Safety and feasibility of pulmonary rehabilitation in patients hospitalized with post-COVID-19 fibrosis: A feasibility study.

BACKGROUND: Emerging data suggest a spectrum of pulmonary complications from COVID-19, ranging from dyspnea to difficult ventilator weaning and fibrotic lung damage. Prolonged hospitalization is known to significantly affect activity levels, impair muscle strength and reduce cardiopulmonary endurance. OBJECTIVE: To assess the feasibility and safety of inpatient pulmonary rehabilitation (PR) and to explore effects on functional capacity, physical performance, fatigue levels, and functional status. DESIGN: A prospective feasibility study. SETTING: Inpatient unit of a tertiary care hospital. PARTICIPANTS: Twenty-five hospitalized patients diagnosed with post-COVID-19 fibrosis referred for PR. INTERVENTION: Individualized PR intervention including breathing exercises, positioning, strengthening, functional training, and ambulation twice a day for 6 days a week. OUTCOME MEASURES: One-minute sit-to-stand test (STST), Short Physical Performance Battery (SPPB), Fatigue Assessment Scale (FAS), and Post-COVID-19 Functional Status Scale (PCFS). RESULTS: Twenty-five participants (19 males, 6 females) with a mean age of 54.2 ± 13.4 years were enrolled. Sixteen completed the two-point assessment after undergoing in-patient PR of mean duration 14.8 ± 9 days. PR led to a significant improvement in all functional outcomes that is, STST (from 7.1 ± 4.3 repetitions to 14.2 ± 2.1 repetitions, SPPB (from 5 ± 2.8 to 9.4 ± 1.5), FAS (from 33.3 ± 10.8 to 25.8 ± 4.7) at the p ≤ .001, and PCFS (from 3.6 ± 0.9 to 2.9 ± 1.2, p ≤ .05). CONCLUSION: Early initiation of PR for hospitalized patients with COVID-19 fibrosis was safe, well tolerated, and feasible and may improve functional status.

Analysis of Postural Risk and Pain Assessment in Bharatanatyam Dancers.

BACKGROUND: Bharatanatyam dance form is an amalgamation of emotion, rhythm, expression, and sculpturesque poses that demand high levels of physical and psychological power during a performance. OBJECTIVES: To explore musculoskeletal pain and analyze risk factors in Bharatanatyam dancers. The level of injury risk for the "Natyarambham" posture adopted by dancers was also assessed. MATERIALS AND METHODS: A cross-sectional study was conducted in forty female Bharatanatyam dancers who received a minimum of 5 consecutive years of formal dance training from a recognized dance institute. A self-designed questionnaire comprising of demographic profile, dancing characteristics, presence of musculoskeletal pain, and specific area of pain according to the body region was administered. The injury risk of the "Natyarambham" posture was evaluated using a rapid entire body assessment tool (REBA). RESULTS: Among 40 female dancers, 75% dancers (n = 30/40, 75% [95% CI 0.61, 0.89] reported pain. The most common site of pain was the low back (n = 22/40, 55% [95% CI 0.39, 0.71]). Using Bonferroni correction for multiple independent comparisons, a significant difference was identified between dancers with and without pain for average performances per year (P = 0.028). As per REBA risk level scoring for Natyarambham posture, 62.5% (n = 25/40, 62.5% [95% CI 0.22, 0.53]) dancers were in the category of high-risk level. CONCLUSION: The findings of this study indicated that the point prevalence of pain in Bharatanatyam dancers is high. Natyarambham posture is considered high risk based on postural assessment.

Psychosocial factors, disability and quality of life in chronic shoulder pain patients with central sensitization.

Chronic shoulder pain is a complex and multidimensional phenomenon with multiple causative factors involved in its perpetuation. Alteration of central nervous system processing along with the central sensitization is a predominant feature in chronic pain. Reduction in physical function has an impact on the psychological well-being of an individual. The aim of the study was to compare pain, kinesiophobia, catastrophizing, disability and quality of life in chronic shoulder pain patients with and without central sensitization. Eighty chronic unilateral shoulder pain patients in the age group of 40 to 60 years were recruited. Of them, 38 were chronic shoulder pain with central sensitization and 42 without central sensitization, classified on the basis of central sensitization inventory. Pain catastrophizing was measured using the pain catastrophizing scale, kinesiophobia using Tampa scale of kinesiophobia, disability using Shoulder pain and disability index and quality of life using 36-Item Short Form Health Survey questionnaire was evaluated in both the groups. Increased pain catastrophizing (p=0.000), kinesiophobia (p=0.000) and disability (p=0.000) was observed in centrally sensitized chronic shoulder pain patients. Also, physical component summary (p=0.000) and mental component summary (p=0.000) of SF-36 quality of life were reduced in chronic shoulder pain with central sensitization as compared to without central sensitization. Hence, these components should be included during assessment which will provide a holistic and multimodal approach towards the understanding, planning and management of chronic shoulder pain patients.

