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Background: Individuals with type 2 diabetes mellitus (T2DM) are prone to musculoskeletal complications, particularly in the upper extremities (UE), which can significantly impair their grip strength and UE muscle strength. This review will provide valuable insights for developing optimized exercise interventions aimed at enhancing upper limb functionality and improving patient outcomes. Aim: To determine the effect of different exercise training on grip strength & UE muscle strength in patients suffering from T2DM. Methodology: A comprehensive search from electronic databases was performed based on the selection criteria and 13 randomized controlled trials (RCT's) were included in the study. Mean changes in grip strength and UE muscle strength were the primary outcome measures. Included studies ranked high on the PEDro rating scale and eta‐analysis was performed by Rev Man 5.4 software. Results: Meta‐analysis results indicated that there was a statistically significant improvement in UE muscle strength of experimental group when compared to control group (mean differences [MD] = 2.91, 95% confidence interval = 0.12, 5.71; p = 0.04) with moderate heterogeneity (I2 = 49%, p < 0.07). Grip strength improved significantly in the experimental group when compared to the control group with (MD = 2.93, 95% CL = −0.00, 5.86; p = 0.05) and moderate heterogeneity (I2 = 66%, p < 0.08). Conclusion: This review indicated a positive role of supervised resistance & aerobic exercises on UE muscle strength in patients with T2DM. Due to lack of RCT's, grip strength needs to be explored by further investigations in these patients. [ABSTRACT FROM AUTHOR]

Objective. the goal of this “systematic review” and meta-analysis is to find out the efficacy of exercise regimes on balance in badminton players. Study design. Systematic review and meta-analysis. data Source. Pub Med, “Cochrane database (Cochrane Central register of controlled Trials)”, google Scholar, Springer, and DoAJ. Eligibility criteria. limits were applied to database searches to identify papers published in English and only human studies were included. results. result of Meta – analysis was statistically significant in “anterior component of Y-balance test” (MD = 2.39, 95% ci = 1.90, 2.89; “p ≤ 0.00001”) with low heterogeneity (i2 = 0%, p < 0.41). There was statistically significant improvement in postero-medial component of y- balance (MD = 2.87, 95% ci = 0.55, 5.19; p ≤ 0.02) with “moderate heterogeneity” (i2 = 39%, p < 0.19). result showed statistically significant improvement in postero-lateral component of y- balance test (MD = 3.09, 95% ci = 0.64, 5.65; p ≤ 0.02) with “moderate heterogeneity (i2 = 38%, p < 0.20)”. There was “statistically significant “improvement in overall balance of y-balance test in “experimental group as compared to control group (MD = 8.49, 95% ci = 4.62,12.36; p ≤ 0.0001) with low heterogeneity (i 2 = 0%, P < 0.47)”. Conclusion. this systematic and meta-analysis concluded that various exercise protocols may result in improvement in the balance of badminton players. PrOSPErO registration number: crD42020193620.

Introduction: One of the most prevalent disorders causing pain in the musculoskeletal system and eventual disability is osteoarthritis (OA). The concurrent use of pharmaceutical and non-pharmacological therapies is an essential component of the therapy. The purpose of this study was to assess the efficacy of iontophoresis therapy in patients with osteoarthritis (OA) of the knee joints using a newly formulated Gel containing symphytum officinale. Material and Methods: The study included 126 patients with Knee osteoarthritis treated at the Outpatient department at Delhi Pharmaceutical Sciences & Research University, New Delhi. Three groups were randomly selected: group I (n = 42), received iontophoresis with newly developed Gel containing symphytum officinale treatment was applied followed by exercise protocol, group II (n = 42) received iontophoresis with Indomethacin gel was applied followed by exercise protocol, and group III (n = 42) received placebo treatment with knee exercise protocol only. The Visual analog scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Pittsburg sleep quality index (PSQI) & Walking cadence were used for the clinical evaluation of the patients. Results: Patients treated with a new gel containing symphytum officinale showed significant improvement in all assessed parameters compared to those treated with Indomethacin gel and placebo. Conclusions: The most favorable iontophoresis resulted from the introduction of a new gel containing symphytum officinale, followed by an exercise protocol. [ABSTRACT FROM AUTHOR]

