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Purpose: Investigating the causes of visual loss and the best corrected visual acuity (BCVA) is crucial for identifying avoidable eye problems and planning appropriate rehabilitation and assistive technology (AT) services. The study aimed to identify various causes of vision loss and determine AT required for vision rehabilitation (VR). Methods: The electronic records of patients who attended the VR clinic at a tertiary eyecare for the past 2 years were reviewed. Information such as demographics, BCVA, and causes of visual impairment were retrieved from the records. BCVA was categorized into better than or equal to 1/60 and less than <1/60 for AT services. Results: In total, 1723 patients, mostly male (71.2%), visited the rehabilitation clinic from 2018 to 2019. Around 58.6% of patients belonged to the age group 16-49 years, whereas 25.6% were less than 15 years old. The most frequent eye problems were retinal disorders (63.5%), followed by retinitis pigmentosa (15.2%) and rod-cone dystrophy (4.7%). In contrast, congenital disorders were the most common cause of vision loss among younger groups. Approximately 36.0% of patients had <1/60 blindness and 16.6% had =1/60. Around 17.1% of patients would benefit from large prints (near vision acuity N18-N12). Conclusion: Early detection and timely management will prevent a significant proportion of patients from developing irreversible vision loss. Around one-third of patients would benefit from visual substitution AT. [ABSTRACT FROM AUTHOR]

Community Re Entry Program (CREP) is a specialized rehabilitation program for individuals with mental disorders, recovering from mental illness. This program is specifically designed to develop and integrate the skills that enable individuals to relearn the skills necessary to fully participate in activities of daily living successfully and return to home or community. [ABSTRACT FROM AUTHOR]

Objective: Preventive measures and appropriate rehabilitation are important in reducing the social burden of blindness. This study was to evaluate the etiologies, proportions, and level of rehabilitation for patients with blindness. Materials and Methods: A prospective observational study with 1000 visually impaired patients was conducted. The data regarding age, gender, socioeconomic status (SES), etiologies, curable or incurable blindness (IB), treatments, awareness, and state of rehabilitation were collected and reviewed. Results: The ratio of curable to IB was 0.82:1. The proportion of blindness rises after 40, even while the proportion of curable blindness (CB) increases after 60. The male–female ratios were 1.25:1 and 1:1.66 in the cases of CB and IB, respectively. On the other hand, the male–female ratio for childhood blindness was 1.66:1. Cataracts (78.22%) were the most common cause of CB, whereas diabetic retinopathy (24%), corneal opacity (17.5%), and trauma (12.4%) were causes of IB. Patients with illiteracy, low SES, and female gender were more likely to develop IB. There were low enrollment rates at the blind school and poor rehabilitation, mainly because of a lack of knowledge. Conclusion: Diabetic retinopathy, corneal opacity, and trauma are the major causes of IB. IB and poor rehabilitation were more profound in women and were associated with illiteracy, low SES, and a lack of awareness. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent opioid use in India has emerged as a critical public health concern, with a 2018 survey revealing 1.8% of adolescents aged 10-17 years as past-year opioid users. We present here the experiences of two cases of adolescent opioid users from a community-based drug treatment clinic in Delhi. Case Description: Case 1 involved a 17-year-old male suffering from opioid and tobacco dependence. His treatment, starting about 3 years back, showcased challenges in withdrawal management, leading to successful opioid agonist treatment (OAT), employment, and positive social reintegration over follow-up. Case 2 was a 15-year-old male with opioid, cannabis, tobacco, and volatile solvent dependence who presented about 2.5 years back to us. Despite treatment initiation in February 2021 and positive strides in OAT, employment, and cessation of injecting drug use, challenges persisted, highlighting the necessity for effective tailored interventions in managing substance use disorder in adolescents. Conclusion: Adolescent opioid use disorder can be managed in the community with OAT, though challenges of dropout do remain. [ABSTRACT FROM AUTHOR]

The current study aims to present our clinical observations and experience gathered during the diagnosis, clinical presentation, medical/surgical treatment, and functional prosthetic rehabilitation of cases of rhino-orbital/cerebral Mucormycosis patients. Mucormycosis is an aggressive, life-threatening invasive fungal infection that occurs in people who are immune-compromised. The rise of ROCM during the second wave of the COVID-19 pandemic in India suggests a more effective association between Mucormycosis and the SARS-CoV-2 delta variant. The treatment strategy for Mucormycosis is an early diagnosis which is critical for a successful outcome. The initial step is to reduce or remove underlying risk factors followed by surgical excision and debridement of the afflicted tissues supplemented with antifungal medication. The first-line antifungal treatment is Liposomal Amphotericin B. Postsurgical resection defects are rehabilitated by either removable partial prosthesis (obturators) or by fixed zygomatic implant/ patient-specific implant supported prosthesis. Management of ROCM requires a multidisciplinary approach. This case series highlights detailed medical, surgical, and functional prosthetic management modalities adopted by our team in managing such a dreaded disease which may be used as a tool for the formulation of standardized prevention and management/treatment/rehabilitation protocols in the future so that disease morbidity and mortality be reduced and an endemic outbreak could be averted. [ABSTRACT FROM AUTHOR]

Introduction: Cochlear implantation has now existed as an intervention for prelingual childhood hearing loss in our country for over two and a half decades. There is a significant need to understand the outcomes achieved in our context to promote the optimization of cochlear implant (CI) as a strategy for early intervention among children with prelingual hearing impairment. The aim of this study was to report auditory, speech-language, and educational outcomes among children with unilateral CIs in India based on the age of implantation and duration of implant use. Methods: Three primary databases (PubMed [including MEDLINE], SCOPUS, and Google Scholar) were searched using predetermined search strategies. This review included studies that described outcomes of children who underwent unilateral cochlear implantation under the age of 12 years. Studies with a minimum sample size of 10, published between 2000 and 2022 in English language, and reporting data from India were included. Cross-sectional, cohort, case–control, and randomized control study designs reporting quantitative data were considered. Results: A total of 32 studies qualified for the systematic review. The majority of studies reported that the age of cochlear implantation among their participants was between 3 and 6 years (72%). There were limited data on the postimplant timelines when sentence-level auditory comprehension and spontaneous connected speech were achieved. There was no data from any study on the integration of children with CI into mainstream schools. Factors such as prior hearing aid use, age of implantation, or duration of implantation were not taken into consideration as confounders. Conclusion: This systematic review suggests that aural re/habilitation outcomes in relation to CI are primarily limited to 1-year post-CI follow-ups. The success rate of open-set sentence/word auditory comprehension, verbal language outcomes with regard to connected speech as well as integration to mainstream education is unknown. Since the number of studies was so less, studies with high bias were not excluded based on quality evaluation. However, it is advised for readers to exercise caution when interpreting the data from these studies. In order to fully understand the value of cochlear implantation as an early intervention strategy in our country, future studies on outcomes should address these methodological flaws and restrictions, improve reporting (publications) of outcomes, conduct long‑term follow-up studies, multi-center studies, and use appropriate research designs. [ABSTRACT FROM AUTHOR]

Rehabilitation services for homeless persons with mental illness (MI), especially females, are rudimentary in India. The Mental Healthcare Act, (MHCA) 2017 of India advocates community-based living for persons with MI where the role of the police is more defined. The aim is to highlight the role of the police helping in the treatment and rehabilitation of homeless females with MI through demonstration of a series of three cases. Three cases have been described in which the patients with MI were found by the police on the street. They were brought to the hospital and engaged in treatment network by the police, who then also facilitated their rehabilitation back in the community. The three cases are an illustration of Section 100 of MHCA 2017, which defines the specific role of the police. The police was guided by the said section to work in collaboration with the treating team for the overall well-being of the patients. Adequate utilization of available resources, along with the legislation can help in the upgradation of the neglected homeless individuals with MI. [ABSTRACT FROM AUTHOR]

