Sarcopenia and frailty among the elderly population in the community: An observational study.

Context: There are few studies on the prevalence of sarcopenia and frailty in India. Aims: The aim of this study was to assess sarcopenia and frailty using simple clinical tools among the elderly population in the community. Settings and Design: This was an observational study. The elderly population with an age group of >60 years residing in villages within 10-15 km of Sumandeep Vidyapeeth, Vadodara, formed the sampling frame of the study. Methods and Material: A total of 785 participants were approached, of whom 556 were included in the study based on inclusion criteria. Participants were assessed for grip strength, muscle mass, gait speed, and frailty. Statistical Analysis Used: The data were analyzed using STATA-IC statistical software version 13. A nonparametric Chi-square (χ2) test was used for categorical variables, and an independent-samples t-test was used to analyze the difference between various variables. Statistical significance was considered at P < 0.05 with a 95% confidence interval (CI). Results: Based on the Indian criteria, 205 participants (36.1%) were diagnosed as having sarcopenia, and 351 participants (63%) were diagnosed as having "no sarcopenia." 5.6% of participants were found to be frail, 19.2% to be pre-frailty, and 75.2% to be no frailty. The χ2 analysis showed a significant association of sarcopenia with gender and different age groups (P value < 0.001). Conclusions: In this study, 36.9% of the elderly participants were found to have "sarcopenia," and 5.6% of the participants had frailty. Simple clinical tools used were easy to administer and suitable for field screening.

Telerehabilitation: Exploring the Untapped Potential.

Telerehabilitation is a burgeoning field that holds immense promise in revolutionizing the delivery of rehabilitation services. Defined as a branch of telecommunication utilizing technologies such as the internet, it facilitates remote interaction between healthcare providers and patients, transcending geographical barriers. This method proves invaluable in patient assessment, counseling, and treatment across various medical domains, including physical therapy, speech therapy, psychotherapy, and occupational therapy. Particularly beneficial for individuals with disabilities or those unable to access traditional healthcare facilities, telerehabilitation mitigates the constraints of time and cost associated with travel. This paper explores the evolution, types, uses, and research findings in telerehabilitation, shedding light on its transformative potential in health care.

Test-Retest Reliability and Internal Consistency of the Coronary Artery Disease Education Questionnaire Short Version in the Marathi Language.

Introduction Patient education specific to the disease must be incorporated into the management of coronary artery disease (CAD) or any other disease as the patients understand the education provided in their native language better. The brief version of the CAD education questionnaire is a valid and reliable instrument for evaluating patients' understanding of the condition. To the best of our knowledge and understanding from the literature review, no questionnaire evaluating the knowledge of CAD in the Marathi language had been found because of which this study was carried out. Methods For the process of translation and cross-cultural adaptation, the framework for self-report measures was taken into consideration in which qualified translators translated both ways forward into the Marathi language and backward into the English language. The translators and a recording observer combined their efforts to create one synthesized version. The questionnaire was fine-tuned by the expert group to produce the final version and 30 diagnosed cases of CAD were tested with the pre-final version. The Marathi version of the questionnaire's validity and reliability were evaluated using Cohen's kappa (k) and Cronbach's alpha (α). Results Thirty individuals with CAD were recruited (mean age 68±12.36, consisting of 22 males and 08 females) to test the pre-final version, and equivalence was tested for every item by probing the participants for the understanding of the item. The Likert scale demonstrated that patients understood the purpose of each question. A total of 200 participants - 153 males population and 47 females with a mean age of 66.64±5.6094 years who can read and speak in the Marathi language were considered to assess the test-retest reliability and internal consistency who completed the questionnaire twice, with a gap of two weeks but only 188 participant's data was analyzed as twelve participants dropped out of the study because they could not report due to transportation and health-related issues. The obtained α value demonstrated satisfactory internal consistency, while the k value indicated almost perfect agreement. Conclusion The study concluded that the Marathi version of the CAD education questionnaire short version is reliable and cross-culturally adapted; therefore, it is an effective tool for evaluating the knowledge of CAD among Marathi language-speaking patients.

Recommendations for standards of physiotherapy care following complete traumatic paraplegia in India.

STUDY DESIGN: Qualitative study. OBJECTIVES: To formulate recommendations for standards of physiotherapy care for people with complete traumatic paraplegia in India using a Delphi methodology. SETTING: India. METHODS: Twenty-three physiotherapy experts were invited to participate in an online consensus process. Fourteen (n = 14) of 23 physiotherapy experts from India accepted an invitation to participate in an online consensus development exercise (Response rate-60.86%). Four rounds of consensus meetings were conducted which involved posting the quotations from a previous study on expectations of people with paraplegia to obtain perceptions of physiotherapy experts in round 1, retrieving codes/code groups from round 1, posting these code groups in rounds 2 and 3 for experts' agreement/disagreement, the preparation of the draft of recommendations, and posting it in round 4 for experts' opinion. Data were analyzed using descriptive statistics and ATLASti software for qualitative data analysis. RESULT: Recommendations for physiotherapy care for persons with complete traumatic paraplegia in India are presented. CONCLUSIONS: Education to patients and/or caregivers regarding care post injury is one of the important recommendations by physiotherapy experts. It is emphasized that the subjective assessment of the patients, including their needs and preferences, is equally important as that of their objective assessment. Physiotherapy students and practicing physiotherapists must also enhance their knowledge to provide optimal physiotherapy care to people with paraplegia.

