Tag: Rajeswari Muthusamy

Učinkovitost pojačanog povratnog odgovora u virtualnom okruženju za rehabilitaciju gornjeg uda nakon akutnog moždanog udara

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

Sažetak
Pozadina. Motorički poremećaji nakon moždanog udara rezultiraju gubitkom funkcije gornjeg ekstremiteta, što je često trajno i onesposobljuje. Pojačani povratni odgovor u virtualnom okruženju (PPVO) mogao bi aktivirati sustave zrcalnih neurona koji su stimulirani tijekom promatranja i izvođenja akcija. Ova studija ima za cilj procijeniti aktivaciju proksimalnih mišića u paretičnom gornjem udu nakon treninga PPVO.
Metodologija. U studiju je uključeno dvadeset četiri pacijenta s moždanim udarom, 12 u kontrolnoj skupini primilo je specifičan trening za oštećenje, a 12 u eksperimentalnoj skupini primilo je PPVO trening uz pomoć Oculus Quest 2 uz specifičan trening vježbi za oštećenje. Površinska elektromiografija (PEMG) mišića ramena zahvaćenog gornjeg uda zabilježena je u obje skupine. Oporavak motorike ruke bilježen je pomoću Chedoke – McMasterove skale za procjenu moždanog udara (CMSA).
Rezultati. Upotrijebljen je uparen t-test za analizu rezultata unutar skupine koji je pokazao poboljšanje u obje skupine, a neparni t-test korišten je za testiranje ishoda između skupina gdje je PPVO skupina pokazala značajno poboljšanje u prosječnoj aktivnosti mišića u prednjem deltoidu, srednjem deltoidu i CMSA rezultatima u usporedbi s kontrolnom skupinom (p < 0,005*).
Zaključak. Rezultati ove studije pokazali su korisne učinke PPVO u treningu gornjeg uda koji su pokazali poboljšanja u aktivaciji mišića u PEMG i oporavku ruke u CMSA rezultatima. Trening PPVO je sigurna i široko prihvaćena učinkovita intervencija u rehabilitaciji akutnog moždanog udara koja bi mogla postati uspješna intervencija za rani funkcionalni oporavak.
Ključne riječi
disfunkcija gornjeg uda, akutni moždani udar, virtualna stvarnost, vizualna povratna informacija, PEMG
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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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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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Hand Grip Strength and Fine Motor Skills in Autism Spectrum Disorders

Rajeswari Muthusamy, Ramachandran Padmanabhan, Binu Ninan, Sailakshmi Ganesan

Rajeswari Muthusamy, Ramachandran Padmanabhan, Binu Ninan, Sailakshmi Ganesan – Hand Grip Strength and Fine Motor Skills in Autism Spectrum Disorders. Fizjoterapia Polska 2020; 20(4); 72-77

Abstract

Background. Autism spectrum disorder (ASD) is primarily considered as psychiatric disorder but physical features are associated with it. Motor impairments are manifested as both delays and deficits, with delays found in gross motor, fine motor and speech domains and deficits found in praxis, coordination and gait. Gross motor functions develop overtime but fine motor is still found to be delayed even at the age of three years. Hand Grip Strength (HGS) is reduced in ASD which might be one of the factors for dependent functional fine motor task. The extent of muscle weakness and its impact on fine motor skills (FMS) is not clear which would provide an insight into the child’s physical limitations and plan of care. Aim. The aim of the study was to find the extent of muscle weakness in hand and impact of hand grip strength on fine motor skills in ASD children. Materials and Methods. This cross sectional study was carried out in 65 ASD children who met the inclusion criteria. Subjects were recruited from Vidyasudha – Centre for children with special needs. Children diagnosed as ASD with Childhood Autism Rating Scale were included in the study. Level of the FMS was assessed by Peabody Developmental Motor Scale (PDMS-2) and grip strength was quantified with Martin Vigorimeter. Results. Unpaired t test analysis showed statistically significant change of HGS between normative values of Martin Vigorimeter in Indian population and ASD children with p < 0.05. Pearson’s correlation showed strong positive correlation between fine motor skills and hand grip strength with r value of > 0.7 and p ≤ 0.05. Conclusion. The result concludes that there is significant weakness in hand grip strength with positive correlation of fine motor skills in ASD children. The result insists routine assessment of muscle strength and use of Martin Vigorimeter for assessing hand grip strength in ASD children followed by strengthening exercises to improve activities of daily living and attain functional independency.

Key words:
Autism Spectrum Disorder, Fine motor skills, Hand grip strength, Peabody Developmental Motor Scales, Martin Vigorimeter
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