Background: Homeless people have difficulties in their basic necessities such as food, clothing, and shelter and they are prone to physical abuse and assault. Homeless mentally ill persons are found to have unhealed injuries and they lack help-seeking behavior, which leads to further deterioration of physical and mental health. In view of the alarming increase in this marginalized population, there is a need to understand their psychosocial needs and enhance their well-being and quality of life. The study aims to understand the psychosocial preparedness of homeless people admitted to a relief and rehabilitation center in Bengaluru. Methods: The study followed a descriptive research design with 90 participants (10% of total inmates), 45 participants each falling under the categories of homeless persons with mental illness (HMI) and homeless persons without mental illness (NMI), selected using a simple random sampling method. A semi-structured interview schedule was used for data collection. Statistics procedures used frequency distribution, mean, median, and standard deviations and inferential statistics such as the Chi-square test. Results: The results of the study show that the majority of the respondents (56% in HMI and 73% in NMI) were male, 62% in HMI and 60% in NMI were literate, 60% in HMI and 86.66% in NMI were employed before institutionalization, 73% in HMI and 69% in NMI belonged to nuclear family. The study also shows that the majority of the HMI (56%) had no plans to start work; however, the majority of the NMI (49%) had plans to start work. Mean scores indicate persons with mental illness have more psychosocial preparedness than persons without mental illness. Discussion: The results showed that there was no significant difference between the mean level of psychosocial preparedness among persons with mental illness and persons without mental illness. [ABSTRACT FROM AUTHOR]

Background: Hearing loss has an impact on the development of speech, language, and social skills in children. A cochlear implant is the best option for most of the child's communication development. Aims and Objectives: The study aimed to analyze the parental perspectives on rehabilitation services offered for pediatric cochlear implant (CI). Materials and Methods: A nonstandardized questionnaire comprising 25 items was created to understand the perspectives of parents of pediatric CI users. Questionnaire was designed in order to examine rehabilitation services such as parental stress, reasons for delay in obtaining services, sources of emotional support and parents' views of their children post-CI. The questionnaire was posed to 100 parents, and responses were recorded and coded. Results: Qualitative and quantitative analyses based on parents' responses identified several factors that significantly influenced parental perspectives during each stage. The major factors delaying the decision to go for CI included a fear of surgery, lack of funds for CI and the subsequent rehabilitation process, and limited knowledge. Key concerns were the child's academic performance and social acceptance. A significant reduction in the parental stress levels was observed following CI surgery. Conclusion: Parents indicated that local support for therapy, financial assistance, and better guidance at each stage would substantially help in lowering stress levels. [ABSTRACT FROM AUTHOR]

Background: Global health care is moving toward function, quality of life, and occupation. Occupational therapy (OT) has been the only profession using "occupation" as core intervention since inception. With advancements in intervention techniques, occupational therapists (OTs) need to ensure the continued use of "occupation" as core intervention type. Previous surveys were conducted to analyze the use of specific intervention types: occupation-based interventions (OBIs), creative activities, acute-hospital-based rehabilitation, and different interventions used in pediatric OT practice. However, information on OT practices and types of interventions used by Indian OTs versus global OTs is unavailable. Objectives: The objective of this study was to analyze differences, if any, in the OT practices and types of interventions frequently used in daily practice by Indian versus global OTs. Study Design: This was an online, survey-based, cross-sectional study. Methods: The Google Forms questionnaire link was sent to OTs on E-mail with electronic written informed consent from May 2020 to March 2021 using convenient sampling. The questionnaire included participant's demographics, 17 clinical practice areas, and 9 intervention types and factors influencing OT practice. Total 201 (84 Indian OTs and 117 global OTs) fulfilled the selection criteria: OTs with at least bachelor's degree and minimum 3 years of work experience. Results: Indian OT workforce showed significantly more male OTs than global OTs (31 [36.9%] vs. 11 [9.4%]; 95% confidence interval [CI]: [0.0236-0.2964]; P = 0.0001) and OTs with master's degree (56 [66.7%] vs. 41 [35.04%]; 95% CI: [0.1852-0.4480]; P = 0.0001). Global OTs have more OTs with additional qualifications in non-OT fields (58 [49.57%] vs. 27 [32.10%]; 95% CI: [-0.3088--0.0406]; P = 0.013) and more OTDs (13 [11.11%] vs. 1 [1.23%]; 95% CI: [-0.1641--0.0335]; P = 0.006) than Indian OTs. Indian OTs practiced significantly more in the private sector: clinic and hospital (52 [61.90%] vs. 40 [35.80%]; 95% CI: [0.1273-0.3947]; P = 0.0001), whereas global OTs practiced significantly more in the government sector (46 [39.31%] vs. 19 [22.61%]; 95% CI: [-0.2930--0.0410); P = 0.0124). Among the organizational roles, Indian OTs work significantly more as consultants (50 [50.95%] vs. 35 [29.91%]; 95% CI: [0.0751-0.3457]; P = 0.0001) while global OTs work significantly more as managers (36 [30.76%] vs. 12 [14.28%]; 95% CI: [-0.2770--0.0526]; P = 0.0069). Among patient population treated, Indian OTs majorly (54.76%) treat children (up to 15 years) but significantly more in "all age groups" (35 [41.67%] vs. 18 [15.38%]; 95% CI: [0.1388-0.3870]; P = 0.0001) while global OTs treat significantly more adults (21-65 years) (61 [52.13%] vs. 25 [29.76%]; 95% CI: [-0.3569--0.0905]; P = 0.0015) and geriatric (>65 years) (50 [42.73%] vs. 17 [20.23%]; 95% CI: [-0.3492-0.1008]; P = 0.0008). Indian OTs practice significantly more in developmental disability rehabilitation (78 [92.85%] vs. 68 [58.11%]; 95% CI: [0.2424-0.4524]; P = 0.0001), ante- and postnatal women's care (15 [17.85%] vs. 3 [2.56%]; 95% CI: [0.0662-0.2396]; P = 0.00018), and hemophiliac rehabilitation (14 [16.67%] vs. 2 [1.70%]; 95% CI: [0.0666-0.2328]; P = 0.00012) areas of practice than global OTs. Indian OTs practice significantly more in clinic outpatient department (OPD) (62 [73.80%] vs. 55 [47%]; 95% CI: [0.1375-03985]; P = 0.0001), hospital OPD (40 [47.61%] vs. 27 [23.07%]; 95% CI: [0.1141-0.3767]; P = 0.0002), and inpatient (37 [44.04%] vs. 30 [25.64%]; 95% CI: [0.0516-0.3164]; P = 0.0006) while global OTs practice significantly more in natural environment settings (53 [45.29%] vs. 24 [28.57%]; 95% CI: [-0.2994--0.0350]; P = 0.016). Most preferred types of interventions among both groups are relatively the same: client education, counseling, and consultation and interview; therapeutic relationships; and therapeutic use of self. Besides these, Indian OTs prefer performance skills training and adaptive interventions, while global OTs prefer activities as therapeutic media and OBIs over other types. Preventive interventions and advocacy were the least preferred types of intervention among each group. Despite these relative preferences, significant differences were found between groups with regard to number of OTs practicing these 5 types of interventions: client education, counseling, and consultation (46 [54.76%] vs. 47 [40.17%]; 95% CI: [0.0073-0.2845]; P = 0.04]; performance skills training (41 [48.80%] vs. 34 [29.05%]; 95% CI: [0.0626-0.3324]; P = 0.004); preventive intervention and health promotion (29 [34.5%] vs. 24 [20.51%]; 95% CI: [0.0148-0.308]; P = 0.026]; adaptive interventions (39 [46.42%] vs. 23 [19.65%]; 95% CI: [0.1390-0.3964]; P = 0.001]; and preparatory interventions: (35 [41.67%] vs. 28 [23.93%]; 95% CI: [0.0467-0.3081]; P = 0.0075). Conclusion: The study provides the current stand for preferences and practices of therapeutic interventions by OTs in India versus globally, thus aiding in repositioning of OT practice, focusing on core OT domains as well as providing a baseline for monitoring practice trends over time. [ABSTRACT FROM AUTHOR]

