ABSTRACT
Tissue flossing (TF) is a novel device that has been shown to cause peripheral compression and concurrent change in joint range of motion, perception of mobility and muscular performance. However, the effect of tissue flossing on pain, perception of mobility and function at the elbow joint has not been thoroughly investigated. The purpose of this pilot study was to examine the acute effect of TF on pain and upper extremity functional performance in subjects with musculoskeletal-related complaints of pain surrounding the elbow joint. We utilized a randomized crossover design. Nine resistance trained participants (8 men/1 woman) mean age 35.6 ± 10.7 took part in this study. We measured the following outcome measures; Pain Visual Analog Scale, Short Form McGill Pain Questionnaire II, pain-pressure threshold and hand grip dynamometry (HHD) pre and post and a Likert scale for movement ability questionnaire, posttest only, following a TF and placebo condition for each participant. TF resulted in significant improvement in all test measures, except HHD, pre to post (p ≤ 0.05). All pre to post changes were associated with large effect sizes for TF compared to the placebo condition applied to the elbow improves pain quality and intensity, perception of mobility and pain-pressure threshold in resistance trained individuals with a history of musculoskeletal pain for greater than 1 month. The results of this pilot study suggest that TF may function as an adjunct to treatment in the management of musculoskeletal pathologies at the elbow joint.
ABSTRACT
CONTEXT: The MCI has laid down a basic framework for interns, which it expects all prospective doctors to be well versed in. Asking students to demonstrate their understanding of the subject, ability to think critically, analyze, infer and act accordingly is imperative to the learning process. AIMS: To assess competency levels in medical interns post internship via a questionnaire developed based on MCI framework and departmental expectations of clinical capabilities. SETTINGS AND DESIGN: This descriptive cross-sectional study was done in a tertiary care hospital involving 74 interns nearing end of internship in the year 2017. METHODS AND MATERIAL: A questionnaire consisting of core competencies such as professionalism, communication skills, learning competency, clinical problem solving amongst others was provided to each and competency levels were assessed against a pre-defined scale. Answers were graded as Poor, Average, Good and Excellent with corresponding numerical equivalents 0, 1, 2 and 3 respectively. STATISTICAL ANALYSIS USED: The values obtained were analysed using Weighted Sum technique through Microsoft Excel tool. RESULTS: An ideal average competency score was initially established and overall competency of each intern was adjudged against the same. Out of 74 candidates that answered the questionnaire, a vast majority of 50 were found at below average competency. Cardio pulmonary resuscitation was known only to 13 students. Around 50 students were severely lacking with regards to knowledge about the use of preferred antibiotic in sepsis and seizures. CONCLUSION: There seems to exist significant disconnect in the expectations of MCI on one hand and actual knowledge and skill acquisition of the doctors on other. A departmental wise curriculum and exams at the end of each departmental posting which is more skill based will enable a well-trained doctor with reasonable skills and knowledge to obtain his license to practice.