Addisonian Crisis (AC) is an endocrinological emergency associated with high mortality, resulting from an acute deficit of hormones from the adrenal glands. It can occur either in a patient with known Adrenal Insufficiency (AI) or as the initial presentation of the disease. Primary Adrenal Insufficiency (PAI), which can be caused by autoimmune adrenalitis or tubercular adrenalitis, is the most common cause worldwide and particularly prevalent in developing countries like India. Other causes of PAI include infiltrative pathology, drugs, haemorrhage, or, rarely, malignancy. Secondary Adrenal Insufficiency (SAI) often occurs due to abrupt steroid withdrawal or defects at the level of the pituitary or hypothalamus. The present case series highlights three cases (three male patients) in which patients presented with adrenal crisis despite no prior history of AI. Subsequently, they were diagnosed with bilateral adrenal masses of different aetiologies, including primary adrenal malignancy and granulomatous infiltration of the adrenals due to Tuberculosis (TB). One case involved bilateral primary adrenal malignancy with left perirenal and pararenal space infiltration, while the other two patients were diagnosed with disseminated TB with adrenal gland infiltration. The presentation of all three cases was characterised by non specific symptoms. Initial management for all three patients involved mineralocorticoid and glucocorticoid replacement, and they were discharged with corticosteroid supplements. However, the patient with bilateral adrenal malignancy was referred to the surgery and oncology department for further evaluation and management, whereas the remaining two patients were started on Antitubercular (ATT) drugs for definite treatment. [ABSTRACT FROM AUTHOR]

Context: Cervicogenic headache (CGH) is a headache that impairs a patient’s life quality and work productivity. Pharmacological management has been found to show short‑term symptomatic relief with adverse effects. Objective: The objective is to evaluate the effect of spinal mobilization (SM), postural correction exercises (PC), and neural mobilization (NM), in the treatment of CGH. Methods: This study has a 1:1 allocation ratio and is a single-blind randomized controlled trial with concealed allocation conducted at the university physiotherapy department. According to the sample size calculation, we aim to recruit 140 participants. The participants are randomized into 4 groups: The SM group, the PC group, the NM group, and the control group. Headache impact test-6 is the primary end measure and the secondary end measures are neck disability index and headache diary for headache-related parameters(headache frequency, headache intensity, and headache duration). All outcomes measured will be evaluated at week 0 (baseline), after week 4 (postintervention), and after week 8 (follow-up). Statistical Analysis Used: Based on the normality of data, parametric/nonparametric tests will be applied. Results: The result will be presented in the form of a 95% confidence interval and P value. Conclusions: This is the first comprehensive randomized controlled trial evaluating the individual impact of three various physiotherapy approaches and comparing these techniques to know the best treatment options available for CGH. [ABSTRACT FROM AUTHOR]

