Tag: Sivakumar Ramachandran

Cross-cultural adaptation, validity and reliability of the Tamil version of the Falls-Efficacy Scale – International in Indian elderly population

Sivakumar Ramachandran, Nandini Rajan

Sivakumar Ramachandran, Nandini Rajan – Cross-cultural adaptation, validity and reliability of the Tamil version of the Falls-Efficacy Scale – International in Indian elderly population –  Fizjoterapia Polska 2024; 24(1); 187-191

DOI: https://doi.org/10.56984/8ZG2EF86RB

Abstract
Background. Fall Efficacy Scale – International (FES-I) is a valid and reliable measure used to assess fear of fall. However, it is worth noting that FES-I is currently not available in the Tamil language. Therefore, the objective of this particular study was to cross-culturally adapt the measure into Tamil and subsequently test the validity and reliability of the translated version.
Methods. The original English version of FES-I was translated according to the protocol set by ProFaNE. The Tamil version, FES-I (T), was given to 81 elderly Tamil-speaking participants. Statistical analyses were done to compare groups based on age, gender, fear of falling, and fall history. The validity of FES-I (T) was assessed by comparing its scores with the TUG test and SPPB. The reliability of FES-I (T) was evaluated using the Intraclass correlation coefficient.
Results. The total scores obtained from FES-I (T) exhibited a positive correlation with the scores obtained from the TUG test (rs = 0.584), while displaying a negative correlation with the scores obtained from the SPPB (rs = −0.619, p-value < 0.001). Furthermore, the test-retest reliability of FES-I (T) was found to be excellent, with the Intraclass correlation coefficient for the total score recording a value of 0.99.
Conclusion. Based on the findings of this study, it can be concluded that the FES-I (T) is a valuable tool that can be effectively utilized in both clinical practice and research settings to assess fear of falling in elderly individuals who speak Tamil.
Keywords
fall efficacy, elderly, Tamil language
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Effectiveness of reinforced feedback in virtual environment for upper limb rehabilitation in acute stroke

Hemayuthika Loganathan, Rajeswari Muthusamy, Sivakumar Ramachandran

Hemayuthika Loganathan, Rajeswari Muthusamy, Sivakumar Ramachandran – Effectiveness of reinforced feedback in virtual environment for upper limb rehabilitation in acute stroke –  Fizjoterapia Polska 2024; 24(1); 146-153

DOI: https://doi.org/10.56984/8ZG2EF8k5q

Abstract
Background. Motor impairments following stroke result in loss of upper extremity function which is often persistent and disabling. Reinforced feedback in the virtual environment (RFVE) could activate mirror neuron systems which are stimulated during action observation and action execution. This study aims to evaluate the activation of proximal muscles in paretic upper limb following RFVE training.
Methodology. Twenty-four stroke patients were included in the study, 12 in control group received impairment specific training and 12 in experimental group received RFVE training using Oculus quest 2 in addition to impairment specific exercise training. Surface electromyography (SEMG) of shoulder muscles of affected upper limb were recorded in both groups. Arm motor recovery was recorded using Chedoke – McMaster stroke assessment scale (CMSA).
Results. Paired t-test was used to analyze the results within the group which showed improvement in the both groups and unpaired t-test was used to test the outcomes between the groups where RFVE group showed significant improvement in average muscle activity in anterior deltoid, middle deltoid and CMSA scores than control group (p < 0.005*).
Conclusion. The results of this study demonstrated the beneficial effects of RFVE in upper limb training which showed improvements in muscle activation in SEMG and arm recovery in CMSA scores. RFVE training is a safe and well-accepted effective intervention in acute stroke rehabilitation that could become a successful intervention for early functional recovery.
Keywords
upper limb dysfunction, acute stroke, virtual reality, visual feedback, SEMG
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Analysis of functional prorpioception in lower limb among younger and older adults

Ravi Shankar, Sivakumar Ramachandran, Radhika CM, Parthiban P

 

Ravi Shankar, Sivakumar Ramachandran, Radhika CM, Parthiban P – Analysis of functional prorpioception in lower limb among younger and older adults. Fizjoterapia Polska 2023; 23(4); 170-174

DOI: https://doi.org/10.56984/8ZG20A7jK

Abstract
Background. Proprioception is the internal sense that assists an individual in learning a motor task and executing it seamlessly. Generally, a proprioception deficit is tested by measuring degrees of error in repositioning a joint or limb in space. Most of the measures use single-joint movement and, on a few occasions, multi-joint movements are tested with high-tech instrumentation in a laboratory setting. Multi-joint testing can reflect the impact of a proprioception deficit in functional activity. We used a novel method to test proprioception as a functional activity.
Aim. The study aims to analyse the functional proprioception in the lower limbs of younger and older adults.
Methodology. Thirty-seven younger and thirty-seven older adults were tested for proprioception in lower limbs with a target-reaching task. The participant was given a target point to touch with the great toe with eyes open. Following the trial, they were asked to touch the target with their eyes closed. The error in distance was measured in centimetres for three attempts. The minimal error was taken for analysis.
Result. The result shows that a mean error of around 2.6 cm and 5.7 to 6 cm is present in young and older adults respectively. There was no difference with respect to the side noted in the young adults, but the left side of adults shows a marginally higher error compared to the right side.
Conclusion. Functional proprioception differs among young and older adults. Multi-joint proprioception can provide different insights into an individual’s ability to use proprioception effectively.
Keywords
proprioception, multi-joint testing, younger adults, older adults
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Hand grip strengthening exercises on fine motor skills in children with autism spectrum disorder