Lack of adequate care post spinal cord injury - a case report.

Introduction: Health needs of individuals with spinal cord injury (SCI) are unmet in developing countries. Quality of life of these individuals is not on par with global standards. The decline in quality of life can be attributed to lack of a specialised rehabilitation centres, lack of expertise in local hospitals and lack of access to dedicated SCI wards/centres in India. The present case report depicts many such challenges in India. Case presentation: As part of an online focus group, A 21-year-old male was identified who sustained SCI in motor vehicle. His care was inappropriate at the accident site. He was not taught basic skills such as bed mobility, transfers, and wheel-chair mobility and was not educated about long-term complications before discharged to home. Lack of training made him functionally dependent on others for his basic needs. There were few job opportunities for him in his state. He strongly emphasises the need to create an awareness regarding SCI among the general public in India. Discussion: This case report depicts many challenges faced by a person with paraplegia in India. These include mishandling at the accident site, lack of adequate care post injury and lack of follow-up post discharge. In addition, lack of knowledge of SCI among the general public and lack of education regarding SCI for the patient and his care givers post injury are reported.

Expectations of persons with paraplegia regarding their care in India: a qualitative study.

STUDY DESIGN: A qualitative study. OBJECTIVE: The aim of this study was to understand expectations of persons with paraplegia in India regarding their care. SETTING: India. METHODS: This study used a qualitative methodology to have a focus group interview of persons with paraplegia in India. Focus group consisted of two to four participants with paraplegia. Adults with level T6 and below, complete injury, duration of at least 6 months post injury and those living in the community were included. Online focus group interviews were conducted using ZOOM online software for online discussions/meetings. Data were collected till data saturation. Recorded videos were transcribed into texts, and the transcribed documents were analysed using the ATLASti.8 software for qualitative data analysis. RESULTS: Forty-eight codes were retrieved under fourteen code groups. These code groups were acceptance, accessibility, advanced technology, assistive devices, basic skills, employment, expectations, experiences, functional independence, government policies, knowledge, psychological make-up, physiotherapy and rural area. CONCLUSION: Because of lack of awareness, knowledge and education provided to persons with paraplegia, their expectations were often unrealistic. Patient education and education of the health professionals are two of the most important aspects in spinal cord injury rehabilitation that must be taken into consideration in India.

An observational study of foot lifts asymmetry during obstacle avoidance.

BACKGROUND: Specific information regarding obstacle-clearance strategies used by community-dwelling young and elderly is scant in the literature, and physical barriers encountered in real-life situations have not been used in most of the studies. AIM: The aim of this study is to determine foot lift asymmetry during obstacle avoidance in young and elderly subjects. SETTINGS AND DESIGN: This was an observational study. MATERIALS AND METHODS: Thirty elderly and 30 young individuals were taken for the study. All the subjects were evaluated using different scales and foot lift asymmetry was measured on a walkway using three obstacles of different heights. RESULTS: The mean and standard deviation (SD) value of the asymmetric index of the young was 3.25±0.28 and the mean and SD value of the asymmetric index of the elderly was 3.53±0.47. The asymmetric index of the elderly population was found to be higher than that of the younger population. CONCLUSION: The asymmetric index of the elderly population was found to be higher than that of the younger population, though it is not clinically significant.

Neurological disorders and barriers for neurological rehabilitation in rural areas in Uttar Pradesh: A cross-sectional study.

BACKGROUND: In India, the majority of individuals with neurological disorders are rural based and cannot even afford the cost of rehabilitation. At the same time, we do not have barrier free environment in India. AIM: This study attempts to find out the neurological disorders and barriers for neurological rehabilitation in rural areas in Uttar Pradesh, India. SETTING: Rural areas in Uttar Pradesh, India. DESIGN: It is a cross-sectional study. MATERIALS AND METHODS: The study was done by means of an interview method using a questionnaire. The rural areas in Uttar Pradesh were visited personally and a data from 201 individuals was collected. STATISTICAL ANALYSIS USED: Data analysis was done by using descriptive statistics. RESULTS: Out of 201 individuals, 76.6% (n=154) individuals were with polio, 12.9% (n=26) were with cerebral palsy, 7.9% (n=16) were with stroke and 2.4% (n=5) were with spinal cord injury. Reasons for not taking the treatment/discontinuation of treatment were financial problem (44%), lack of awareness (43%), family negligence (6%), transportation problem (3.5%) and other environmental barriers (1%). CONCLUSION: In our study, we found polio to be the most prevalent disorder followed by Cerebral Palsy, Stroke and Spinal Cord Injury. Financial problem was the major barrier for neurological rehabilitation followed by lack of awareness, family negligence and transportation problem.