Tag: Surya Vishnuram

Effect of neurokinetic therapy on core muscle dysfunction among subjects with low back pain

Theepan Kumar, Kumaresan A, Surya Vishnuram

Theepan Kumar, Kumaresan A, Surya Vishnuram – Effect of neurokinetic therapy on core muscle dysfunction among subjects with low back pain –  Fizjoterapia Polska 2025; 25(4); 169-172

DOI: https://doi.org/10.56984/8ZGA431YVHR

Abstract
Objective. Core muscle dysfunction is commonly identified as a contributing factor to low back pain. This study examined the effects of Neurokinetic Therapy (NKT) on core muscle dysfunction in individuals with low back pain.
Methods. Sixty-six subjects aged 20–50 years with chronic nonspecific low back pain were randomized into two groups (NKT and control). The NKT group received treatment for eight weeks. Manual muscle testing was conducted during this period alongside the identification of dysfunctional movement patterns and biweekly neuromotor reprogramming sessions.
Results. The primary outcome, core muscle endurance, improved significantly in the NKT group. Plank endurance time increased from a mean of 45.2 seconds (SD 10.5) at baseline to 61.0 seconds (SD 12.4) post-intervention, while the control group showed a smaller improvement. Side-bridge endurance times also demonstrated a greater increase in the NKT group (30.4 seconds [SD 8.2] to 42.6 seconds [SD 9.3]) compared to the control group. The Wilcoxon test confirmed these improvements were statistically significant (p < 0.01).
Conclusion. The findings suggest that interventional techniques such as NKT should be incorporated into clinical practice for managing chronic low back pain, especially when core dysfunction is present.
Key words
Neurokinetic Therapy, core muscles, low back pain, muscle dysfunction
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The impact of structured postnatal exercise program on salivary cortisol levels in postpartum women following caesarean section

Dasarapu Indrani, Shenbaga Sundaram Subramanian, Prathap Suganthirababu, Dubba NagaRaju, Surya Vishnuram, Jagatheesan Alagesan, Purna Chandra Shekhar, Rahul Shaik, K.Himabindu, Kiran Velukuri

Dasarapu Indrani, Shenbaga Sundaram Subramanian, Prathap Suganthirababu, Dubba NagaRaju, Surya Vishnuram, Jagatheesan Alagesan et al. – The impact of structured postnatal exercise program on salivary cortisol levels in postpartum women following caesarean section –  Fizjoterapia Polska 2025; 25(3); 423-427

DOI: https://doi.org/10.56984/8ZG7D19P4A8

Abstract
Background. Elevated cortisol levels contribute to maternal stress and delayed recovery in the postpartum period, particularly following lower segment caesarean section (LSCS), which poses unique physiological and psychological challenges.
Objective. To evaluate the impact of a 12-week structured postnatal exercise program on salivary cortisol levels in postpartum women following LSCS.
Methods. Sixty postpartum women who had undergone LSCS were randomly assigned to either an experimental group (n = 30) or a control group (n = 30). The experimental group received a physiotherapist-guided postnatal exercise program, progressing from breathing and mobility exercises to core stability training. Salivary cortisol levels were measured pre- and post-intervention. Secondary outcomes included core strength, exhaustion, and mental health.
Results. Post-intervention salivary cortisol levels were significantly lower in the experimental group than in the control group (mean difference: 5.2607 nmol/L; 95% CI: 3.9917–6.5296; p < 0.0001), with the experimental group demonstrating significant improvements in secondary outcomes.
Conclusion. A structured postnatal exercise program effectively reduces salivary cortisol levels and enhances recovery after LSCS. These findings support the incorporation of physiotherapy-led exercise into routine postpartum care to reduce stress and improve maternal health outcomes.
Keywords
cortisol levels, postpartum, caesarean section, postnatal exercise, stress
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Effect of bodyweight exercises versus resistance band exercises to improve strength in post-COVID individuals

Dubba NagaRaju, Shenbaga Sundaram Subramanian, Dasarapu Indrani, Surya Vishnuram, Kiran Velukuri, S Purna Chandra Shekhar, K. Himabindu, Jagatheesan Alagesan, Fadwa Alhalaiqa

Dubba NagaRaju, Shenbaga Sundaram Subramanian, Dasarapu Indrani, Surya Vishnuram,Kiran Velukuri, S Purna Chandra Shekhar et al. – Effect of bodyweight exercises versus resistance band exercises to improve strength in post-COVID individuals –  Fizjoterapia Polska 2025; 25(3); 408-411