Background: Occupational therapy (OT) enhances functional independence in the daily activities of people with disabilities and subsequently their quality of life. Research in OT generates evidence to provide safe and effective services to the disabled. However, OT research in India has been shown to have various methodological limitations. These methodological limitations are expected to impact the quality of OT research as well as the evidence derived from this research to inform decision-making in rehabilitation. The majority of the OT research is disseminated and promoted through the All India Occupational Therapists' Association's (AIOTA) annual national conference (ANC). Analyzing the abstracts, selected for the presentation at the ANC could help understand and strategically improve the quality of OT research in India. Objectives: To explore and describe the quality of OT research in India. Study Design: Descriptive analysis. Methods: Descriptive, nonsystematic review and analysis of the key methodological aspects of the conference abstracts submitted for the AIOTA ANC published in the Indian Journal of OT (IJOT) from 2017 to 2021 was carried out. Information related to the methodological aspects of the research abstracts was extracted using a data extraction form and the data were synthesized and reported descriptively. Results: About 218 abstracts had been selected for either poster or oral presentations in the AIOTA ANC. All the abstracts were included for the review. A total of 8055 participants were recruited for the studies conducted from 2017 to 2021. About 5757 (72%) of the participants were recruited for cross-sectional studies. Nearly 72 (33%) of the abstracts presented were related to cross-sectional studies, 52 (24%) were case studies and 66 (30%) were experimental studies. However, research designs implying highest level of evidence such as systematic reviews were only 4 (2%) and randomized controlled trials were only 9 (4%) with 297 participants. Notably, 203 (98%) of the all the studies evaluating effectiveness of interventions or aiming to investigate associations reported positive results with statistically significant improvements and associations. Conclusion: The review provides invaluable information related to the quality of OT research in India. It implies the need to improve the scientific rigor of the evidence generated in relation to OT research in India. This review also implies the need for a radical change and strengthening of OT research within OT education and professional practice in India. National and global OT associations need to prioritize good quality OT research by enhancing the research skills and competencies of OTs in India. This could help promote evidence-based OT science and develop the OT profession in the world's second-most populous country. In addition, it is also expected to encourage those OT researchers who have been striving to build OT research standards in India. [ABSTRACT FROM AUTHOR]

Background: Occupational therapists are considered an important workforce for the rehabilitation of persons with disabilities globally. However, in India, the profession is just beginning to gain recognition within the national and state-level systems for health care. One of the reasons for this could be the paucity of specific research related to the development of occupational therapy (OT) and its benefits to the health systems. Therefore, it is of immense public health importance to explore the priorities and gaps in OT research in India. A vast majority of the OT research in India is promoted and disseminated through the All-India Occupational Therapists Association (AIOTA) and its annual national conference (ANC). Objectives: The objective of this study is to descriptively review the conference abstracts of the AIOTA ANC published in the Indian Journal of OT (IJOT), an official publication of the AIOTA, from 2017 to 2021. Study Design: The study design was a descriptive, nonsystematic review. Methods: Review of the abstracts selected for the AIOTA ANC published in the IJOT from 2017 to 2021. A data extraction form was developed and used to synthesize data related to the clinical and demographic characteristics of OT research in India. Results: The search yielded 218 abstracts. State-level trends indicated that close to 85% of the research submissions were from four states and no submissions from the northeastern states until 2020. Nearly 60% of the abstracts were clinical research with OT interventions. About 40% of these research abstracts were related to pediatrics, followed by neurology (17%), musculoskeletal (15%), mental health (10%), and ergonomics and assistive technology (8%). There were 1%-2% of research abstracts submitted related to coronavirus disease-2019 (COVID-19) and geriatrics. About 85% of the research abstracts were related to impairment (39%), activity limitation (26%), and social participation (22%). Conclusion: This review highlights the need for diversifying the research in OT in India. This is particularly important in relation to expanding from selected states to pan-India research and development, especially in the northeastern states. Furthermore, the focus of OT research must move beyond impairments and approach disability from the biopsychosocial perspective. It is also very important to diversify the research in OT to areas that are of public health importance such as COVID-19, geriatrics, noncommunicable diseases, and rehabilitation in health systems. Priority setting for research in OT in India is an important implication of this review. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic and the subsequent lockdown declared by the Indian Government in March 2020 lead to an unexpected turn of events for many, causing a huge psychosocial impact on them. Methodology: The study focused on evaluating a family from Kerala with major language difficulties and the distress being faced by them during their stay in the government provided shelter home in Delhi. The family was assessed by the multidisciplinary team from the Institute of Human Behavior and Allied Sciences visiting various shelter homes across the state. The study was aimed to assess the importance of psychological first aid (PFA) on the individual and the family in distress. Results: The family was assessed by the student counselor, who was well versed in their native language Malayalam. They were able to connect well, and hence, an appropriate psychosocial intervention was provided to them under the guidance of her supervisor. The family was highly distressed and had almost developed xenophobia. They were very happy to get a Malayalam-speaking counselor and were provided with all possible support. The authorities were also explained about their specific needs, which was not possible earlier due to the language barrier. They were ultimately successfully integrated with the other residents and returned to their home state, i.e., Kerala. Conclusion: Although PFA is definitely not a substitute for mental health care, ample research and experience has shown that it is a useful tool to assist people in acute distress when applied with a truly professional yet sensitive, empathetic approach. [ABSTRACT FROM AUTHOR]

Background: In India, about 50% of all childhood blindness is either preventable or treatable. Hence, controlling childhood blindness may be an effective way to reduce blindness in this country in the long run. Strategies to combat childhood blindness require accurate data regarding its magnitude, distribution, and determinants in a population. In this regard, district disability rehabilitation centres (DDRC) are working in India to diagnose and rehabilitate the subjects with blindness of various degrees. Objectives: The objectives of the study are to estimate the proportion of childhood blindness among the visually challenged subjects registered under the DDRC of West Tripura district, to find out the different ocular morbidities in this population and to study the factors associated with these disabilities. Materials and Methods: This facility‑based cross‑sectional study was conducted using secondary data from 2,260 visually challenged subjects enlisted in the DDRC of West Tripura district of India from June 1, 2018, to May 31, 2020. Results: The proportion of childhood blindness was found to be 3.89% (88) among the visually challenged subjects catered by the DDRC of West Tripura district. About 68.18% of the study subjects belonged to the lower socio‑economic class as per BG Prasad’s socio‑economic classification, 39.77% subjects had 30% blindness and 15.90% subjects had 100% blindness. Among these 88 cases (134 eyes) of blindness, 20.14% were refractive error, 7.50% corneal opacities, 12.68% phthisis bulbi, 3.73% congenital cataract and pseudophakia, 2.98% congenital glaucoma, 23.88% congenital globe anomalies, 8.20% retinal diseases, 11.94% nystagmus and 8.95% were due to miscellaneous causes. Conclusion: Childhood blindness is still a public health problem in this part of India. Congenital globe anomalies were found to be the commonest cause followed by refractive errors. [ABSTRACT FROM AUTHOR]

