Tag: Hariharan J

Comparing the effectiveness of Hoffman and Oketani techniques in managing inverted nipples for improved breastfeeding outcomes

Nithyadarshini Nadar, Senthilkumar S, Kamalakannan M, Hariharan J, Priyanga Seemathan, Priyadharshini V, Thiagarajan D

 

Nithyadarshini Nadar et al. – Comparing the effectiveness of Hoffman and Oketani techniques in managing inverted nipples for improved breastfeeding outcomes –  Fizjoterapia Polska 2025; 25(3); 150-155

DOI: https://doi.org/10.56984/8ZG7D196QEQ

Abstract
Background. Inverted nipples can hinder breastfeeding, leading to challenges such as poor latch, nipple pain, and reduced milk transfer, which may discourage mothers from continuing breastfeeding. Effective and non-invasive interventions are essential to support successful breastfeeding. This study compares the Hoffman and Oketani techniques for managing inverted nipples in postpartum mothers.
Methods. This experimental study included 90 pregnant women (32–36 weeks gestation) with clinically diagnosed inverted nipples at Saveetha Medical College and Hospital. Participants were randomly assigned to group A (Oketani technique, n = 45) or group B      (Hoffman exercise, n = 45). Interventions were administered twice daily for 30 minutes over six weeks. Outcome measures included the LATCH score for breastfeeding effectiveness, nipple length measured with a caliper, and nipple pain assessed using the visual analog scale (VAS). Data were collected before and after the intervention to evaluate improvements in breastfeeding outcomes.
Results. The Oketani technique significantly outperformed the Hoffman exercise, with higher post-intervention LATCH scores                 (8.57 ± 0.93 vs. 6.40 ± 0.50, p = 0.0001), greater nipple length increase (5.00 ± 1.05 vs. 4.21 ± 0.32, p = 0.0001), and greater reduction in VAS scores for nipple pain (3.49 ± 1.04 vs. 4.62 ± 0.91, p = 0.0001).
Conclusion. The Oketani technique is a superior intervention for addressing inverted nipples, offering significant benefits in reducing nipple pain, enhancing latch quality, and improving nipple length. Its non-invasive, simple, and cost-effective application makes it a valuable addition to antenatal and postpartum care programs aimed at promoting breastfeeding success.
Key words
breastfeeding, inverted nipple, hoffman technique, oketani technique, nipple pain, postpartum care
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Effect of plyometric training in unilateral knee osteoarthritis

Prasanna Kumar R, Kotteeswaran K, Kamalakannan M, Hariharan J, Supriya P, Priyanga Seemathan, Dinesh S

 

Prasanna Kumar R et al.– Effect of plyometric training in unilateral knee osteoarthritis –  Fizjoterapia Polska 2025; 25(3); 100-103

DOI: https://doi.org/10.56984/8ZG7D19PD06

Abstract
Background. Osteoarthritis is a degenerative condition that begins with the onset of pain and gradually leads to decreased functional movement and activities. It is a complex, progressive disorder resulting in loss of articular cartilage, reduction of joint space, pain, loss of function, and physical incapacity, which together deteriorate quality of life. Plyometrics can be effective in improving joint awareness, balance, and neuromuscular properties, helping to enhance proprioception, kinaesthesia, and muscle performance.
Materials and methods. One hundred and four subjects with unilateral knee osteoarthritis were included in the study. Subjects with rheumatoid arthritis, polyarthritis, other joint complaints, systemic inflammatory arthropathies, previous knee replacement surgery, or intra-articular corticosteroid injections in either knee in the past 12 weeks were excluded. Participants were divided into two groups of 52 each: a control group (conventional exercises) and an experimental group (plyometric training along with conventional exercises) for 4 weeks. Pre- and post-tests were conducted using the knee injury and osteoarthritis outcome score (KOOS), which assesses pain, daily activities, and quality of life.
Results. The post-test values of both groups were compared to determine the difference in improvement due to the interventions. Based on all the data, the results show that the experimental group demonstrated greater improvement in KOOS components compared to the control group that received only conventional treatment.
Conclusion. It is concluded that plyometric training is an effective intervention for improving pain and functional outcomes among individuals with unilateral knee osteoarthritis.
Key words
conventional exercises, knee injury and osteoarthritis outcome score (KOOS), knee osteoarthritis, plyometric exercises
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Exploring the link between shoulder external rotation range and Y-Balance Test performance in young cricketers

Karthika Ramalingam, Kamalakannan M,Karthik Tamildasan, Hariharan J, Priyanga Seemathan, Priyadharshini V, Thiagarajan D, Delphin Kavya D

