Context: Correcting lumbar hyperlordosis, a main cause of back pain, will reduce the stress on the lumbar spine thereby preventing future problems in back and lower limb. Clinical trials are lacking where mat Pilates, Egoscue exercises and lumbar stabilization exercises are compared for their effect on spinal malalignment. Aims: This study aims to compare the effectiveness of Pilates, Egoscue, and lumbar stabilization exercises for reducing hyperlordosis angle in asymptomatic individuals with lumbar hyperlordosis. Settings and Study Design: A randomized controlled trial conducted on volunteer participants from Health Science University of Belagavi. Materials and Methods: Asymptomatic individuals with lumbar hyperlordosis (n = 51) were randomly allocated to Pilates, Egoscue and Lumbar stabilization groups. Outcomes assessed were index of lumbar lordosis, pelvic tilt, and tolerance to exercise performance which was measured at baseline and after 4 weeks. Results: There was significant reduction in the hyperlordosis score (P < 0.001) in the three study groups when compared for pre-and post-intervention scores. However, more reduction was seen in the Pilates and Egoscue groups compared to the lumbar stabilization. Pilates and Egoscue groups were equally effective in Lumbar lordosis angle (P = 0.68) and pelvic tilt (P = 0.51). Participants of Pilates group graded the exercises with superior tolerance to performance (P < 0.0006) than Egoscue and Lumbar stabilization. Conclusion: Pilates group and Egoscue group were equally effective and superior to lumbar stabilization group in correction of hyperlordosis. Further, ease of performance of exercise was rated high for Pilates than the Egoscue exercise. These exercises should be included by the clinicians in preventive or corrective rehabilitation towards spinal posture malalignments.

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Buccal mucosa squamous cell carcinoma is rare and is considered as an aggressive form of oral cavity cancer. It is also associated with a high rate of local regional recurrence and is seen commonly in people who are habitual tobacco chewers and/or smokers with or without alcohol intake. This case report represents a 40-year-old, moderately built female of buccal mucosa carcinoma who visited the surgical oncology department with involvement of the underlying skin and underwent commando surgery with complaints of pain, restriction of movements at the operated site, chest pain and breathlessness, swelling of left side of cheek, and limited mouth opening as postoperative complications, highlighting on the postsurgical physiotherapy management in commando surgery for buccal mucosa carcinoma and alleviating symptoms that were apparent with improvement in the quality of life of the patient.

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Introduction: Plantar Fasciitis (PF) is common musculoskeletal condition associated with difficulty in performing activities of daily living. The aim of the study is to investigate the effectiveness of single session of Matrix Rhythm Therapy (MaRhyThe) in Plantar Fasciitis. Methods: It was an experimental study conducted on 17 subjects diagnosed with plantar fascitit in the age group of 18-35 years. One session of MaRhyThe was given to calf and plantar aspect of foot for 45 – 60 minutes. Pre and post intervention outcome was measured in terms of pain using pressure algometer (PPA), local skin temperature using non-contact infrared thermometer (IRT) and functional activities using Foot and Ankle Ability Measures (FAAM) scale. Results: Pre Post intervention demonstrated statically significance in terms of reduced pain (P < 0.001), increased local skin temperature (P < 0.001) and improved scores of Foot and Ankle Ability measure (P < 0.001). Conclusion: Single session of MaRhyThe treatment was found to be effective in reduction of pain, improved skin temperature and functional activities in patients with plantar fasciitis.

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Objectives: Variety of physiotherapy interventions have proven to be efficient in reducing pain and neck disability, to improve range of motion (ROM) which results in the improvement in quality of life (QoL) in head and neck cancer (HNC) patients. The aim of this study was to determine the effect of myofascial release (MFR) versus muscle energy technique (MET) on trapezius spasm for pain, disability, ROM, and QoL in postoperative HNC patients. Materials and Methods: Twenty-four patients with HNC cancers who underwent surgery were recruited in the study. The pre–post assessment for neck disability, pressure pain threshold, cervical and shoulder ROM, and QoL was done at baseline and after 6 days of intervention using Neck Disability Index, pressure algometer, universal goniometer, and Functional Assessment of Cancer Therapy - Head and Neck scale, respectively. Results: MFR and MET groups are effective for pain reduction P = 0.0001 and neck disability P = 0.0022 when compared within the groups. Cervical and shoulder ranges showed significant improvement in cervical flexion (P = 0.0162), cervical extension (P = 0.0096), shoulder flexion (P = 0.0205), shoulder extension (P = 0.0408), shoulder abduction (P = 0.0037), and shoulder adduction (P = 0.0037) when compared between the two groups. When compared within the two groups cervical and shoulder ranges showed significant improvements (P = 0.0001) in both the groups. Conclusion: MFR and MET are effective when applied individually to reduce pain and neck disability and increase cervical and shoulder ROM in HNC patients.