The current practice for low vision management in India exclusively focuses on clinical aspects without much of the rehabilitation components. While making all efforts to improve independent living skills, daily living activities, and quality of life as a whole for people living visual disabilities, vision rehabilitation is an indispensable component. There is no single appropriate low vision and rehabilitation model implementable at health care institutions in the country to cover these fundamental aspects of a visually impaired individual. We did a literature review to know the existing practices of low vision and various disability models. The purpose of the review is to discern any pitfalls and shortcomings in managing visually disabled in India and to underpin the credibility and feasibility as well as suitability of the developed model. The review was done using search key terms low vision, current practices, visual disability, disability models, vision rehabilitation, and service delivery. Therefore, the article discusses the development of an inclusive low vision management model name as "Clinico-Social Model", which we consider the most appropriate for the best management of people with vision loss. The primary aim of this model is to provide both clinical and vision rehabilitation components of management for people with visual disabilities. Such an approach is likely to have the potential to improve the quality of life of people with vision loss and can provide practical guide to eye care managers across India. Given the specific context in the current practices of low vision in India, it is desirable to design a similar model to care for the visually disabled. [ABSTRACT FROM AUTHOR]

Background: The prime concern for an individual with disability is independence. Self-help groups (SHGs) provide opportunities for those with such needs. Objectives: The objectives of the study were (i) to assess the impact of SHGs on the livelihood, social inclusion, and community participation of those with disability and (ii) to evaluate the self-esteem and assess the role of such SHGs among those with disability. Materials and Methods: This was a community-based, cross-sectional study. An interview schedule captured responses to standardized questionnaires (community-based rehabilitation assessment tool, Rosenberg's self-esteem score, and Social Inclusion Scale). Responses were scored and compared among the two groups of those with disability (member or nonmember of SHGs). Results: The median scores for all our outcome variables were found to be more among those with disabilities enrolled in SHGs than those who were not with a significant association in the component of empowerment, sociocommunity participation, social inclusion, and self-esteem. Conclusion: SHGs improve social and community participation of individuals with disability. It empowers them to lead independent lives and also contributes to social inclusion. [ABSTRACT FROM AUTHOR]

The article focuses on the fundamental concern of mental health care in India is the gap between demand and services. It mentions that poverty, poor awareness, and stigma are other factors that affect clinical practice. It also mentions that psychiatric practice in India has been studied by various investigators over the years.

Context: Schizophrenia is a major psychiatric illness that is stressful for both patients and their families. Along with clinical improvement with medications, psychosocial rehabilitation is an essential part of treatment to improve functioning and quality of life. Aims: This study aims to assess the rehabilitation needs of patients with schizophrenia and to identify the association of these needs with demographic and clinical variables. Settings and Design: A cross-sectional descriptive design was used. The study was conducted in a general hospital psychiatric unit (GHPU) of a tertiary care teaching hospital. Subjects and Methods: The sample included 770 subjects (385 patients and 385 caregivers). A standardized self-administered questionnaire, the Rehabilitation Needs Assessment Schedule was used to assess the patients' rehabilitation needs. Statistical Analysis Used: Categorical variables were expressed as frequencies and percentages. Continuous variables were expressed in terms of mean with standard deviation or median with an interquartile range. The association between different rehabilitation needs was analyzed using the Chi-square test or Fisher's exact test. Results: The most common requirement was skill training rehabilitation needs (93.8%), followed by psychosocial modification rehabilitation needs (88%) and help for family members (87%). There were significant associations (P < 0.05) between age at onset of illness with employment, current living status with overall needs, and help needed by the family. Conclusion: The study found that 76.9% of the patients required help in at least one rehabilitation domain. The findings of the study have implications in planning and implementing rehabilitation programs. [ABSTRACT FROM AUTHOR]

Introduction: Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life. However, such psychosocial rehabilitation centers are limited in India. Aims: The present study assesses psychosocial rehabilitation centers (of urban day-care and rural residential rehabilitation center) operated by Ashadeep Charitable Foundation, a civil service organization and its effect on health outcomes of patients living with chronic mental illness. Materials and Methods: Records of 170 cases were retrieved for secondary analysis of demographic information, diagnosis, duration of stay, and health outcomes. Results: Rehabilitation activities included yoga, light physical exercises, group discussion, training for daily living skills, social skills, life skills, vocational training, individual, and family counseling. In addition, extensive outreach activities, mental health camps were also integral part of the rehabilitation activities. Patients who have accessed rehabilitation services were diagnosed with schizophrenia, psychosis, bipolar disorder, depression, and intellectual disability. The average duration of rehabilitation of patients (other than persons with intellectual disability) was ranged from three to four months. Out of those rehabilitated, 69% of them were successfully re-integrated with the family. Conclusion: Combination of pharmacological and psychosocial interventions are effective for re-integrate patients with mental illness to the family. This model of community-based rehabilitation has potential for scale-up. [ABSTRACT FROM AUTHOR]

Background: This study was carried out to assess the reach of medico-social and economic programs to the silicosis victims in Karauli. The district is infamous for large-scale unregulated sandstone mining, a pulmonary hazard, causing silicosis, a debilitating occupational disease compensable under Indian laws. Methodology: A sample of 250 silicosis cases from 38 villages were randomly recruited and interviewed from four different sites. Results: The study reports that 99% of sandstone miners came from marginalized poor communities, had large families, and lived in mud houses. Victims' linkage to their entitlements and welfare programs was poor (51%). Victims (43%) continue to work as casual laborers including in mining sector due to economic compulsions. Greater than 68% of the laborers were wrongly treated for tuberculosis (TB) prior to their diagnosis, >50% go out of the state or cities for better treatment, and 60% of cases had not received their compensation from the government. Among those who received compensation, only 4% spent money for productive purposes and 44% victims were not in a position to work due to health difficulties. Conclusions: Silicosis has affected the poorest of the poor; victims are wrongly diagnosed and treated for TB. The district is not equipped to deal with the health problems of the victims, forcing them to seek treatment in other states and cities. In conclusion, the impact of rehabilitation programs in the district is ineffective and inadequate and has limited reach. Findings of the study will have far-reaching implications for informed policymaking on the rehabilitation of silicosis victims in the state. [ABSTRACT FROM AUTHOR]

Background: Demonstrated multidisciplinary, scalable, and replicable panchayat models for effective inclusion of persons with disabilities (PwDs) are much needed in a developing country like India, with its 70% of population being rural. Literature on disability suggests a shift in policy thinking from the charity-, medical-, and institutional-based models of disability to social, community-based rehabilitation (CBR), and rights-based models. This study explored in-depth the Community-Based Inclusion and Rehabilitation (CBIR) program model of the Chinmaya Organisation for Rural Development (CORD), a nongovernmental organization working with 1800 PwDs in 100 panchayats of Kangra district of Himachal Pradesh. Objectives: The objectives were to identify PwDs with all types of disabilities in ten selected panchayats associated under the CORD's CBIR program as per the definitions of disabilities under the PWD Act, 1995, and the National Trust Act, 1999, and to explore multidisciplinary, scalable, and replicable aspects and interventions under the CBIR as a model for inclusion of all types of PwDs in rural India with reference to the World Health Organization's (WHO's) CBR matrix. Study Design: This is a descriptive, qualitative, and quantitative study conducted on the CORD's CBIR model with reference to the WHO's CBR matrix. Methods: A convenient sample of ten panchayats out of 100 panchayats under the CORD's CBIR interventions was studied. The principal investigator with a team of two co-researchers and five field facilitators worked as a team to conduct this study. A baseline format with reference to the WHO's CBR matrix was developed and administered for the collection of primary data besides related interviews of PwDs, their families, and related stakeholders. The CORD's CBIR program data, narratives, and focus group discussions were used to supplement the outcomes of this study. Results: This study observed that availability of disabilities specific, disaggregated and recorded government data on PwDs at the panchayat level was poor and non-existent. Primary data of 124 (100%) PwDs among the 4487 households with a total population of 22,438 in ten panchayats were collected and further investigated from April 2017 to March 2018. The findings highlighted 87 (70%) PwDs newly identified during the study, 60 (48%) PwDs below poverty line, and 113 (91%) marginal and socially backward PwDs. The program interventions enrolled 26 (21%) PwDs in schools, 72 (58%) mothers and women with disabilities in community groups, and 44 (35%) PwDs in productive livelihoods locally. Conclusion: There was evident marginalization of PwDs in multiple ways varying from data to dignity issues at the panchayat level. The CORD's CBIR model promotes the "empowering inclusion and development" of PwDs in the mainstream community at the panchayat level. The recent enactment of the comprehensive Rights of Persons with Disabilities Act 2016, covering 21 types of disabilities, further share an opportunity for effective inclusion of PwDs within the existing policies, programs, and development agenda in rural India as well as globally. [ABSTRACT FROM AUTHOR]