Karthika Ramalingam et al. – Exploring the link between shoulder external rotation range and Y-Balance Test performance in young cricketers –  Fizjoterapia Polska 2025; 25(2); 313-316

DOI: https://doi.org/10.56984/8ZG00E1LTAJ

Abstract
Aim. The aim of this study is to investigate the relationship between shoulder external rotation range of motion (ER ROM) and performance on the Y-Balance Test in young cricketers. Specifically, the study seeks to determine whether greater shoulder external rotation is associated with improved dynamic balance, which is crucial for cricket performance, particularly in movements like throwing and bowling. The research aims to provide insights that may help guide training and injury prevention strategies in young athletes.
Methods. A total of 50 cricketers were selected based on defined inclusion and exclusion criteria. The active ROM of shoulder external rotation on the dominant side was measured using a goniometer. Participants performed the three directional movements of the YBT using non-instrumented floor markings.
Findings. The study analyzed the relationship between Y-Balance Test (YBT) performance and shoulder external rotation range of motion (ROM) in young cricketers. The mean medial component of YBT was 80.42, with a weak positive correlation (r = 0.048, p = 0.82). The superolateral component had a mean of 59.18 and a weak negative correlation (r = −0.284, p = 0.16). The inferolateral component showed a moderate negative correlation (r = −0.365, p = 0.073) with a mean of 74.98. Shoulder external rotation ROM had a mean of 88.12, but no significant correlations were found.
Conclusion. Among the three YBT components, only the medial component demonstrates a positive correlation with shoulder external rotation on both the dominant and non-dominant sides. Conversely, the superolateral and inferolateral components exhibit a negative correlation.
Key words
shoulder external rotation, range of motion (ROM), goniometer, Y-Balance Test
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Effectiveness of neck extensor stretching and strengthening in cyclist neck syndrome: a randomized controlled study utilizing Kinovea and NPRS

Nirmal Khanna R, Kamalakannan M, Hariharan J, Priyanga Seemathan, Priyadharshini V, Thiagarajan D, Durga N, Delphin Kavya D

 

Nirmal Khanna R et al. – Effectiveness of neck extensor stretching and strengthening in cyclist neck syndrome: a randomized controlled study utilizing Kinovea and NPRS –  Fizjoterapia Polska 2025; 25(2); 238-244

DOI: https://doi.org/10.56984/8ZG00E1150

Abstract
Introduction. The condition known as cyclist neck syndrome, characterized by fatigue and the inability of the neck muscles to support the head, often results from prolonged cycling in an improper position. This repetitive strain on the neck extensor muscles commonly leads to reduced range of motion, pain, and impaired performance.
Aim of the study. To assess the effectiveness of neck extensor stretching and strengthening exercises in reducing symptoms of cyclist neck syndrome, improving range of motion, and enhancing overall neck function.
Materials and methods. A total of 50 participants diagnosed with cyclist neck syndrome were randomly selected. Inclusion criteria included individuals aged 20–50 years, cycling at least five times per week, and covering a minimum of 75 km per ride. Exclusion criteria encompassed a history of neck surgery, traumatic neck pain, spinal instability, rheumatological conditions, and recent neck interventions. Participants were divided into two groups of 25: Group A received conventional treatment plus neck extensor stretching and resistance training; Group B received only conventional treatment. Pre-treatment data were collected using the Numerical Pain Rating Scale (NPRS) and cervical range of motion (ROM) for flexion and extension, assessed with Kinovea software. The intervention lasted 4 weeks, with 4 sets per session, 15 repetitions per set, conducted 3 times per week.
Results. Post-treatment mean NPRS score for Group A was 2.16, compared to 5.2 for Group B. Group A showed improved post-treatment cervical ROM in flexion (67.04) and extension (53.4), whereas Group B showed 46 and 47.4, respectively. These results indicate that Group A achieved greater reductions in pain and better functional outcomes.
Conclusion. The findings support that incorporating neck extensor stretching and resistance training significantly improves symptoms and neck function in individuals with cyclist neck syndrome.
Key words
neck syndrome, extensor stretches, resistance training, range of motion
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Effectiveness of Mulligan “MWM” versus Spencer technique on functional ability in subjects with adhesive capsulitis of the shoulder joint

Sundar Rajan M S, Kotteeswaran K, Kamalakannan M, Hariharan J, Priyanga Seemathan, Delphin Kavya D, Dinesh S, Koteeswari Arumugam