Mohandass G., Rajeswari Muthusamy, Sivakumar Ramachandran


Mohandass G., Rajeswari Muthusamy, Sivakumar Ramachandran – Hand grip strengthening exercises on fine motor skills in children with autism spectrum disorder. Fizjoterapia Polska 2023; 23(1); 134-140

DOI: https://doi.org/10.56984/8ZG07B63F

Abstract
Background. Movement impairments in autism spectrum disorder (ASD) are manifested as both delays and deficits, with delays found in gross motor, fine motor and speech domains and deficits found in coordination, postural control and gait. Functional fine motor task is dependent on hand grip strength (HGS) which is found to be decreased. Therapeutic strategies focus primarily on sensory integration issues but HGS is not comprehensively addressed in improving fine motor skills (FMS).
Objective. The aim of the study was to analyse the effect of hand grip strengthening exercises on improving FMS in children with ASD.
Materials and Methods. This interventional study was carried out in 27 children with ASD who were recruited from Vidya sudha – Centre for children with special needs. After including in the study, level of FMS was assessed by Peabody Developmental Motor Scale (PDMS-2) and HGS was quantified with Martin Vigorimeter. Control group received conventional therapy and Intervention group received hand grip strengthening exercises along with routine therapy for duration of 6 weeks and HGS and level of FMS were reassessed with same outcome measures.
Results. Paired t test showed statistically significant change of HGS in Intervention group and FMS of both the group with p < 0.05. Unpaired t test showed statistically significant change of HGS and FMS with p < 0.05 in Interventional group compared to control group.
Conclusion. Hand grip strengthening exercises improves the HGS and has positive effect on FMS which can be included in the standard plan of care in rehabilitating children with ASD.
Keywords
motor impairments, fine motor skills, hand grip strength, Peabody Developmental Motor Scales, Martin Vigorimeter
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Development of a functional training protocol to improve lower limb motor recovery in early sub-acute stroke patients

Meenakshi Jharbade, Sivakumar Ramachandran, Shankar V, John M Solomon


Meenakshi Jharbade, Sivakumar Ramachandran, Shankar V, John M Solomon – Development of a functional training protocol to improve lower limb motor recovery in early sub-acute stroke patients. Fizjoterapia Polska 2022; 22(1); 234-239

Streszczenie
Abstract
Background. Functional training is a common intervention practiced in stroke rehabilitation. The efficacy of lower limb functional training to improve functions has been widely tested in patients with chronic stroke. Improvement in function generally does not reflect changes in motor recovery. The effect of this training on motor recovery has been less explored. Moreover, a standard protocol for lower limb functional training is elusive in literature.
Aim. To develop an intervention protocol of functional training for lower extremity to improve motor recovery and functions in acute and early subacute stroke patients.
Methods. Study was conducted in two phases. First phase involved literature review to identify the components for functional training for lower extremity in patients with stroke. Second phase involved two rounds of Delphi survey to design an intervention protocol. First round of Delphi survey was conducted to identify the functions of lower extremity that can be used as components of training and second round was conducted to receive the consensus on activities of lower extremity which can be practiced in acute and early subacute stroke patients.
Results. Functions of lower extremity and exercises of functional training which received consensus of atleast 70% and above in Delphi survey are selected to design the protocol. Weight-bearing, postural control, sit to stand, stepping, walking, standing, manipulation function was selected to design activities for functional training.
Conclusion. A Functional training protocol was developed with activities for weight bearing, postural control, manipulation and walking function.
Key words:
stroke, physiotherapy, functional training, rehabilitation, task oriented exercise
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Comparison of visual and goniometric assessment and analysis of inter observer difference in assessing amiel tison angles in high risk infants

K. P. Rupasree, Rajeswari Muthusamy, Sivakumar Ramachandran, C.Arockia Pramila, N. Udayakumar

K. P. Rupasree, Rajeswari Muthusamy, Sivakumar Ramachandran, C.Arockia Pramila, N. Udayakumar – Comparison of visual and goniometric assessment and analysis of inter observer difference in assessing amiel tison angles in high risk infants. Fizjoterapia Polska 2022; 22(1); 38-42

Abstract
Background. High risk infants (HRI) are more vulnerable for neurodevelopmental delay and require periodic developmental assessment at first year of life to prevent and identify the neuromotor deficit at an early age. Clinically visual method is widely followed in evaluating muscle tone using Amiel tison angles (ATA) in HRI but erroneous interpretation of ATA might have consequences in identification and management of subtle tonal deviation. This study intends compare the visual and Goniometric assessment and inter observer difference in the assessment of muscle tone using ATA in HRI.
Methods. 37 HRI who met the inclusion criteria were included and two Physiotherapists with similar qualifications who work in the area of paediatrics participated in the study. The first assessor assessed the ATA visually followed by Goniometric assessment which was followed by visual assessment of ATA by the second assessor.
Results. Unpaired t test was used to compare the difference between goniometric and visual assessment which showed statistically significant difference with p < 0.05. Intraclass correlation coefficient test was used to analyse the inter observer difference. Adductor and Heel to ear angles showed an excellent correlation and popliteal angle showed good correlation with ICC value of 0.97, 0.91and 0.79 respectively.
Conclusion. The result shows that interobserver difference of visual assessment is acceptable but emphasizes that the assessor should gain experience in visually assessing the angles trained initially by using goniometer to prevent erroneous interpretation which could reduce the difference between visual and goniometric estimates in the later stage.
Key words:
high risk infants, amiel tison angle, visual assessment, inter observer difference
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