Purpose: To explore the knowledge of retinopathy of prematurity (ROP) and habilitation services for children with visual loss from ROP, among health care professionals (HCPs) involved in care of preterm children and to explore their attitudes and practices in relation to referral for habilitation.Methods: A modified knowledge, attitude and practice questionnaire were administered to ophthalmologists and paediatricians associated with ROP care. Data were collected about their knowledge, beliefs and practices of ROP and referral to rehabilitation facilities. Data were analysed to establish level of knowledge, type of attitude and practices and its association with speciality.Results: Response rate was 78% (25/32). Most (14/25, 56%) were ophthalmologists. All (100%) participants knew that ROP can cause blindness. Knowledge about Indian ROP screening criteria was poor among a third (8/25, 32%), more so in paediatricians (5/11, 45.5%). Most (21/25, 84%) did not have knowledge of what a habilitation service entails and where such facilities are located. More than two-thirds (18/25, 72%) believed that special education should be preferred over inclusive education. Overall, 10/25 (40%) of the HCPs had never referred a child for rehabilitation. More than a half (13/25, 52%) were not confident of counselling parents of blind children. All agreed that rehabilitation services are not part of but should be included in medical curriculum.Conclusion: Indian guidelines for ROP screening are not universally known among HCPs. Educating medical undergraduates, providing counselling training to professionals and integration of rehabilitation into the health system will ensure continuity of care for children with visual loss and their families. [ABSTRACT FROM AUTHOR]

The prevalence of mental health problems in older adults is increasing globally as well as in India due to population ageing. Mental Healthcare Act (MHCA) 2017 has a rights-based approach and came into force in India in May 2018. Its provisions have significant implications for promoting mental health care and protecting the rights of persons with mental illness (PMI). Older adults with mental health problems such as dementia have a high risk for loss of mental capacity, abuse, violation of their rights, and institutionalization. This act advocates the development of specialized clinical services for the older adults in mental health care institutions. It also recognizes the rights of PMI to access a range of services required, including rehabilitation services. Several provisions of the act, such as those related to mental capacity, advance directive, nominated representative, and responsibilities of other agencies, have specific challenges related to older adults with mental illness. In this article, we present a critical appraisal of the implications of MHCA 2017 in the context of the care of the older adults with mental illness. [ABSTRACT FROM AUTHOR]

Background: Rehabilitating disabled child maximizes functional independence, thereby, enhancing the quality of life and better community participation. Utilization of rehabilitation services is a significant issue in developing countries like India. This study aims to observe the pattern of utilization of institutional rehabilitation services by pediatric patients with disability. Methods: This was an observational study (descriptive cross-sectional study) conducted at Department of Physical Medicine and Rehabilitation in a tertiary care set-up. Descriptive data from an ongoing study involving children with and without developmental delay (DD) over 1 year were collected in terms of age, gender, distance from the institute, diagnosis, and frequency of visit. Utilization pattern for rehabilitation services among pediatric patients was analyzed with respect to diagnosis and frequency of visit under each diagnosed category. The demographic variable of age, gender, and distance from the institute was further correlated to frequency of visit. IBM SPSS statistics 22 was used for descriptive statistical analysis and correlation of variables. Results: Of 464 disabled children using rehabilitation service, data for 399 (M: 255, F: 144) children were complete with age ranging from 3 months to 18 years and distance from 1 km to 600 km from institute. There were 330 children with DD and 69 in non-DD category. Two hundred and sixty-eight cases used one-time consultancy, 86 preferred intermittent services, and 45 patients were regular. Negligible correlation with a trend toward negative values was observed between frequency of service utilization and distance (Rho = −0.139 Sig. = 0.006, at 0.01 level) and between age and utilization frequency (Rho = −0.074, Sig = 0.140). Conclusions: The study showed that children with DD were main utilizers of rehabilitation services. Nearly 67% of disabled children utilized services only once with a trend toward younger age group and those nearer to institute were noted. [ABSTRACT FROM AUTHOR]

Period of Custodial Care Only: The magnificent "Institute of Mental Health" has its history almost from 1795 when the East India company appointed Surgeon Valentine Conolly to be in charge of a "House for accommodating persons of unsound mind." After a few transitions, backed by a government order for the construction of a lunatic asylum in a 66 1/2 acre site, the asylum started functioning from 1871. The period of about six decades from its inception could be referred to as "the period of custodial care." However, the quality of care for the general medical problems gradually improved with the creation of separate facilities for some common ailments and also one for seriously ill. Separate wards were also conceptualized for criminal patients and female inmates. Towards Modern Comprehensive Patient Care: Thanks to Government sanctions, the staff strength gradually increased with regularization of bed strength to 1800, and by 1948-1957, the hospital had 14 medical officers and a host of other staff. The period from 1939 to 1948 witnessed the introduction of electroconvulsive therapy and insulin coma therapy including the modified one and also insulin histamine therapy. During the prephenothiazine era, the drugs used were barbiturates, paraldehyde, opiates, and Rauwolfia serpentina, which were discontinued after the use of Chlorpromazine from 1954. Psychosurgery was also undertaken in selected cases from 1948, but the procedure went out of vogue soon due to the quality of outcome being poor and development of complications. Rehabilitation of patients got a fillip with the introduction of occupation therapy in 1949 and industrial therapy center in 1970. Extension of psychiatric services to general hospitals began from 1949. Advances in Academic Spheres And Research Activities: Regular training was imparted to paramedical and undergraduate medical students from 1948. The institute had the privilege of hosting the Annual National Conference of Indian Psychiatric Society - 1957. The institute also spearheaded in several pioneering researches such as insulin coma therapy, syphilis, and Alzheimer's dementia, to name a few. The pivotal role played by the State Psychiatric Institutes in patient care, training, and research, should speak for adequate empowerment of these government institutes. [ABSTRACT FROM AUTHOR]

Auditory brainstem implantation (ABI) can provide auditory stimulation in cases where cochlear implantation is contraindicated. The purpose of this study was to assess the development of auditory, speech, and, language skills of Indian paediatric ABI recipients. Five children between January 2009 and April 2012, with ages ranging from 13 to 94 months received an auditory brainstem implant. The auditory, speech, and, language development of the participants were assessed using formal and informal assessment tools, at regular intervals up to 36 months after activation of audio processor of the ABI. All these participants attended post-operative auditory habilitation sessions. There was an improvement in all the participants in terms of auditory perception, speech intelligibility, and, receptive and expressive language scores over time, although none achieved maximum scores on any test. Only three participants were assessed beyond the 12-month interval. The development stagnated after the habilitation program ended. Informal assessment (AuSpLan) gave a detailed information regarding development of the participants in these three domains. Auditory brainstem implantation provided access to sounds in environment and supported development of auditory, speech, and language skills in paediatric recipients. Informal assessment tools provided a more nuanced and complete picture of development than formal tests alone, and could be a valuable addition to the test batteries. The auditory habilitation professionals should consider the skills and needs of an ABI recipient, prior to choosing an appropriate communication approach for habilitation. Further aspects to be considered include extending the post-operative habilitation support for longer duration and/or; developing an effective home-training program to maximize benefit from an auditory brainstem implant. [ABSTRACT FROM AUTHOR]