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Background and Objective: Trigger points in the myofascial system form the major reason for pain and tenderness in nonspecific low back pain (NSLBP). These points can be treated using manual therapy techniques such as integrated neuromuscular inhibition technique (INIT). Due to lack in the literature about its effect in NSLBP condition, the present study was undertaken to evaluate the effects of INIT on trigger points in patients with NSLBP. Materials and Methods: Forty-four patients with NSLBP were randomly assigned to either of the two study groups using envelope method. Group A (n = 22) was treated with stretching and strengthening exercises, whereas Group B (n = 22) was treated with INIT. Both the groups received hot moist pack and therapeutic ultrasound as common treatment. Five consecutive sessions of intervention were given over 5 days. Outcome measures in terms of pain pressure threshold (quadratus lumborum [QL] and erector spinae [ES]), lumbar range of motion (ROM), and disability were measured at baseline and end of the fifth session of treatment. Results: The within-group analysis showed a reduction in pain, improved ROM, and disability in both the study groups (P < 0.001). However, the between-group analysis reported that INIT was more effective than the control group in terms of reducing trigger point tenderness of QL (P = 0.0011) and ES (P = 0.0001) as well as reducing functional disability (P = 0.0481) but not the ROM (P > 0.05). Conclusion: The present study concluded that INIT is superior to stretching and strengthening exercises in reducing trigger point tenderness and better functionality in patients with nonspecific low back pain.

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Context: Globally, uptake of cardiac rehabilitation (CR) is low, more so in lower middle-income countries (LMICs) compared to developed nations. LMICs share a greater burden of cardiovascular diseases, and hence, there is an urgent need for enhancing CR services. Aims: The objective of this retrospective study was to describe a multicomponent strategy employed in a tertiary care hospital from an LMIC and to improve CR services and its impact on CR availability, uptake, and barriers. Materials and Methods: To ensure the CR availability and uptake, a multi-component strategy involving sensitization of all concerned health-care team members about the importance and need of CR, strengthening infrastructure and resources, laying down appropriate clinical pathways, and culturally adapting standard guidelines and protocols were put in place. For the present retrospective analysis, utilization of CR services by patients diagnosed with coronary artery disease (CAD) was extracted from the medical records of the hospital. Results: Between February 2017 and December 2017, a total of 629 patients with diagnosis of CAD underwent percutaneous transluminous coronary angioplasty (PTCA) (78%) or coronary artery bypass grafting (CABG) (22%). All patients (629) received Phase I rehabilitation (rehab) (100%), 145 patients (23%) received Phase 2 rehabilitation, and 44 patients (7%) received Phase 3 rehabilitation. Residence location, gender, dependency on caregivers, and employment status were identified as barriers to Phase 3 CR uptake. Conclusion: This multi-component strategy positively influenced CR uptake, and a few barriers were identified that need to be addressed. Clinical Implication: Importance of multidisciplinary and multicomponent strategic management to increase the uptake in a CR program.

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Context: Physiotherapy plays a significant role in health care system. The pursuit of career in physiotherapy depends largely on the information available to the students about the practice of physiotherapy. Aims: To investigate the level of awareness and perception of physiotherapy profession among senior secondary school students. Settings and Design: The cross-sectional study recruited 259 senior class students in selected secondary schools in Owo local government area of Ondo-state, South-western Nigeria. Materials and Methods: A self-administered questionnaire adapted from similar studies was used to obtain information on level of awareness and perception of physiotherapy. Statistical Analysis Used: Data were summarized using mean, standard deviation, frequency and percentiles. Results: 71.0% of participants were aware of physiotherapy profession. 76.8% were aware that physiotherapy can be studied in University while others believed it can be studied in polytechnic (3.9%), college of education (6.6%) and technical schools (5.4%). 45.9% knew about adequate subject combination for gaining admission to study physiotherapy while 54.1% did not know about adequate subject combination. The overall knowledge score of <48.0% among the participants indicated inadequate knowledge about physiotherapy practice, treatment modalities and specialties. Conclusions: Participants in this study demonstrated a high level of awareness about physiotherapy. The knowledge level of the participants about the practice of physiotherapy, treatment modalities and specialties other than orthopedic remains inadequate. Professional body of Physiotherapy should create a detailed career talk in secondary school to increase the level of awareness and knowledge about the practice of physiotherapy, treatment modalities and specialties.