 

Sundar Rajan M S et al. – Effectiveness of Mulligan “MWM” versus Spencer technique on functional ability in subjects with adhesive capsulitis of the shoulder joint –  Fizjoterapia Polska 2025; 25(2); 54-59

DOI: https://doi.org/10.56984/8ZG7D19F64U

Abstract
Background. Frozen shoulder, or adhesive capsulitis, is characterized by pain and progressive loss of both active and passive shoulder range of motion due to capsular contracture and fibrosis. The Spencer technique focuses on mobilizing the glenohumeral and scapulothoracic joints. The Mulligan technique combines active movement with passive accessory mobilization to achieve pain-free motion by restoring impaired accessory glide.
Objective. To evaluate the effectiveness of Mulligan “MWM” versus the Spencer technique in patients with adhesive capsulitis of the shoulder joint using range of motion (ROM) and the Shoulder Pain and Disability Index (SPADI).
Methods. Forty subjects meeting the inclusion and exclusion criteria were selected. The procedure was explained in detail, and informed consent was obtained before initiating the study. Pre- and post-test values were measured using ROM and SPADI. Participants were divided into two groups: Mulligan “MWM” with exercise (n = 20), and the Spencer technique with exercise (n = 20). Both groups received arm circles, pendulum stretch, towel stretch, wand exercise, wall climbing, and upper body stretch, three days a week for six weeks (2 sets of 10 repetitions with a 10-second hold).
Results. The data were statistically analyzed using an unpaired t-test. The Mulligan “MWM” group showed significantly greater improvement (p < 0.01) in pain reduction and functional ability compared to the Spencer technique, as measured by ROM and SPADI.
Conclusion. Mulligan “MWM” is more effective than the Spencer technique, when combined with exercise, in reducing pain and improving functional ability in individuals with adhesive capsulitis of the shoulder joint.

Key words
adhesive capsulitis, range of motion, SPADI, Mulligan “MWM”, Spencer technique

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Effectiveness of lumbopelvic hip-core stabilisation exercises versus conventional strengthening exercises on electromyographic analysis of vastus medialis oblique activation in knee osteoarthritis

Nevatha S, Kotteeswaran K, Kamalakannan M, Priyadarshini Babu Rajendra Prasad, Hariharan J, Josyula Snigdha

 

Nevatha S, Kotteeswaran K, Kamalakannan M, Priyadarshini Babu Rajendra Prasad, Hariharan J, Josyula Snigdha – Effectiveness of lumbopelvic hip-core stabilisation exercises versus conventional strengthening exercises on electromyographic analysis of vastus medialis oblique activation in knee osteoarthritis –  Fizjoterapia Polska 2025; 25(2); 23-27

DOI: https://doi.org/10.56984/8ZG7D19CE52

Abstract
Introduction. Knee osteoarthritis (OA) is a common and debilitating condition, particularly affecting the medial compartment of the tibiofemoral joint, leading to pain, stiffness, and functional limitations. Exercise therapy, including muscle strengthening, is a primary conservative treatment for managing OA symptoms. The vastus medialis oblique (VMO) plays a crucial role in patellar stability, and its dysfunction is frequently associated with knee OA, contributing to altered joint mechanics and increased pain. Lumbopelvic hip-core exercises focus on improving control of trunk and pelvic movements, which may influence lower limb alignment and reduce knee joint load. Conventional quadriceps strengthening exercises primarily target the knee extensors, with an emphasis on enhancing VMO function.
Aim. The aim of the study was to determine which exercise approach is more effective in enhancing VMO activation, improving knee stability, and optimizing rehabilitation outcomes.
Materials and methods. Based on inclusion and exclusion criteria, 104 individuals diagnosed with knee osteoarthritis were recruited from Saveetha Hospital. Each group completed five exercise sessions per week over a four-week period. Electromyographic (EMG) analysis was used to assess muscle activation patterns and determine which intervention more effectively enhanced VMO activation.
Results. The post-test mean value for the experimental group was 60.29, while the control group had a mean of 48.15 (p < 0.0001). This indicated a statistically significant difference between the experimental and conventional exercise groups.
Conclusion. This study concludes that lumbopelvic hip-core stabilisation exercises are more effective than conventional quadriceps strengthening exercises in enhancing VMO activation, improving knee stability, and supporting rehabilitation in individuals with knee osteoarthritis.