Epilepsy is a common neurological disorder whose consequences are influenced socially and culturally, especially in India. This review (second of the two part series) was carried out to understand the social impact and economic burden to develop comprehensive program for control and prevention of epilepsy. Epilepsy is known to have adverse effect on education, employment, marriage, and other essential social opportunities. Economic burden associated with epilepsy is very high with treatment and travel costs emerging as an important contributing factor. A vicious cycle between economic burden and poor disease outcome is clear. There is no significant change in the perception, stigma, and discrimination of epilepsy across the country despite improvement in educational and social parameters over the time. The huge treatment gap and poor quality of life is further worsened by the associated comorbidities and conditions. Thus, a multidisciplinary response is needed to address the burden and impact of epilepsy which calls for an integrated and multipronged approach for epilepsy care, prevention, and rehabilitation. Service delivery, capacity building, integration into the existing program, mobilizing public support, and increasing public awareness will be the hallmarks of such an integrated approach in a public health model. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a chronic progressive disease which is one of the leading causes of handicap in young subjects. The large range of symptoms associated with MS lead to continuing decline in neurologic status and quality of life. The coexistence of physical and cognitive impairments, together with the imprevisible evolution of the disease makes MS rehabilitation very challenging. The main objective of rehabilitation is, therefore, to ease the burden of symptoms by improving self-performance and independence. Inpatient, outpatient and Home rehabilitation with multidisciplinary team has been shown to be beneficial in improving disability. Individualized programs elaborated by a multidisciplinary team of experts are the key to success of rehabilitation. Family plays a big role and Family Based Rehabilitation will be important in long term rehab program in MS. [ABSTRACT FROM AUTHOR]

Women, the fair sex, are principal providers of care and support to families. But, they are considered to be the weaker sex and one of the most powerless and marginalized sections of our society. The provision of Rehabilitation for mentally ill women has been, and still is, one of the major challenges for mental health systems reform in the last decades, for various reasons. The present paper discusses the global and Indian scenario of rehabilitation of mentally ill women and goes on to detail the contribution of the state and voluntary agencies in this regard. It explores the need of recovery, multilayered strategy of Rehabilitation services and the availability of present services. The stigma attached and legal defects which interfere in good quality of life for the mentally ill women are reviewed. Strategies for changes in future are recommended. [ABSTRACT FROM AUTHOR]

Background: Fatigue contributes significantly to the morbidity and affects the quality of life adversely in Guillain-Barre Syndrome (GBS). Objective: To determine the prevalence of fatigue in GBS in neurological rehabilitation setting and to study its clinical correlates. Materials and Methods: We performed secondary analysis of data of patients with GBS admitted in neurological rehabilitation ward of a tertiary care centre, recorded at both admission and discharge. Assessment of fatigue was done by Fatigue Severity Scale (FSS), disability-status by Hughe's Disability Scale (HDS), functional-status by Barthel Index, anxiety/depression by Hospital Anxiety Depression Scale, sleep disturbances by Pittsburgh Sleep Quality Index and muscle weakness by Medical Research Council sum scores. Results: A total of 90 patients (62 men) with mean age 34 years (95% CI 32.2, 37.7) were included. Median duration of, stay at neurological rehabilitation ward was 30 days, while that of symptoms was 18.5 days. Presence of fatigue at admission (FSS ≥ 4 in 39% patients) was associated with ventilator requirement (P = 0.021) and neuropathic pain (P = 0.03). Presence of fatigue at discharge (FSS ≥ 4 in 12% patients) was associated with disability- HDS (≥3) (P = 0.008), presence of anxiety (P = 0.042) and duration of stay at rehabilitation ward (P = 0.02). Fatigue did not correlate with age, gender, antecedent illness, muscle weakness, depression and sleep disturbances. Conclusion: Fatigue is prevalent in GBS during early recovery phase of illness. Despite motor recovery fatigue may persist. Knowledge about fatigue as burden of disease in these patients will improve patient care. [ABSTRACT FROM AUTHOR]

Purpose: Blindness is a devastating condition with psychosocial and economic effects. The shortcomings result in a burden to the blind person, the family and society. Rehabilitation of the blind can transform their lives. The aim of this study was to assess the "change-readiness" of the blind to undergo a "change-management." Materials and Methods: The study was a semi-structured pre-tested questionnaire-based study of 50 blind subjects in a medical college hospital. The blind participants were assessed for depression using the Beck Depression Inventory II, for the perceived effect of blindness on family, social life and occupation. The participants were counseled to undergo psychiatric management, vocational training, use blind aids and learn Braille. The willingness of the participants with reasons was assessed using a verbal analogue scale. Pearson Chi-square test, ANOVA and the t-test were used for statistical analysis. Results: Over two-thirds of the subjects were depressed. Family life, social life and occupation were perceived to be affected by 44%, 66% and 74%, respectively. Change-readiness scores were low for low vision and blind aids, vocational training, psychiatric management, change of job and learning Braille. The low score was due to the associated taboo, dependence, lack of skills, embarrassment, etc., The most valuable feature was the family cohesiveness. Conclusion: The results suggest that there is a need to modify health policy to include blind rehabilitation, to improve visibility of blind rehabilitation centers, to include family members and co-professionals while managing the blind so that we treat the "blind person" and not a "pair of blind eyes." [ABSTRACT FROM AUTHOR]

Background: Occupational therapy (OT) research in India has been shown to have various methodological limitations. This can subsequently impact the quality of research as well as on the evidence derived from this research to inform decision making in health care. The majority of the OT research is disseminated through the All-India Occupational Therapists Association's annual national conference (ANC). Analyzing the abstracts, selected for the presentation at the ANC could help understand the quality of OT research in India. Objectives: The objective of the study is to assess the quality of occupational therapy research in India. Study Design: A descriptive analysis Methods: Descriptive, non-systematic review and analysis of the key methodological aspects of the conference abstracts of the AIOTA ANC published in Indian Journal of OT (IJOT) between 2017 and 2021. Results: About 218 abstracts have been selected for either poster or oral presentations in the conference. In the total abstracts selected for the ANC, 8055 participants were recruited for the studies conducted between 2017 and 2021. 72 % (5807) of the participants were recruited for cross-sectional studies. 33% of the abstracts presented were related to cross-sectional studies, 24% were case studies and 30% were experimental studies. However, there were 4% of randomized controlled trials with 297 participants and 2% were systematic reviews that constitute the peak of the evidence pyramid. Positive results were reported with statistically significant improvements and associations in 98% of the studies evaluating the effectiveness of interventions or aiming to investigate associations. Conclusion: The review provides invaluable information related to the quality of occupational therapy research in India. The positive results reported in 98% of the intervention and correlational studies, imply potential reporting bias and methodological flaws in the conduct. Only four percent of the studies in this review had a design that could inform evidence, imply a radical change and strengthening of OT research as well as prioritization of research within OT education and professional practice in India. Funding: This work was supported by the DBT/Wellcome Trust India Alliance Fellowship [grant: IA/CPHE/16/1/502650], awarded to Dr. Sureshkumar Kamalakannan. [ABSTRACT FROM AUTHOR]

