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Leo Rathinaraj, A. S.
- Evaluation of Inter-Rater Reliability to Measure Hand and Arm Function in Reaching Performance Scale for Stroke Patients
Authors
1 Maharashtra Institute of Physiotherapy, Latur, IN
2 MAEER's Physiotherapy College, Talegaon, Pune, IN
3 Santosh College of Physiotherapy, Ghaziabad, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 7, No 1 (2013), Pagination: 259-263Abstract
Objective: This study is to assess the inter-rater reliability of Reaching Performance Scale test in hand function evaluation.Introduction: Stroke is defined as a rapidly developing clinical sign of focal or global disturbance of cerebral function lasting for more than 24 hours or leading to death due to no other reason than vascular origin. As there is high incidence of middle cerebral artery stroke, upper limb is more affected than the lower extremity and about 20% of the individual fail to regain any functional use of affected upper extremity. When a stroke patient attempts to move and encounters all the deficits the natural reaction is to compensate with available motor strategies. The measurement of the performance of the affected arm and hand of the patient with hemiplegia is important for determining the goal of intervention as well as outcomes of rehabilitation. So there is a need to have a scale that measures the quality of motor performances specific to the task and identify which elements of the task are missing and how they are compensated. Reaching performance scale is for the identification and quantification of movement pattern and their compensation during reach to grasp task in patients with upper extremity involvement after a stroke.
Materials & Methodology: 30 Hemiplegic patients between age group of 40-60 years who met the inclusion criteria were selected and explained about the study and procedure, and the consent for the study was taken. The Type of study is Inter-rater reliability study (correlation). The Materials used were card board cone, Table, inch tape and a chair.
Procedure: The patients were examined by two Physiotherapists respectively. The patient was seated in a chair with backrest but no arm rest. Reaching performance scale evaluated six components. For all patients both close target [Task I] and Far target [Task II] were assessed and graded. Only reach to grasp component of task are taken into account. The inter-rater reliability to measure the hand and arm function in Reaching Performance scale was statistically analysed by the Mann-Whitney test with P
Result & Conclusion: In this study the reliability between the investigators is very highly significant correlation of closed target (0.951) and P <0.05, Far target (0.946) and P<0.05. So we can conclude that inter rater reliability of RPS scale in assessing arm and hand function is high and hence RPS can also be used to assess the compensatory strategies in stroke patients for an effective intervention.
Keywords
CVA, Stroke, Arm and hand function, Reaching Performance scale, Inter-rater Reliability, Compensatory strategies
References
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- Kinetic Chain Exercise for Patello Femoral Pain Syndrome - A Randomised Control Study
Authors
1 Maharashtra Institute of Physiotherapy, Latur, IN
2 Department of Physical Therapy, COAMS, University of Hail, SA
3 MAEER's Physiotherapy College, Talegaon, Pune, IN
4 Santosh College of Physiotherapy, Ghaziabad
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 7, No 3 (2013), Pagination: 245-249Abstract
Objective: The objective was to compare the effect of open kinetic chain exercise and closed kinetic chain exercise in quadriceps strength and pain in patients with patella femoral pain syndrome.Introduction: Patello femoral pain syndrome [PFPS] can be defined as retropatellar pain or peri patellar pain resulting from physical and biochemical change in patella femoral joint. The patients with patello femoral pain syndrome have anterior knee pain, which typically occurs during activity and often worsens with descending stairs and also triggered by prolonged sitting. Patello femoral pain syndrome is due to the degeneration in the articular cartilage of the knee cap. PFPS is the most prevalent disorder involving the knee and can be misdiagnosed sometime as bursitis, meniscus, and ligament instability. Osteoarthritis, chondromalacia patella produce more stress on the patella femoral mechanism.
Materials & Methodology: After getting the ethical clearance for this study 30 patients with PFPS were selected and randomized into 2 groups after due consideration of the inclusive and exclusion criteria. The patients consent for this study was taken and documented. Procedure: Group A and Group B subjects were given with open kinetic chain [OKC] and closed kinetic chain [CKC] exercises respectively. The dosimetry of these exercises was 30 minutes duration every alternate day for 4 weeks. Data collected for statistical analysis included Maximal Isometric Voluntary Contraction [MVIC] using surface EMG on Vastus Medialis [quadriceps muscle] and Pain by visual analog scale [VAS] before and after exercise.
Result: Data collected were statistically analyzed using the SPSS 11 version for t-test. The paired ttest value for both CKC and OKC shows that there is a significant improvement in the quadriceps strength and pain reduction in both the groups. The unpaired t-test between the groups for quadriceps interference [3.45] and pain score in VAS scale [2.89] with p value at 0.01 shows that closed kinetic chain [CKC] exercise is better than the open kinetic chain [OKC] exercise in improving the strength and reducing the pain among PFPS patients.
Conclusion: To conclude, though both OKC and CKC exercises are beneficial in PFPS patients, CKC proved to be better than the OKC in improving the quadriceps muscle strength and reducing the pain. This study proves this statement statistically with significance.
Keywords
Patello Femoral Pain Syndrome [PFPS], Open Kinetic Chain Exercise, Closed Kinetic Chain Exercise, Kinetic ExercisesReferences
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