DOI: https://doi.org/10.56984/8ZG7D192ROZ

Abstract
Background. Resistance training is essential for enhancing muscular strength and overall physical health. Among various methods, bodyweight and elastic resistance training are economical and accessible, making them especially useful for young adults. However, limited research compares their relative effectiveness. The aim of this study was to determine the impact of bodyweight exercises versus resistance band exercises on muscle strength in young adults.
Methods. Thirty young adult participants were randomly assigned to two groups: group A (bodyweight training) and group B (elastic band training), with 15 individuals in each. A structured training protocol was followed for four weeks. Strength was assessed pre- and post-intervention using the push-up test and squat test. Paired t-tests were used to determine within-group changes at p < 0.05.
Results. Both training modalities significantly improved muscular strength. Group A demonstrated notable gains in both the push-up          (t = -9.025, p < 0.001) and squat tests (t = -13.169, p < 0.001). Group B showed greater improvements, with push-up                                           (t = -23.438, p < 0.001) and squat (t = -16.430, p < 0.001) scores improving significantly, and higher mean changes compared to group A.
Conclusion. While both bodyweight and elastic resistance exercises effectively enhance strength, elastic band training yielded slightly superior outcomes. These preliminary findings support the use of resistance bands, especially in settings with limited resources.
Key words
strength training, bodyweight workout, elastic resistance, young adults, push-up test, squat test
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Effectiveness of concentric and eccentric strengthening program on pain and functional performance in patellofemoral pain syndrome among sprinters – A pilot study

Buvanesh Annadurai, Vinodhkumar Ramalingam, Devadharshini Balakrishnan, Surya Vishnuram, Shenbaga Sundaram Subramanian, Santhana Lakshmi S, Pavithra Aravind, Pavithra S, Rajesh G, Thamer A. Altaim

Buvanesh Annadurai et al. – Effectiveness of concentric and eccentric strengthening program on pain and functional performance in patellofemoral pain syndrome among sprinters – A pilot study –  Fizjoterapia Polska 2025; 25(3); 288-292

DOI: https://doi.org/10.56984/8ZG7D19JL5P

Abstract
Background. Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that primarily affects athletes, particularly those who engage in repetitive knee flexion and extension. Collegiate sprinters are especially susceptible to PFPS because certain strokes, including the freestyle and breaststroke, demand repetitive lower-limb actions. The estimated prevalence of PFPS in elite athletes is 35.7%, 28.9% in adolescents, and 13.5% in the military. PFPS affects individuals across various age groups, with a general population prevalence rate of 23%. Muscle imbalances surrounding the knee joint, especially weakness of the quadriceps muscles, which are essential for patellar stabilization, are frequently linked to PFPS. Strengthening exercises can be broadly divided into concentric and eccentric modalities, although different rehabilitation strategies may be applied. This study aims to compare the influence of concentric and eccentric strengthening programs on pain levels and functional performance in collegiate sprinters diagnosed with PFPS.
Objective. To compare the effectiveness of changes in functional performance and pain following both concentric and eccentric exercises in PFPS among collegiate sprinters.
Materials and methods. A total of 24 participants were allocated into two groups using a convenient sampling method: group A (n = 12) and group B (n = 12). Group A received concentric exercise, while group B underwent eccentric exercise for three weeks. Materials required included a chair, stopwatch, clear floor space, and measuring tape to ensure accurate assessment and execution of exercises. Outcome measures included the Numeric Pain Rating Scale (NPRS) to assess pain levels and the Timed Up and Go (TUG) test to evaluate functional mobility and balance.
Results. Statistical analysis of the quantitative data showed no statistically significant difference between group A and group B, with a p-value of < 0.0001. Both groups demonstrated considerable improvement post-intervention in pain and functional performance; however, no significant difference was found between the groups. Therefore, both concentric and eccentric strengthening programs appear equally effective in managing patellofemoral pain syndrome among collegiate sprinters.
Conclusions. According to this study’s findings, concentric exercises with therapeutic ultrasound (group A) and eccentric exercises with therapeutic ultrasound (group B) are similar in effectiveness in lowering pain and improving functional performance in collegiate sprinters with patellofemoral pain syndrome.
Key words
anterior knee pain, patellofemoral pain, patellofemoral pain syndrome
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Exploring the relationship between glycated haemoglobin levels and geriatric syndromes in elderly patients with diabetes (a cross-sectional study)