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Background: Forward head posture (FHP) is the most frequently attained attitude of the head associated with rounded-shoulder posture (RSP) that leads to muscle imbalances. This needs to be corrected to prevent neck pain. Self-care exercises are home exercises that work positively for the prevention of the secondary effects of RSP. Aims: The aim of this study is to determine the effects of two self-care exercises, namely Bruegger's postural relief position and quadruped track cervical brace exercise in the management of asymptomatic FHP in terms of craniovertebral angle (CVA) and craniocervical flexion endurance (CCFE). Settings and Design: A single-group pre–post study design was conducted on physiotherapy volunteer student population of the Health Science University, Belagavi. Materials and Methods: Fifteen participants with asymptomatic FHP (<44° of CVA) were recruited. They have prescribed the two self-care exercises (Bruegger's postural relief exercise and quadruped track cervical brace exercise), twice a day for 10 consecutive days. The outcome measures were the degree of FHP in terms of CVA and strength of deep cervical flexor muscles by CCFE test that were assessed pre- (day 1) and posttreatment (day 10). Results: The mean age of the participants was 23.00 years (standard deviation = 1.56). The comparison of pre- and postintervention scores for CVA and CCFE outcomes demonstrated a statistically significant improvement (P < 0.0001). Conclusions: The two self-care exercises showed an effective reduction of CVA and increased deep cervical flexor strength in FHP. Once learned by the patients, the exercises can be self-administered and can be performed independently by the patients.

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Context: Neck problems are the second most reported musculoskeletal condition. Neck injuries and pain are the common and frequent causes of absenteeism and disability. These conditions have a negative impact on individuals' activities of daily living. Aim: The aim of this study is to compare the effectiveness of virtual reality training (VRT) along with conventional physiotherapy over conventional treatment alone on pain, range of motion (ROM), and kinesiophobia in the patients with cervical spondylosis. Setting and Design: This was a randomized control trial done at the tertiary care hospital, Pune, India. Materials and Methods: Forty-four participants were randomly allocated using the chit method to the conventional group (n = 22) and conventional plus VRT group (n = 22). VRT was given using an immersive virtual reality headset. The outcomes assessed were pain using the Numeric Rating Scale and cervical ROM (all movements) using universal goniometer and kinesiophobia. Pain and ROM were assessed on the immediate (day 1) and short-term (day 3) basis while kinesiophobia was assessed only on day 3. Statistical Analysis Used: Statistical analysis was performed using the Statistical Package for the Social Sciences software version 16.0. Results: Intragroup analysis revealed a statistically significant difference in the immediate and short-term assessment in both the groups for all the variables (P ≤ 0.05). However, intergroup analysis revealed that VRT is effective in alleviating pain in the immediate (P = 0.02) and short-term (P = 0.00) analysis and improving rotation (left rotation [ P = 0.04]; right rotation [ P = 0.01]) and side flexion (left side flexion [ P = 0.00]; and right side flexion [0.01]) ranges. The results were insignificant for flexion, extension, and kinesiophobia. Conclusion: The present study concluded that both the protocols are effective in reducing pain and improving ROM. VRT was better in reducing pain than conventional treatment on the immediate and short-term basis. However, VRT group was not effective in improving ROM on an immediate basis. Both the treatment methods were equally effective in reducing kinesiophobia.

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Background and Objectives: Prolonged forward head posture (FHP) leads to the development of buffalo hump (BH) at the base of the posterior neck, predominantly seen in females. MaRhyThe (MRT) and myofascial mobility tool (M₂T) are novel physiotherapy methods applied in various soft-tissue disorders. A dearth of literature exists about using these methods for the treatment of BH and FHP. Hence, the aim of the present study was to compare the effects of MRT and M₂T in female individuals having FHP and BH. Materials and Methods: The study was a randomized clinical trial. Twenty female were randomly allocated to Group A (n = 10) and Group B (n = 10) who received MRT and M₂T, respectively. The primary outcomes assessed included craniovertebral angle (CVA), neck circumference (NC), and skinfold measure. The secondary outcomes were cervical endurance and range of motion that were assessed on day 1 (pre) and day 10 (post). Exercise and study intervention (MRT/M₂T) were given alternately for 10 days. Results: All the primary and secondary outcome parameters analyzed at days 1 and 10 showed statistically significant results for both the study groups (P < 0.001). However, analysis between the two study groups showed no statistically significant difference for Northwick Park Neck Pain Questionnaire (P = 0.08), NC (P = 0.56), and skinfold measure (P = 0.72) except for CVA (P = 0.03). Conclusion: Both MRT and M₂T interventions were effective in reducing the BH and correction of FHP in addition to improving cervical mobility and endurance. However, MRT proved to be superior to M₂T in terms of correction of FHP and reduction of the BH.

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