Background: Rehabilitation care is vital for patients having debilitating illness. There is a need to deepen the reflection on post corona virus disease 2019 (COVID-19) complications, assess the role of occupational therapists in the healthcare system in India, and develop guidelines to form standards of safety and ethical practice of occupational therapy in post COVID-19 rehabilitation. Objectives: The study aimed to conduct a survey to assess the role of Occupational therapy practice in post COVID-19 rehabilitation among occupational therapy professionals in India. Study Design: Cross sectional survey study design was used. Methods: A survey was conducted amongst occupational therapists practicing in India having a minimum work experience of 2 years and more. Selection of the participants was as per the inclusion criteria. Administration of online survey through Google Forms was done on the identified subjects. Prior to administration of the survey, the healthcare professionals were overviewed about the purpose of the study and prior consent was taken, following which the Google Forms link were sent to them. Data collection and interpretation of the obtained data was done. Results: One hundred and two (n=102) occupational therapists (mean= 34.52, 1± 9.73) participated in the study. 77.5 % indicated tiredness/fatigue as the major problem faced by post covid-19 patients. 82.4% suggested occupational therapy functional assessment as a major assessment tool. Occupational therapy approaches to intervention: In ICU/ Acute post covid-19 patients: 83.3% mentioned relaxation techniques, following discharge: 77.5% mentioned advice on management of breathlessness, fatigue, out-patient settings: 80.4% said to encourage engagement in meaningful occupations, physical activity, relaxation to promote well-being and reduce symptoms of mental health. Expected occupational therapy role in view of post COVID-19 rehabilitation: 79.4% have suggested remedial services and restorative care. Conclusion: The study concludes there is future expected occupational therapy role in the management and long-term rehabilitation of post covid-19 patients. [ABSTRACT FROM AUTHOR]

Background: The majority of the Occupational Therapy (OT) research in India is disseminated through the All India Occupational Therapists Association's Annual National Conference (ANC). Analyzing the abstracts, selected for the presentation at the ANC could help identify the research priorities for OT in India. Objectives: The objective of the study is to assess the trends in Occupational therapy research in India. Study Design: Descriptive analysis and non-systematic review. Methods: Descriptive, Non-systematic Review and analysis of the conference abstracts of the AIOTA ANC published in Indian Journal of OT (IJOT) between 2017 and 2021. Results: 218 abstracts were identified from the ANC abstract publications between 2017 and 2021. State level trends indicated that close to 85% of the research submission were from Maharashtra (49%), New Delhi (15%), Karnataka (10%), and Tamil Nadu (9%). We did not find any submission from the North-eastern states until 2020. About 40% of these research abstracts were related to Paediatrics, followed by neurology (17%), Musculoskeletal (15%), mental health (10%), ergonomics and assistive technology (8%). There was only 1-2% of research abstracts submission related to COVID-19 and Geriatrics. Close to 60% of the abstracts were clinical research with occupational therapy interventions. About 85% of the research abstracts were related to impairment (39%), activity limitation (26%), and participation (22%). Conclusion: This review highlights the need for diversifying the research in occupational therapy in India. This is particularly important in relation to expanding from selected states to a pan India research and development, especially including the north-eastern states. Also, the focus of OT research must move beyond impairments and approach disability from the social model perspective. It is also very important to diversify the research in occupational therapy to areas contributing substantial disability-adjusted life years such as COVID-19, geriatrics and non-communicable diseases. Priority setting for research in occupational therapy in India is an important implication of this review. [ABSTRACT FROM AUTHOR]

Background and Purpose: The purpose of this study was to assess the effectiveness of modified constraint induced movement therapy (m-CIMT) in stroke subjects. Materials and Methods: A total of forty sub-acute stroke subjects were randomly assigned to either a m-CIMT (n = 20) or in a control group (n = 20). The m-CIMT group (14 men, 6 women; mean age = 55.2 years) consisted of structured 2 h therapy sessions emphasizing affected arm use, occurring 5 times/week for 2 weeks. A mitt was used to restrain the unaffected arm for 10 h/day for 2 week. The control group (11 men, 9 women; mean age = 56.4 years) consisted of conventional rehabilitation for time-matched exercise program. The outcome measures were evaluated at pre- and post-intervention by using the Wolf Motor Function Test (WMFT) and Fugl-Meyer assessment (FMA) of motor recovery after stroke. Results: After intervention significant effects were observed in m-CIMT group on WMFT (pre-test and post?test score was 28.04 ± 6.58, 13.59 ± 2.86; P =0.003). Similarly on FMA (pre- and post-test score was 31.15 ± 6.37, 55.7 ± 6.4; P = 0.00). Conclusion: There is a significant improvement in upper extremity function so it indicates that m-CIMT is effective in improving the motor function of the affected arm in stroke subjects. However, its long-term effect has not proved since there was no follow-up after intervention. [ABSTRACT FROM AUTHOR]

Background and Objective: Evidence supports the use of pulmonary rehabilitation in the treatment of chronic obstructive pulmonary disease (COPD) patients both during acute exacerbation and at later stages. It is used in India; but, to date, there has been no study that has investigated the structure of pulmonary rehabilitation programs for COPD patients in India. The recent study aims to determine the current practice patterns of Indian Physiotherapists for COPD patients admitted in Intensive Care Units (ICUs) and wards in terms of assessment and treatment. Materials and Methods: A questionnaire-based survey was conducted across India. Questionnaires were distributed to around 800 physiotherapists via E-mail. Physiotherapists with a Master Degree and a specialization in cardiopulmonary science or a minimum of 1 year of experience in treating cardiopulmonary patients were included. The questionnaires addressed assessment measures and treatment techniques given to COPD patients. Results: A total of 342 completed questionnaires were received, yielding a response rate of 43.8%, with a majority of responses from Karnataka, Maharashtra and Gujarat. The assessment and treatment techniques used were almost similar between ICUs and wards. More than 80% of the responders carried out the assessment of certain respiratory impairments in both ICUs and wards. An objective measure of dyspnea was taken by less than 40% of the responders, with little attention given to functional exercise capacity and health-related quality of life. Eighty-five percent of the responders used Dyspnea-relieving strategies and traditional airway clearance techniques in both ICUs and wards. Eighty-three percent of the responders were giving patients in the wards training for upper and lower extremity. Fifty percent were giving strength training in the wards. Conclusion: Whether patients are admitted in ICUs or Wards, the practice pattern adopted by Physiotherapists to treat them vary very little with respect to certain measures taken. Assessment predominantly focused on respiratory impairment measures, followed by dyspnea-quantifying measures, with little attention given to functional exercise capacity and health-related quality of life measures. Treatment techniques given were concentrated on dyspnea-relieving strategies, airway clearance techniques and upper and lower extremity exercises, with little attention given to strength training. [ABSTRACT FROM AUTHOR]

Objective: The objective was to assess functional outcome of rehabilitation in chronic severe traumatic brain injury (TBI) in-patients. Setting: The study was performed at university tertiary research hospital. Study Design: A prospective cross-sectional study Materials and Methods: Forty patients (34 men) with mean age of 30.1 years (range 6--60, SD 10.8), severe TBI (Glasgow coma scale 3--8, duration of coma > 6 hours, post-traumatic amnesia> 1 day postinjury) were admitted in rehabilitation unit minimum 3 months (mean 7.7±4.6 months, range 3--22 months) following injury falling in Glasgow outcome scale (GOS) of 3. Functional recovery was assessed using the Barthel Index (BI) score and disability rating scores (DRS). Data Analysis: Paired Student's t-test was used for the assessment of functional recovery using mean BI scores at admission and discharge. The Wilcoxon nonparametric test was used for the assessment of functional recovery by comparing admission and discharge DRS scores. Results: Mean duration of stay was 30.8 days (range 18--91, SD15.6). Significant functional recovery observed in patients comparing BI and DRS scores at admission and discharge (mean BI admission 50.5±25.4, range 0--85 vs. mean discharge BI score 61.1±25.3, range 0--95, P<0.001, mean DRS admission score 7.57±4.1, range 2.5--21.0 vs. mean discharge DRS score 6.36±4.3, range 1.0-21.0, P<0.001). Conclusion: Patients with severe TBI continue to show functional recovery even in chronic phase with rehabilitation. They are left with significant residual physical and cognitive deficits and would require long-term care and assistance from care givers for the daily activities, as suggested by the mean DRS score at discharge. [ABSTRACT FROM AUTHOR]

