is as an effective valid and reliable tool to assess knowledge, Attitude, and Barrier towards Tele physiotherapy. Implications: Developing and validating Questionnaire will help us measure the knowledge, Attitude and Barriers towards Tele- Physiotherapy amongst Physiotherapists across India in a comprehensive way. This in turn will help policymakers and Authorities to make new policies/ modify existing ones for effective use of Tele- Physiotherapy.
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Purpose: To determine association of musculoskeletal pain, body part and posture due to the use of various electronic devices in higher secondary school students. Relevance: The present situation of COVID-19 has show increased use of electronic devices for studies in students' life. Children using gadgets for long duration attain improper posture which are associated with musculoskeletal disorders. Participants: High school students of age between 14–18 years with a minimum use of electronic devices for 6 months. Methods: An observational study design was conducted at various schools in Belagavi city for a sample of 388 students. Data collection was based on an E-form (Google form) which included informed consents, informed assents and assessment tool Adolescent pediatric pain tool (APPT). Analysis: Standard descriptive statistics were used for the data, frequency tables and percentage analysis for categorical variables. Pearson Correlation test were used. Result: The results of study showed that pain in the right and left knee was associated with use of television and significantly corelated to assumption of certain positions. Neck pain was associated with the use of laptops and assuming particular positions. The duration of time spent using an electronic device and the severity of pain were found to have a strong positive correlation. Conclusion: There is significant association present between pain, body part and posture due to the use of electronic device in students of age 14–18 years. Implications: The knowledge about the improper posture and its musculoskeletal consequences can help minimize and prevent further complications associated with it by ergonomic advice.
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Background: COVID-19 presents with symptoms of fever, headache, dry cough, and dyspnea. Acute hypoxemic respiratory failure is the most common complication occurring in 60%–70% of patients admitted to the intensive care unit (ICU). Positioning and breathing exercise formed the mainstay of physiotherapy intervention in patients admitted to COVID ICU. This was primarily aimed at reducing the ventilation/perfusion mismatch. The aim of this study was to retrospectively analyze the immediate effect of breathing exercise and positioning on oxygen saturation (SpO2). Materials and Methods: The available data of COVID-19 patients admitted to an ICU of a tertiary care hospital in Mumbai from June 5 to July 5, 2020 were retrospectively analyzed. Demographics and mode of oxygen delivery were noted. Changes in SpO2 after positioning and breathing exercises during a single session of treatment were analyzed using Wilcoxon paired signed-rank test with a level of significance at P < 0.05. Results: There was a statistically significant improvement in SpO2 after breathing exercises and prone positioning in all patients on oxygen supplementation. Side-lying positioning showed an improvement in oxygen saturation in patients who were on non-invasive ventilation and facemask. Conclusion: Both breathing exercises and positioning show an immediate improvement in oxygen saturation in patients with COVID-19.
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Purpose of Review: The increased use of musculoskeletal ultrasound (MSKUS) in clinical practice warrants achieving competency earlier in physiatrists' careers. Physical Medicine and Rehabilitation (PM&R) residency programs have started incorporating formal MSKUS training in their curricula; however, significant heterogeneity remains in MSKUS education. Recent Findings: Numerous barriers contribute to the lack of consensus for MSKUS training during residency, but the COVID-19 pandemic severely disrupted in-person learning. As an adjunct or alternative to in-person learning, teleguided technology is being utilized. Summary: This curriculum demonstrates the role of a hybrid MSKUS training with interinstitutional collaboration. Twenty PM&R learners, from two institutions, were divided into a fundamental or advanced track. Virtual didactic sessions alternated weekly with hands-on ultrasonographic scanning sessions. Following a 12-month longitudinal curriculum, an end-of-year practical examination was used for competency assessment, in addition to a survey assessing resident perceptions and feedback. To our knowledge, this is the first collaborative and hybrid MSKUS curriculum for PM&R learners that can be easily reproduced at most training institutions and circumvent some of the barriers amplified by the COVID-19 pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s40141-023-00380-z.
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Introduction: With the coronavirus disease 2019 (COVID-19) pandemic causing the need for social distancing, telemedicine saw a significant increase in use to provide routine medical care. As a field, physiatry had already been implementing telemedicine prior to the pandemic. In this study, we characterized the use of telemedicine among physiatrists during the early phase of the COVID-19 pandemic to understand the barriers and facilitators to implementing telemedicine use in the field of physiatry in the future. Methods: Online survey of a cross-sectional sample of physiatrists. Analysis was conducted using logistic regression. Results: One hundred seventy one (n = 171) participants completed the survey. Before the pandemic, only 17.5% of respondents used telemedicine. In the logistic regression, physicians who used a hospital-provided platform were more likely to use telemedicine in the future compared with those who used their own secure platform, conducted a phone visit, and used a non-secure platform or other platforms. The three most popular barriers identified were "inability to complete the physical examination," "patients lack of access to technology," and "patients lack of familiarity with the technology." Discussion: Focus on education on telemedicine functional examination strategies and technology strategies for patients and providers (including addressing the digital divide and hospital-provided secure platforms) are potential targets of implementation strategies for greater telemedicine uptake for physiatrists in the future.
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The coronavirus disease-19 pandemic has caused a considerable deterioration in medical practices. This resulted in a rapid shift to telemedicine/telehealth as an alternative to conventional interventions and in-person visits. Telerheumatology practices have been increasing worldwide. Virtual consulting for remote physiotherapy advice in rheumatic diseases is also essential. The present topical review aimed to provide an insight to telehealth for musculoskeletal physiotherapy among patients with rheumatic diseases. Patient assessment, goal setting, teleeducation, and providing individual-based, goal-directed exercises are components of telerehabilitation. Telephone/video calls can be used to further progress the exercise program and to evaluate patient adherence. Future studies on the role of virtual consulting for physiotherapy advice in rheumatic diseases would be of value. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.