Diovin Derose Vianni, Shenbaga Sundaram Subramanian, Surya Vishnuram, Hazliza Razali, Madhanraj Sekar, Naseem Alyahyawi, Hana K Almufadda, Riziq Allah Mustafa Gaowgzeh,Fadwa Alhalaiqa

Diovin Derose Vianni et al. – Exploring the relationship between glycated haem

Diovin Derose Vianni et al. – Exploring the relationship between glycated haemoglobin levels and geriatric syndromes in elderly patients with diabetes (a cross-sectional study) –  Fizjoterapia Polska 2024; 24(5); 293-299

DOI: https://doi.org/10.56984/8ZG020CN4TC

Abstract Background. One common chronic condition is diabetes mellitus (DM), which is more prevalent in the elderly and is often linked to a variety of issues and concomitant conditions. Geriatric symptoms, such as depression, weakness, tiredness, and insomnia, are known to impact health outcomes in this demographic significantly. Objective. This study investigated the connection between glycated hemoglobin (HbA1c) levels and geriatric symptoms in seniors with diabetes. Methods. An appropriate sample of fifty senior people (60–85 years old) with diabetes mellitus was selected from the outpatient ward of Saveetha Hospital. The HbA1c values were assessed in addition to examinations for geriatric symptoms using established measures. Potential correlations between HbA1c levels and geriatric syndromes were examined by statistical analysis. Results. The following variables showed significant positive relationships with HbA1c levels: frailty (r = 0.571, p < 0.000), fatigue (r = 0.725, p < 0.000), sleeplessness (r = 0.631, p < 0.000), and geriatric depression (r = 0.529, p < 0.000). Conclusion. In older diabetes mellitus patients, higher HbA1c levels were linked to a higher prevalence of fatigue, insomnia, frailty, and depression. These results emphasize the need for glycemic control in treating geriatric diseases in this population.
Key words diabetes mellitus, geriatric syndromes, glycated hemoglobin, depression, frailty, fatigue, insomnia, elderly patients
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Effect of deep breathing and bladder retraining on older women with diabetic-induced stress incontinence

Getcyal Devakirubai Martin Jeyaraj,Shenbaga Sundaram Subramanian, Surya Vishnuram,Keerthana A.K., Saad Suleman Alfawaz, Riziq Allah Mustafa Gaowgzeh, Huda Ibrahim Bakhour, Fadwa Alhalaiqa

Getcyal Devakirubai Martin Jeyaraj et al. – Effect of deep breathing and bladder retraining on older women with diabetic-induced stress incontinence –  Fizjoterapia Polska 2024; 24(5); 227-231

DOI: https://doi.org/10.56984/8ZG020CPW1T

Abstract Background. An increasing number of older women, especially those with diabetes, are experiencing stress incontinence. This ailment can significantly affect the quality of life, frequently made worse by weaker pelvic floor muscles and more significant abdominal strain. The combined impact of deep breathing exercises and bladder retraining is a well-researched technique. Purpose. This research aims to determine how deep breathing techniques and bladder retraining affect stress incontinence in older female diabetics. Methods. Eighty older women with diabetic-induced stress incontinence were randomized into a group for intervention (receiving deep breathing exercises along with bladder retraining) and a control group (receiving standard diabetic care). The research employed a randomized controlled trial design. The frequency of incontinence episodes, stress levels examined using conventional scales, and blood sugar levels before and after the intervention, determined by glycosylated hemoglobin (HbA1c), were among the outcome measures. Results. The frequency of incontinence events in the intervention group was statistically significantly lower compared to the control group. Furthermore, the intervention group displayed a statistically significant decrease in stress levels compared to the control group, which showed no discernible benefits. Measurements of hemoglobin A1c, which tracks blood sugar regulation, demonstrated a noteworthy amelioration in the intervention cohort relative to the control cohort. Conclusion. Together, deep breathing exercises and bladder retraining significantly reduce stress-related incontinence, enhance blood sugar management, and reduce the perceived stress levels of older women with diabetes. This integrated, non-invasive approach effectively treats psychological and physiological elements of stress incontinence. Healthcare providers should apply this strategy to improve the treatment of older diabetic women.
Key words stress incontinence, diabetes mellitus, deep breathing, bladder retraining, older women, integrative therapy, blood sugar control
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The effectiveness of virtual reality (VR) therapy on balance and mobility in elderly patients: a randomized controlled trial