Key words
knee osteoarthritis, vastus medialis oblique, lumbopelvic hip-core stabilisation, conventional strengthening, surface EMG

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Effectiveness of lower limb antigravity muscle strengthening in recreational footballers. A comparative study

Kaviyarasan P, Sarvan kumar J, Kamalakannan M, Hariharan J, Priyadarshini Babu, Priyanga Seemathan, Priyadharshini V, Thiagarajan D

Kaviyarasan P et al. – Effectiveness of lower limb antigravity muscle strengthening in recreational footballers. A comparative study –  Fizjoterapia Polska 2025; 25(1); 439-447

DOI: https://doi.org/10.56984/8ZG007D9BZJ

Abstract
Introduction. The study investigates the effectiveness of lower limb antigravity muscle strengthening exercises versus conventional exercises among recreational football players. Enhancing endurance and agility is critical for performance in football, making it essential to identify optimal training methods.
Aim of the study. To evaluate and compare the effects of lower limb antigravity muscle strengthening and conventional exercise on endurance and agility in recreational football players.
Materials and methods. This experimental study involved 56 recreational football players selected from Saveetha University using convenient sampling. Participants were randomized into two groups:
1. Lower limb antigravity muscle strengthening group. Engaged in targeted exercises (lunges with dumbbells, reverse Nordic curls, dumbbell squat thrusts, agility T-drills, and single-leg box jumps) for 5 days a week over 6 weeks.
2. Conventional exercise group. Performed traditional exercises (squats, lunges, calf raises, step-ups, and crunches) under the same schedule.
Each group underwent a 5-minute warm-up and cool-down. Outcome measures included the 30 Seconds Endurance Jump Test and the Agility T Test, which were assessed post-intervention.
Results. The results indicated that the conventional group’s post-test mean endurance was 38.71, while the antigravity muscle strengthening group achieved 42.68. For agility, the conventional group scored 11.8282, compared to 10.64957 for the antigravity group. Both interventions showed significant improvements with p-values less than 0.0001.
Conclusion. Both training methods led to positive enhancements in endurance and agility, with the lower limb antigravity muscle strengthening group demonstrating superior results. This suggests that integrating both training styles may optimize performance for recreational football players.
Key words
lower limb antigravity muscle strengthening, endurance, conventional exercise, agility
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Enhancing recovery: the impact of foam roller-assisted stabilization exercises on low back pain — a comparative analysis with conventional therapies

Revanth M, Kamalakannan M, Hariharan J, Priyadharshini V, Dinesh S, Priyanga Seemathan, Praveenkumar R

 

Revanth M et al. – Enhancing recovery: the impact of foam roller-assisted stabilization exercises on low back pain — a comparative analysis with conventional therapies –  Fizjoterapia Polska 2025; 25(1); 369-375

DOI: https://doi.org/10.56984/8ZG007DLGP0

Abstract
Background. Low back pain (LBP) is one of the most prevalent musculoskeletal conditions affecting individuals worldwide, often resulting in significant disability and reduced quality of life. As the leading cause of years lost to disability globally, the burden of LBP continues to rise alongside an aging and expanding population. Regular exercise plays a pivotal role in alleviating LBP by enhancing spinal muscle strength, improving flexibility, and optimizing posture. Interferential therapy (IFT), a transcutaneous electrical stimulation modality utilizing medium-frequency currents, is a well-established intervention for musculoskeletal disorders. This study evaluates the effectiveness of stabilization exercises using a foam roller in comparison to conventional exercise in individuals with LBP.
Methods. A total of 82 participants meeting the inclusion and exclusion criteria were randomized into two groups: a stabilization exercise group (n = 41) and a conventional exercise group (n = 41). Both groups received IFT alongside their respective exercise protocols. Each intervention session lasted 30 minutes and was administered five times per week for three weeks.
Results. Post-intervention assessments using the Modified Oswestry Disability Index (MODQ) revealed a mean score of 18.8 in the stabilization exercise group compared to 22.93 in the conventional exercise group, with a statistically significant p-value of < 0.0001. These findings demonstrate a superior reduction in pain and disability in the stabilization exercise group.
Conclusion. Stabilization exercises incorporating a foam roller provide enhanced therapeutic benefits for individuals with LBP compared to conventional exercises. The foam roller introduces an unstable surface, challenging participants and promoting greater core activation and postural control.
Key words
foam roller, low back pain, stabilization exercise, interferential therapy (IFT), Modified Oswestry Disability Index (MODQ)
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Comparative efficacy of mobilization vs. stabilization exercises combined with TENS therapy and pelvic floor muscle training in managing pelvic girdle pain

