ABSTRACT
CONTEXT: Chronic obstructive pulmonary disease (COPD) is the second leading contributor to the disease burden of India. The current COPD burden cannot be managed effectively just through a physician-based approach. In a primary care setting, community health workers (CHWs) can play an effective role in making COPD care accessible and effective. AIM: Findings of an assessment of a training program for CHWs on COPD have been reported here. Methods: 90 CHWs working as a part of a noncommunicable disease prevention and care program in a rural primary care setting were exposed to a series of five training sessions. The sessions were designed and administered jointly by a team of public health experts and physiotherapists in the year 2017-18. Topics covered were basic clinical aspects of COPD, monitoring a patient with COPD, and basic aspects of pulmonary rehabilitation. The assessment comprised 12 MCQs and short questions, 7 video exercises, 2 case vignettes, and 5 skill assessments through objectively structured clinical examination (OSCE). STATISTICAL ANALYSIS: Mean percentage scores were calculated for each domain of assessment to make it comparable. RESULTS: 70 CHWs with a mean age of 42.2 years completed all the training and underwent the assessment. Mean percentage score (SD) for knowledge was 62% (16.3). In OSCE assessment, scores were best in sputum clearance technique demonstration (92.1%) and the least in dyspnea relieving positions (59.2%). The CHWs had difficulties in identifying signs of respiratory distress (score - 55.1%). No statistically significant association was observed between performance scores and their sociodemographic profile. CONCLUSION: The results were encouraging and the program may be pilot tested in a government setting particularly using the health and wellness centers (HWC) platform.
ABSTRACT
BACKGROUND: Adolescent age group as school going children who experience a period of accelerated growth and development of skeletal and soft tissue. Any daily physical stresses external forces such as load carrying may also influence alignment of the human body. It is assumed that daily intermittent abnormal postural adaptations could result in pain and disability. OBJECTIVES: To know the effect of backpack loading on cervical and sagittal shoulder posture (SSP) in standing and after dynamic activity in school going children. MATERIALS AND METHODS: The research project was conducted after getting clearance from Human Research Ethics Committee of the H M Patel Institution for Education and research center. Study was conducted on 160 school going children, and measurement were taken to know the loading over the cervical region along with their bagpacks were weighed. RESULTS: Total 160 students were enrolled in the present study. Study found that average value of the subject's body weight was 34.83 kg, and subjects backpack weight was 6.42 kg that was equivalent to 18% of the subject's body weight. The mean value of cranio-vertebral angle (CVA) without school bag was 40.62. The mean values of cranio-horizontal angle (CHA) while standing with 18% of body weight and after dynamic activities with 18% of body weight were 24.51 ± 10.3 and 28.93 ± 4.34, respectively. The mean value of SSP without school bag was 39.39 ± 4.31, whereas the mean values of SSP while standing with 18% of body weight and after dynamic activities with 18% of body weight were 54.38 ± 21.19 and 77.62 ± 17.50, respectively. CONCLUSIONS: Study revealed that there is a significant reduction in the CVA (or increased forward head position), increase in CHA, and SSP were found while carrying a backpack weight 18% of body weight over both shoulders.