Objectives. Hypertension is also known as Elevated Blood Pressure in which SBP is equal to 120-129 mm Hg while DBP is equal or less than to 80 mm Hg or if a person taking antihypertensive drugs at any stage of higher BP according to American college of Cardiology/American Heart Association 2017 guidelines The main objective of this study was to evaluate the efficacy of posture correction on Blood Pressure in persons with Forward Head Posture: A Randomized Control Trial. Materials and methods. 86 patients with a mean age of 56.83±11.40 who had Forward Head Posture and raised blood pressure were randomly assigned to 2 group (N= 43 in each group) Group 1 is experimental group who performed strengthening exercise (Cervical isometrics, Rhomboids and Longus Capitis) and stretching exercises (Trapezius, Scalene, Sternocleidomastoid and Pectoralis Major and minor) 6 repetitions of each exercise, twice per week for 4 weeks). Group 2 is a control which was on antihypertensive drugs for 4 weeks. The outcome measures used was BP using Sphygmomanometer. Patients were assessed at baseline, after 4 weeks of treatment. Outcomes. Of 86 patients, 43 patients who received stretching and strengthening exercise, received intervention twice per week for 4 weeks. There was significant within group effects (p=0.000) for Blood Pressure. The findings obtained by comparing both groups were, SBP & DBP reduced significantly after 4 weeks SBP (MD = 2.86; 95% CI 3.23 to 2.48; p= 0.000) DBP (MD = 2.48; 95% CI 2.82 to 2.15; p= 0.000) Conclusions. The efficacy of posture correction in persons with Forward Head Posture is an effective treatment and could considerably decrease the Blood Pressure in Hypertensive patients. [ABSTRACT FROM AUTHOR]

Purpose. Present study describe the case of lumbar radiculopathy with radiating pain up to knee joint managed with Mulligan bent leg raise (BLR) technique. Case presentation. Total six intervention sessions were carried out over two consecutive weeks, three times per week. Three repetitions of BLR techniques with 5-10 seconds of sustained stretch with one minute rest between each repetition were given on first visit. On consecutive visits six repetitions were delivered in pain free zone. Study outcomes were measured by using straight leg raise (SLR) range of motion and “visual analog scale (VAS)” for back and leg pain. After two weeks of interventions, range of motion of SLR was increased from 45° to 56° while VAS score improve by 3 points both in back and radiating thigh pain. Conclusions. Mulligan BLR technique resulted in reduction in back and radiating thigh pain as well as increase in range of SLR. Therefore, Mulligan BLR technique can be used a first line of treatment in lumbar radiculopathy with radiating pain up to knee joint. [ABSTRACT FROM AUTHOR]

Background. This pilot trial reports the initial estimates of the efficacy of manual therapy interventions in lumbar prolapsed intervertebral disc and determines the feasibility and acceptability of full powered “randomized controlled trial” on efficacy of “spinal mobilization with leg movement (SMWLM)”, high velocity low amplitude thrust (HVLA) and neural mobilization (NM) in lumbar PIVD (Prolapsed Inter-Vertebral Disc) and pilot data will be used to perform sample size calculation for full trial. Material and methods. 48 subjects diagnosed lumbar PIVD were randomly distributed into 4 groups. The primary outcomes were feasibility, assessment procedure, retention rate, adherence and acceptability to the intervention. The secondary outcomes measures were pain, disability and straight leg raise (SLR) range of motion. Results. 90 subjects were screened based on selection criteria. Out of them, 50 (55.55%) were eligible. 48(96%) subjects accepted to participate in study. Baseline data of all the groups was similar but post-intervention score were significant when compared the data between the groups. Highest mean change for visual analog scale (VAS), oswestry disability index (ODI) and SLR were found in SMWLM group. No adverse effects were reported by subjects. Results also suggest that the outcome measures were feasible and acceptable and the treatment considered as the beneficial approach. Conclusions. Present study suggests that it is feasible and acceptable to do a fully powered “randomized controlled trial (RCT)” to evaluate the efficacy of manual therapy interventions in management of lumbar PIVD. This study also reveals that manual therapy interventions are effective in management of lumbar PIVD. [ABSTRACT FROM AUTHOR]

Purpose. This report describes the case of prolapsed lumbar intervertebral disc with radiating pain to leg managed with spinal mobilization with leg movement (SMWLM) combined with intermittent lumbar traction (ILT) and interferential therapy. Case presentation. Twelve treatment sessions carried out over 4 consecutive weeks thrice weekly consisting of spinal mobilization with leg movement, intermittent lumbar traction and interferential therapy. Outcome measures were documented by using Visual analog score (VAS), Oswestry disability index (ODI) and range of straight leg raise (SLR) score. After 4 weeks, VAS improved by 7 points and ODI score improved by 19 points. Range of straight leg raise also increased significantly from 46.30 to 68.40. Conclusions. Spinal mobilization with leg movement combined with intermittent lumbar traction and interferential therapy resulted in decrease in disability and pain as well as improvement in range of straight leg raise. Therefore, it may be used as a first line of treatment with massive disc prolapse before surgical intervention. [ABSTRACT FROM AUTHOR]