Nithyadarshini Nadar, Suriya Nedunchezhiyan, Kamalakannan M, Hariharan J, Snigdha Josyula, Priyanga Seemathan, Rajashri R

Nithyadarshini Nadar et al. – Comparative efficacy of mobilization vs. stabilization exercises combined with TENS therapy and pelvic floor muscle training in managing pelvic girdle pain –  Fizjoterapia Polska 2025; 25(1); 238-241

DOI: https://doi.org/10.56984/8ZG007DHXNY

Abstract
Background. Pelvic girdle pain (PGP) is a prevalent and debilitating condition, particularly during and after pregnancy, often requiring tailored therapeutic interventions. Despite various treatment options, the comparative effectiveness of different multimodal approaches remains insufficiently explored. This study evaluates the impact of mobilization exercises combined with transcutaneous electrical nerve stimulation (TENS) therapy and pelvic floor muscle training versus stabilization exercises paired with the same adjunct therapies.
Objective. To compare the effectiveness of these two intervention strategies in reducing pain, improving functional mobility and pelvic stability, and enhancing quality of life in individuals with PGP.
Methods. Eighty patients diagnosed with PGP were randomly assigned to two groups. Group A underwent mobilization exercises, TENS therapy, and pelvic floor muscle training, while Group B engaged in stabilization exercises, TENS therapy, and pelvic floor muscle training. The six-week intervention included daily exercises and five weekly TENS therapy sessions. Outcome measures included pain severity (via Visual Analog Scale), functional mobility (Pelvic Girdle Questionnaire scores), pelvic stability, and patient-reported quality of life.
Results. Group A demonstrated a significant reduction in pain (VAS scores from 4.1 to 2.6, p < 0.001) and improved functional mobility (PGQ scores from 29.3 to 16.2, p < 0.001) compared to Group B. Patient-reported outcomes, including satisfaction, stability, and quality of life, were also significantly better in Group A. While both groups experienced improvements, mobilization exercises combined with TENS therapy and pelvic floor muscle training proved superior in overall effectiveness.
Conclusion. Mobilization exercises combined with TENS therapy and pelvic floor muscle training offer a more effective approach to managing PGP than stabilization exercises with the same adjunct therapies. This combination provides superior pain relief, functional mobility, and overall quality of life improvements, supporting its use in clinical practice.
Key words
pelvic girdle pain, pelvic floor, mobilization, stabilization, TENS therapy, quality of life
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Examining the relationship between extensor carpi radialis brevis pennation angle and grip strength. A cross-sectional study

Vivek K, Kamalakannan M, Hariharan J, Josyula Snigdha, Praveenkumar R, Priyanga Seemathan

Vivek K, Kamalakannan M, Hariharan J, Josyula Snigdha, Praveenkumar R, Priyanga Seemathan – Examining the relationship between extensor carpi radialis brevis pennation angle and grip strength. A cross-sectional study –  Fizjoterapia Polska 2025; 25(1); 217-221

DOI: https://doi.org/10.56984/8ZG007D2P2D

Abstract
Background. This cross-sectional study aimed to investigate the relationship between the pennation angle of the extensor carpi radialis brevis (ECRB PA) and grip strength. Additionally, the study explored potential gender differences in ECRB PA and its association with grip strength.
Methods. A total of 155 healthy participants were recruited. Ultrasound imaging was used to measure the ECRB PA, while grip strength was assessed using a Jamar dynamometer. Statistical analysis was conducted to examine the correlation between ECRB PA and grip strength.
Results. ECRB PA and common extensor tendon (CET) thickness correlated significantly with grip strength, showing gender-specific patterns. In males, ECRB PA had a moderate positive correlation with grip strength (r = 0.474), and CET thickness showed a strong correlation (r = 0.714), suggesting that both factors contribute to grip strength. In females, ECRB PA correlated moderately with grip strength (r = 0.585), while CET thickness showed a weak inverse correlation (r = –0.136). These findings suggest that CET thickness may indirectly reflect physiological cross-sectional area (PCSA) and influence grip strength in males, whereas ECRB PA plays a more critical role in females.
Conclusion. This cross-sectional study provides evidence of a correlation between ECRB PA and grip strength in healthy individuals. The findings suggest that individuals with a larger ECRB PA may have reduced grip strength. Furthermore, the observed gender differences in ECRB PA could partially explain variations in grip strength between males and females. Further research is needed to validate these findings in clinical populations with wrist and hand pathologies.
Keywords
ECRB, pennation angle, grip strength, ultrasound imaging, Jamar dynamometer
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