Tag: Kamalakannan.M

Exploring the impact of active release technique combined with strengthening exercises on shoulder function and scapular position in upper cross syndrome

Sridivyadharshini S R, Kotteeswaran K, Kamalakannan M, Bharathi Krishnan K, Bharathi Ravichandran

Sridivyadharshini S R, Kotteeswaran K, Kamalakannan M, Bharathi Krishnan K, Bharathi Ravichandran – Exploring the impact of active release technique combined with strengthening exercises on shoulder function and scapular position in upper cross syndrome –  Fizjoterapia Polska 2025; 25(3); 249-254

DOI: https://doi.org/10.56984/8ZG7D191MJQ

Abstract
The purpose of this study was to evaluate the effect of the active release technique combined with strengthening exercises using the SPADI to improve shoulder function and a vernier caliper to measure scapular position in upper cross syndrome. In this experimental study at SMCH, 70 participants aged 30 to 50 were selected based on inclusion and exclusion criteria. Written informed consent was obtained from all subjects prior to the commencement of the study. The experimental protocol and procedures were explained to all subjects before obtaining their consent. These 70 participants were allocated into two groups using convenient sampling: the ART with strengthening group and the conventional group. Both groups received a 30-minute exercise program. The study employed standard outcome measures including the SPADI score to evaluate shoulder function and a vernier caliper to assess scapular position. The pre-test and post-test values were analysed. The results suggest that the ART with strengthening group showed significant improvement when compared with the conventional group, with p < 0.0001, indicating superior changes in scapular position and shoulder function. The active release technique group demonstrated better outcomes. According to this study, the ART with strengthening group achieved better results than the conventional group. ART with strengthening is more effective in improving shoulder function and scapular position among subjects with upper cross syndrome.
Key words
active release technique, strengthening exercises, upper cross syndrome, shoulder function, scapular position
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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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Comparison of transcutaneous tibial nerve stimulation and transcutaneous electrical nerve stimulation on pain and quality of life in primary dysmenorrhea

Yuktha N, Kamalakannan M, Bharathi Ravichandran, Tamilselvan Ravichandran, Srikanth V, Praveen Vasanthan Murugan

 

Yuktha N, Kamalakannan M, Bharathi Ravichandran, Tamilselvan Ravichandran, Srikanth V, Praveen Vasanthan Murugan – Comparison of transcutaneous tibial nerve stimulation and transcutaneous electrical nerve stimulation on pain and quality of life in primary dysmenorrhea –  Fizjoterapia Polska 2025; 25(3); 43-52

DOI: https://doi.org/10.56984/8ZG7D19CE53

Abstract
Background. Dysmenorrhea, characterized by painful menstrual cramps, affects a significant percentage of adolescents, leading to considerable discomfort and disruption in daily activities. It is categorized into primary dysmenorrhea, which is not associated with any underlying gynecological conditions, and secondary dysmenorrhea, which is linked to identifiable pelvic pathologies. Primary dysmenorrhea typically arises due to uterine contractions mediated by prostaglandins and can significantly impact the quality of life (QoL) for affected individuals.
Aim. The aim of this study is to compare the efficacy of transcutaneous tibial nerve stimulation (TTNS) and transcutaneous electrical nerve stimulation (TENS) in reducing pain and enhancing the quality of life in adolescents with primary dysmenorrhea.
Method. This twelve-week study involved 80 participants aged 18 to 25 with primary dysmenorrhea and no pelvic pathologies. The participants were divided into two groups, each receiving either TENS or TTNS. Outcome measures included the Numeric Pain Rating Scale (NPRS) and the Menstrual Distress Questionnaire, evaluating pain and quality of life before and after the intervention.
Result. The study revealed a significant decrease in pain intensity (p < 0.0001) and improved quality of life (p < 0.0001) post-intervention, indicating the effectiveness of TENS and TTNS.
Conclusion. This study provides evidence supporting the effectiveness of TENS and TTNS in managing primary dysmenorrhea symptoms. The observed improvements in pain reduction and quality of life suggest the potential of these interventions as valuable components in the management of primary dysmenorrhea.
Key words
TENS, TTNS, primary dysmenorrhea, pain reduction, quality of life
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Game based rehabilitation in treating coccydynia among multiparous postpartum women

Geethapriya Vadamalai, Senthilkumar S, Karthika Ramalingam, Kamalakannan M, Tamilselvi S, Bharathi Ravichandran, Rakesh K C

 

Geethapriya Vadamalai st al – Game based rehabilitation in treating coccydynia among multiparous postpartum women –  Fizjoterapia Polska 2025; 25(2); 421-426