Madhanraj Sekar, Prathap Suganthirababu, Shenbaga Sundaram Subramanian, Surya Vishnuram, Vinodhkumar Ramalingam, Anitha Arul, Andrew Anbarason

Madhanraj Sekar et al. – The effectiveness of virtual reality (VR) therapy on balance and mobility in elderly patients: a randomized controlled trial –  Fizjoterapia Polska 2024; 24(5); 191-194

DOI: https://doi.org/10.56984/8ZG020C8UWP

Abstract Introduction. Balance impairments and mobility limitations are prevalent challenges among elderly individuals, often contributing to an increased risk of falls and a diminished quality of life. Traditional physiotherapy interventions have effectively addressed these issues, but novel approaches, such as virtual reality (VR) therapy, have emerged as potential enhancements to rehabilitation protocols. Through its immersive environments, VR therapy may engage and challenge patients, potentially leading to improved outcomes. Objective. To investigate whether VR therapy enhances balance and mobility outcomes in elderly patients compared with a traditional physiotherapy protocol. Methods. Sixty elderly individuals, aged 65 and above, referred for outpatient physiotherapy due to balance and mobility issues, were recruited for this randomized controlled trial (RCT) with two parallel arms. They were randomly allocated to the intervention group, treated with VR therapy sessions, while the control group received traditional physiotherapy sessions focused on balance exercises and mobility. The treatment duration was twice a week for over 8 weeks. Baseline assessments were conducted before the intervention, and follow-up assessments were performed immediately after the 8-week intervention period. Outcome Measures. Primary Outcome: Balance was assessed using the Berg Balance Scale (BBS) as the primary outcome, while mobility was assessed using the Timed Up and Go (TUG) test, and quality of life was evaluated using the EQ-5D Questionnaire as the secondary outcome. Results. The VR therapy group demonstrated a more significant improvement in balance (BBS score increase of 12.4 points) than the control group (BBS score increase of 7.6 points). Regarding mobility, the VR group reduced TUG time by 3.8 seconds, compared to 2.8 seconds in the control group, indicating faster completion times and improved functional mobility. The VR group reported a more significant increase in quality of life (0.17 EQ-5D improvement) compared to the control group (0.12 improvement), suggesting that immersive therapy positively impacted overall well-being. Conclusion. It was anticipated that the VR therapy group would demonstrate more significant improvements in balance, mobility, and quality of life than those in the traditional physiotherapy group.
Key words augmented learning, virtual reality, software technology, balance, risk of fall
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Effectiveness of low-level laser therapy with Buerger Allen exercise versus LIPUS with Buerger Allen exercise for diabetic foot ulcer

Srivatsan M, Tamil Ponni S, Shenbaga Sundaram Subramanian, Surya Vishnuram, Ramya S, Hazliza Razali, Inayat Fatima, Fadwa Alhalaiqa

Srivatsan M et al. – Effectiveness of low-level laser therapy with Buerger Allen exercise versus LIPUS with Buerger Allen exercise for diabetic foot ulcer –  Fizjoterapia Polska 2024; 24(5); 174-178

DOI: https://doi.org/10.56984/8ZG020CB7JK

Abstract
Background: Diabetic foot ulcers (DFUs) are a severe diabetes complication with a burden similar to cancer. Risk factors include peripheral neuropathy, arterial disease, foot abnormalities, and socioeconomic and geographical influences. Low-Level Laser Therapy (LLLT) relieves pain, promotes tissue repair, and aids wound healing. Ultrasound therapy enhances circulation and tissue healing through sound waves. Buerger-Allen Exercises (BAE) improve lower extremity perfusion, aiding wound healing and reducing neuropathy symptoms. Purpose: This pilot study compared the effectiveness of LLLT with BAE versus Low-Intensity Pulsed Ultrasound Therapy (LIPUS) with BAE in managing DFUs. Methods: 40 patients were assigned to two groups (20 each). Group A received LLLT for 10 minutes, while Group B received LIPUS for 10 minutes. Both groups performed BAE for 10 minutes on alternate days, 3 days a week for 12 weeks. Outcomes were assessed using the Visual Analog Scale (VAS), Bates-Jensen Wound Assessment Tool (BWAT), and Diabetic Foot Ulcer Scale (DFS). Results: Both groups showed significant improvements (P ≤ 0.05), but LLLT with BAE was superior in pain reduction, wound healing, and quality of life. Conclusion: LLLT with Buerger-Allen exercises is a more effective treatment for DFUs than LIPUS.
Key words
diabetic foot ulcer, Laser therapy, Ultrasound therapy, Buerger-Allen exercise
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Effectiveness of dynamic cupping therapy versus IASTM with eccentric training for shin splint syndrome among football players