Objective: The objective of this meta-analysis and systematic review is to analyze the efficacy of physiotherapy interventions in management of lumbar prolapsed intervertebral disc (PIVD). Method: Randomized controlled trials (RCTs) were searched in PubMed and Cochrane Library using related keywords and advanced option, from commencement to January 2019. Quality of researches was assessed by PEDro scoring. Risk of bias and homogeneity were assessed using Cochrane risk of bias tool and I2value, respectively. Meta-analysis of included study was done using “Review manager (Software, version 5.3).” Results: Eleven RCTs were included in this systematic review. Six RCTs were excluded from meta-analysis due to insufficient data availability. Meta-analysis reveals significant decrease in pain (P = 0.001, mean difference (MD) −0.91; 95% confidence interval (CI) −0.35 to −1.48) and disability (P < 0.0001; MD −5.76; 95%CI; −3.18 to −8.34) with moderate heterogeneity (I²=40%; P = 0.17, I²=54%; P = 0.09, respectively). There was non-significant improvement in straight leg raise (SLR), P = 0.07; MD 7.96; 95%CI; −0.59–16.51 with moderate heterogeneity (I²=56%; P = 0.11). Conclusion: Physiotherapy interventions are effective in management of lumbar PIVD. Physiological and biomechanical factors such as correction of the displaced disc, opening of the foramina, increase in intervertebral space, and reduction in herniation size with negative intradiscal pressure may be possible mechanisms. [ABSTRACT FROM AUTHOR]

Lumbar prolapse intervertebral disc (PIVD) is a common back related disability throughout the world. It is one of common cause for work absenteeism and pose high economic burden on society. Till date, the etiology of lumbar PIVD has not been clearly established. Mechanical compression and chemical irritation are the major pathophysiological changes in lumbar PIVD. The accurate diagnosis of lumbar PIVD is a prerequisite for appropriate therapy. Lumbar PIVD results in significant disability and loss of productivity. Therefore, it is pertinent to summarize the intricacies and nuances of Lumbar PIVD as well as its evidence based management. Various cost effective and time saving protocols are available in surgical and non-surgical management of lumbar PIVD. In the present review, an attempt has been made to highlight etiology, underlying pathophysiological mechanisms of lumbar PIVD, as well as evidence based management of lumbar PIVD. [ABSTRACT FROM AUTHOR]

Introduction. Migraine is a public health problem of great impact on patients as well as society. Migraine prophylaxis requires daily administration of anti-migraine compounds whether or not migraine attack is occurring. All the drugs used for migraine prevention have potential and often relevant adverse effect or contraindications. The purpose of present study was to evaluate effi cacy of non-pharmacological management techniques like Cognitive Behavioral Therapy (CBT) and Transcranial Direct Current Stimulation (TDCS) on headache related disability and impact of headaches on life of patients suffering from migraine. Methodology. Sixty six subjects fulfi lling the selection criteria were recruited for the study. They were randomly allocated into three groups. Group one received TDCS, Group 2 received CBT , and Group 3 (Control group) did not receive any treatment. Participants were asked to fi ll HDI and HIT 6 prior to start of intervention, post intervention and at follow up. Collected data was analyzed for statistical signifi cance. Results. We found a signifi cant decrease in HDI and HIT 6 scores in TDCS and CBT Group as compared to Control Group. This improvement was maintained during follow up period. Conclusion. TDCS and CBT can be effective in decreasing headache related disability and impact of headache on daily life in patients suffering from Migraine. [ABSTRACT FROM AUTHOR]