DOI: https://doi.org/10.56984/8ZG00E129S4

Abstract
Background and need for the study. Coccydynia is a condition that causes pain around the tailbone. Women are five times more likely than men to develop coccydynia. The condition most often occurs during or after childbirth and pregnancy, including in lactating mothers. This research aimed to treat coccydynia in multiparous women using a game-based rehabilitative program, followed by postnatal exercises and ergonomic advice.
Methods. This study included 29 multiparous postpartum women aged 25 to 35 with a clinical diagnosis of coccydynia. Individual examinations were conducted, and demographic data were collected. The study procedure was explained, and informed consent was obtained prior to initiation. A 4-week rehabilitation program was implemented with four sessions per week, totaling 16 sessions. The sessions included gaming, pelvic rehabilitation, postnatal exercises, and ergonomic guidance. Outcome measures used to assess pain, mental health status, and pelvic floor muscle function were the Numerical Pain Rating Scale (NPRS), Edinburgh Postnatal Depression Scale (EPDS), and electromyography (EMG).
Results. The median subjective scores on the NPRS and EPDS were 7 and 14 before the intervention and decreased to 2 and 7 afterward, indicating significant improvements in pain and mental health. Relaxation tone of the pelvic floor muscles also improved, as assessed using EMG.
Conclusion. Postpartum coccydynia requires targeted intervention and preventive strategies to address pain, mental health concerns, and muscle function. This study concludes that game-based rehabilitation improves pelvic floor muscle relaxation, pain, and moderate depressive symptoms in multiparous postpartum women.
Key words
pelvic floor hypertrophy, electromyography, postnatal exercises, physiotherapy intervention, lactation
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Effect of positional release technique versus suboccipital muscle inhibition technique in reducing pain intensity and improving range of motion in subjects with cervicogenic headache

Menisha A, Kamalakannan M, Bharathi Ravichandran, Tamilselvan Ravichandran, Sushil Bella Amali J, Siyam Ganesh S

 

Menisha A, Kamalakannan M, Bharathi Ravichandran, Tamilselvan Ravichandran, Sushil Bella Amali J, Siyam Ganesh S – Effect of positional release technique versus suboccipital muscle inhibition technique in reducing pain intensity and improving range of motion in subjects with cervicogenic headache –  Fizjoterapia Polska 2025; 25(2); 338-344

DOI: https://doi.org/10.56984/8ZG00E1G75C

Abstract
Background. Unilateral neck discomfort originating from the soft tissues or bony structures of the neck is a symptom of cervicogenic headache (CGH). This common headache generally starts with a shift of the neck and is chronic and recurring. It is usually accompanied by a reduction in neck range of motion (ROM). It may be confused with tension-type headache or other common headache conditions. Cervicogenic headaches are rare, chronic headaches most frequently occurring in people aged 30 to 44. According to several studies, the prevalence among headache sufferers ranges from 0.4% to 4%, depending on diagnostic criteria. It affects males and females approximately equally. This study investigates the effectiveness of the positional release technique and the suboccipital muscle inhibition technique in reducing pain and improving range of motion.
Aim. The aim of this study is to evaluate the effectiveness of the positional release technique (PRT) and the suboccipital muscle inhibition technique (SMI) in reducing pain intensity and improving range of motion in subjects with cervicogenic headache (CGH).
Method. According to the criteria provided by the International Classification of Headache Disorders, 50 subjects diagnosed with cervicogenic headache were included in this study. They were divided using basic random sampling into experimental and control groups. Baseline measurements were taken prior to the intervention. The experimental group received PRT and conventional exercises, while the control group received SMI and conventional exercises. Both groups were treated four times per week for six weeks. Outcome measures were taken before and after treatment using the Numerical Pain Rating Scale (NPRS) to assess pain and a goniometer to assess neck range of motion. Paired and unpaired t-tests were used to analyze the data.
Result. The pre-test NPRS value in the positional release technique group was 2.4, and in the suboccipital muscle inhibition technique group was 3.1. The post-test ROM values in the positional release technique group were 39.2 and 37.1, and in the suboccipital muscle inhibition technique group were 35.5 and 34.4. Thus, the positional release technique demonstrated a greater statistical improvement compared to the suboccipital muscle inhibition technique.
Conclusion. Both the suboccipital muscle inhibition technique and the positional release technique are effective in reducing headache symptoms and improving ROM in subjects with cervicogenic headache. However, the positional release technique offers additional benefits in improving ROM and quality of life.
Key words
cervicogenic headache, pain reduction, positional release technique, suboccipital muscle inhibition technique
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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

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 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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