Tamil Ponni S, Srivatsan M, Shenbaga Sundaram Subramanian, Surya Vishnuram, Ramya S, Mohammed Atallah F Almutairi, Riziq Allah Mustafa Gaowgzeh, Naseem Alyahyawi, Fadwa Alhalaiqa

Tamil Ponni S et al. – Effectiveness of dynamic cupping therapy versus IASTM with eccentric training for shin splint syndrome among football players –  Fizjoterapia Polska 2024; 24(5); 114-118

DOI: https://doi.org/10.56984/8ZG020CD2WT

Abstract Background. Shin splints result from repetitive stress on the shin bone, causing strain in the muscles and connective tissues of the lower leg. Among athletes, females (55.3%) experience shin splints more frequently than males (44.7%). Dynamic cupping combines negative pressure, massage movements, and joint motions, while instrument-assisted soft tissue mobilization (IASTM) involves repeated strokes to stimulate muscles, tendons, and fascia. Eccentric exercises enhance muscle activation through lengthening. Purpose. This study aimed to compare the effectiveness of dynamic cupping therapy with eccentric exercise and IASTM with eccentric exercise in managing shin splints among football players. Method. Forty football players were divided into two groups: Group A (dynamic cupping + eccentric exercise) and Group B (IASTM + eccentric exercise). Pain (VAS), medial tibial stress syndrome (MTSS) questionnaire, and range of motion (ROM) were assessed weekly to evaluate outcomes. Results. Dynamic cupping therapy with eccentric training showed significant improvements in pain reduction and ROM compared to IASTM with eccentric training. Conclusion. Dynamic cupping therapy combined with eccentric exercise was more effective than IASTM with eccentric exercise in treating shin splints in football players.
Key words shin splint, cupping therapy, soft tissue mobilization, eccentric exercises, soccer players, range of motion
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Evaluating the integrated effect of aromatherapy and biofeedback therapy with rehabilitation among geriatric population with panic disorder

Bhavaani sree Dhandapani, Shenbaga Sundaram Subramanian, Surya Vishnuram, Syed Abudaheer K, SaadSuleman Alfawaz, Nouf Yousef Khojah, Riziq Allah Mustafa Gaowgzeh, Fadwa Alhalaiqa

  

Bhavaani sree Dhandapani et al – Evaluating the integrated effect of aromatherapy and biofeedback therapy with rehabilitation among geriatric population with panic disorder –  Fizjoterapia Polska 2024; 24(5); 45-49

DOI: https://doi.org/10.56984/8ZG020CF7JA

Abstract
Background. Aging or senescence is mainly associated with multiple health concerns that impact the physical, psychological, and cognitive functions of older individuals, significantly affecting their daily living. The prevalence of panic disorder in this population is rising, often manifesting as fear of falls, anxiety, decreased self-esteem, and breathing difficulties, leading to increased caregiver dependency. Current anxiety disorders, characterized by neurological and psychiatric symptoms, elevated cortisol levels, and irregular immune function, contribute to heightened mental distress and are associated with palpitations and elevated blood pressure. Objectives. The study aims to explore the integrated effect of aromatherapy and biofeedback therapy combined with conventional rehabilitation on reducing fear of falls, anxiety, and breathing difficulties among geriatric patients with panic disorder. Method. One hundred geriatric participants aged 65 years and above were randomly selected into Group A and Group B. Group A received aromatherapy and biofeedback therapy, and Group B received conventional rehabilitation. Outcome measures included pre- and post-treatment assessments using the Fall Efficacy Scale-International, Borg Dyspnoea Scale, Panic Disorder Severity Scale, and standard Hamilton Anxiety Scale. Result. This study shows a significant decline in fear of falls, anxiety, and breathing difficulties by integrating aromatherapy and biofeedback therapy compared to standard rehabilitation. There was no significant differentiation in treatment outcomes within the aromatherapy and biofeedback groups. Conclusion. Integrated aromatherapy and biofeedback therapy with conventional rehabilitation provides an effective strategy for managing fear of falls, anxiety, and breathing difficulties among geriatric patients with panic disorder. These holistic approaches may enhance the quality of care and improve health outcomes and quality of life for this vulnerable population.
Key words
aromatherapy, biofeedback therapy, panic disorder, fear of fall, anxiety, breathing difficulty
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