The burden of chronic obstructive pulmonary disease (COPD) has increased recently in developing countries. On the other hand, structured or non-structured rehabilitation services for COPD patients are not routinely available in these countries. We, therefore, planned this review to re-emphasize the emerging benefits of pulmonary rehabilitation in COPD population. Aim of this review is to stimulate pulmonary physicians in India and other resource-poor areas of the world so that they start using pulmonary rehabilitation or its components more often. The search included standard english literature PubMed citation of relevant original articles, review articles and practice guidelines. The articles and reviews were searched including standard MeSH terms – Rehabilitation (TIAB) and pulmonary disease, chronic obstructive/therapy (MAJOR) and guidelines (TIAB). Available 58 articles in English including 23 reviews from July 2001 to October 2010 were screened for evidence-based benefits regarding respiratory rehabilitation as a whole or its different components. The cross references and current citations relating to primary articles were also included for description. No attempt was done to make a systematic analysis because our purpose was not to derive evidence-based recommendations from database and because sufficient evidence is already available for benefits of selected components of pulmonary rehabilitation in COPD patients. Pulmonary rehabilitation has emerged as an important modality as an adjunct to other therapies in patients of COPD. Limited and more cost-effective protocols are to be developed and executed by healthcare providers, especially in developing countries like India. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the issues speech-language pathologists (SLPs) face in the rehabilitation of people with aphasia (PwA) in India. A survey questionnaire was distributed to 540 SLPs through e-mail. Among 437 survey recipients, 61 SLPs participated in the study. The questionnaire explored various 'client-related' and 'clinician-related' issues in the rehabilitation of PwA in addition to the sections that gleaned into the clinician and therapy characteristics, and finally the SLPs' concerns toward aphasia rehabilitation. The major 'client-related' issues highlighted were: poor economic status, distant therapy centres, poor family support and subjects' motivation, associated problems (e.g. hemiplegia), acute stage, lack of awareness about aphasia and its management in the common public. The main 'clinician-related' issues were the lack of adequate time for rehabilitation and the general inefficiency of the therapy techniques. More importantly, the survey stressed on the lack of basic epidemiological research on aphasia in India. Being a preliminary survey of first in its kind, the study revealed several basic issues in the rehabilitation of PwA confronted by SLPs in India. [ABSTRACT FROM AUTHOR]

BACKGROUND: Breast cancer is the most common cancer in urban India, but no study has been carried out on psychosocial disorders in breast cancer patients. AIMS: The present study has been undertaken to evaluate behavioural and psychosocial impacts before and after treatment of women with breast cancer. SETTINGS AND DESIGN: The study was carried out in a reputed hospital in Delhi. PATIENTS AND METHODS: A total of 97 breast cancer patients matched for age and economic status were divided into group A (66) and group B (31) on the basis of treatment modalities offered to the patient. These women were interviewed, before and after the treatment, and the observations were recorded in a pretested structured questionnaire. STATISTICAL ANALYSIS: Chi-square test and Fisher's exact test were used to calculate statistical significance. RESULTS: Although the extent of sociobehavioral disorders were higher in patients on postoperative adjuvant chemotherapy and radiotherapy when compared with those on postoperative adjuvant chemotherapy alone, the difference was, however, not statistically significant. Psychological reactions were observed in 31% of patients but after intervention, 65% showed adjustment within 4 to 12 weeks, whereas the rest showed late adjustments. CONCLUSIONS: Breast disfigurement and sexuality were found to be least important, but psychological and social support appears to significantly influence the treatment outcome and rehabilitation of breast cancer patients in India. [ABSTRACT FROM AUTHOR]

According to World Health Organisation statistics, individuals of the Indian subcontinent have the highest prevalence of orofacial cancer. Surgery, radiation, chemotherapy or combination therapies are commonly administered treatment modalities for treatment of oral cancer. Surgical resection can be mutilating, disfiguring and may deeply affect self-image of patients. Orofacial defects have unique limitations and challenges. A coordinated effort from the surgeon, oral physician and the maxillofacial prosthodontist to treat such patients is the need of the hour. This article presents an overview of the orofacial rehabilitation of postcancer treatments along with case reports. [ABSTRACT FROM AUTHOR]

The article discusses a study that aims to evaluate the proportion and pattern of deformities among registered leprosy affected individuals (LAIs) in Chamrajanagar district, India. The study also aims to evaluate the care needs for disability limitation and rehabilitation among leprosy patients with deformity. It notes that the proportion of deformities in the district is rising and there is a need to monitor LAIs for deformity during treatment and maybe even after the completion of the treatment.

Psychiatric rehabilitation is an important component in the management of the mentally ill. This article presents a selective review of the publications in this journal. Questions addressed in this review range from assessment of rehabilitation needs to different rehabilitative approaches. Although the number of publications providing the answers is meager, there are innovative initiatives. There is a need for mental health professionals to publish the models they follow across the country. [ABSTRACT FROM AUTHOR]

Occupational injuries create a lot of trouble not only in the management of wound but also in the process of integration too. Some of the industrial accidents are not life-threatening, but the impact is larger than that, i.e., permanent damage to the body part which reduces one or more major functions. A patient came with occupational injury to us with badly damaged hind foot (mid of foot to heel, tendo achilles, and lower calf) but fortunately forefoot was spared. He was a young man and a bread earner for his family. With multiple surgeries, somehow wounds are managed, but the question arises was the patient is able to walk? As per surgeon, discretion, he estimated at least 6 months to initiate weight bearing for walking. 10 days (postwound healing for rehabilitation), 3 weeks (hospital stay). Sole of the foot was so badly damaged that weight-bearing bulk and muscles are lost, resulting into loss of cushion at sole. The patient could stand with the unconventional splints and modified walking aid on the 3rd day after dressing removal and able to walk by walker on the 5th day. He took 7 days for independent walking and stair 1W climbing. Since the patient was made to walk during hospitalization, he did not require conventional follow-ups. With the use of so, he was quite comfortable in walking. Periodically, change in shoes was required and status of scar has to be monitored every time to ensure proper mobility. It was important to keep hopes alive even in difficult situations. Sometimes, a consultant may not sure about prognosis in rehabilitation, due to low awareness in tier 2 cities about occupational therapy. Here, with the use of optimum knowledge and application, the patient is not only able to walk, but he also resumes his job to earn bread within 45 days of injury. A successful discharge requires a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Burn injuries create severe pain and psychological distress, which are highly variable between patients. Distinct injuries may require some different approach to treat whether it is from a surgeon's perspective or from another team member. Sometimes, standard protocols do not allow a proper rehabilitation care; hence, there is chance of developing further complications. Some adjustment has to be made to match a surgeon's need as well as to rehabilitate a patient properly. These adjustments not only make the patient physically able but also boost his/her confidence to perform routine tasks by his/her own. This is the story of an only bread earner of a family who works in factory and accidentally got burnt badly at his lower limb. All major muscles lost and this is a challenge for multidisciplinary team not only to heal wounds but also to send back him on his job. Sural artery flap with unconventional methods of splinting is used. Simultaneously, spared muscles are being keep intact functioning. After a marathon, 5 weeks of stay and with certain rehabilitation programs, which core muscle strengthening, and splinting, patient was able to stand and walk but in limping pattern. After this recovery, there is a hope of achieving goal of sending back to job. With weekly follow-ups, and scar management (miniaturization, pressure garment, stretch, and splinting), gait pattern improved remarkably. Further, his routine activities, job, and importantly performing roles and responsibilities for family were fulfilled after 6 months of injury, of course, lots of efforts from team as well as caregivers and last but not least by the patient himself. [ABSTRACT FROM AUTHOR]