Evaluation of learning approaches in physiotherapy students: A valuable insight.

INTRODUCTION: Every individual has different learning approaches in acquisition and processing of knowledge. Physiotherapy, an evolving allied health science profession, is developing rapidly. Exploration of learning approaches among physiotherapy students will help the academicians to enrich the quality of learning. This study aimed to analyze the learning approaches among physiotherapy students. MATERIALS AND METHODS: A cross-sectional study was carried out among 435 physiotherapy students. The Approaches and Study Skills Inventory for Students questionnaire was used to evaluate learning approaches in both preclinical and clinical students. Data were analyzed using the Statistical Package for the Social Sciences software version 21. Statistical significance was set at P < 0.05. RESULTS: A total of 435 participants, 233 (53.56%) in preclinical phase and 202 (46.44%) in clinical phase with a mean age of 19.01 ± 1.01 and 22.03 ± 1.43 years, respectively, participated in the study. Among the 435 students, 411 (94.49%) adopted the deep approach, while only 21 (4.83%) and 3 (0.69%) adopted strategic approach and surface approach, respectively. Preclinical students had significantly higher mean scores for strategic and surface approaches than clinical (P = 0.000) and (P = 0.000) using independent t-test, respectively. Out of the 435 students, 50 (11.45%) were male and 385 (88.51%) were female. Male students appeared less likely to adopt the deep learning approach than female students (P = 0.013). CONCLUSIONS: Assessment of learning approaches will assist the academicians to develop teaching and learning strategies and effective curriculum depending on the perspectives of students. Multiple methodologies focused on interactive student-centric approach should be utilized to enhance positive learning outcomes.

Psychometric Properties of the Hindi Version of the Fear-Avoidance Beliefs Questionnaire in Patients With Chronic Non-Specific Low Back Pain.

STUDY DESIGN: Prospective cohort study. OBJECTIVE: To translate, adapt, and establish psychometric properties of the Fear-Avoidance Beliefs Questionnaire (FABQ) for Hindi-speaking patients with chronic non-specific low back pain. SUMMARY OF BACKGROUND DATA: The FABQ is a patient-reported measure to assess beliefs regarding how physical activity and work are influenced based on fear related to low back pain. METHODS: Standardized translation guidelines were implemented to confirm Hindi-version of the FABQ (FABQ-H). A cross-sectional study design was utilized. Construct validity analysis included factor analysis of the FABQ and use of Pearson correlation coefficients to report convergent and divergent validity. Reliability assessment included calculation of intraclass correlation coefficient (ICC) and Cronbach α for internal consistency. Outcome measures consisted of Numeric Rating Scale (NRS), Roland Morris Disability Questionnaire (RMDQ) Hindi, and Tampa Scale of Kinesiophobia (TSK). RESULTS: In total, 100 patients with chronic non-specific low back pain were recruited, with a mean age of 36.89 (±7.78). Factor analysis revealed a three-factor structure of the FABQ, which consisted of subscales FABQ Physical activity, FABQ Work, and FABQ Work prognosis. Convergent validity analysis demonstrated a moderate correlation between FABQ-H and TSK (r = 0.413). Divergent validity analysis displayed a moderate correlation between FABQ-H and NRS (r = 0.362) and RMDQ Hindi (r = 0.399). ICC value for the FABQ-H was observed as 0.938 indicating high significance for test-retest reliability. Cronbach α for the FABQ-H was recorded as 0.806 demonstrating high internal consistency. CONCLUSION: A successful translation and adaptation of the Hindi version of FABQ is reported in this study. The three-factored FABQ-H exhibited satisfactory construct validity, test-retest reliability, and internal consistency. Based on findings of this study, the FABQ-H can be implemented in Hindi-speaking patients with chronic non-specific low back pain (LBP). LEVEL OF EVIDENCE: 3.

Reliability of the Identification of Functional Ankle Instability (IdFAI) Scale Across Different Age Groups in Adults.

BACKGROUND: Functional ankle instability (FAI) is the tendency of the foot to 'give way'. Identification of Functional Ankle Instability questionnaire (IdFAI) is a newly developed questionnaire to detect whether individuals meet the minimum criteria necessary for inclusion in an FAI population. However, the reliability of the questionnaire was studied only in a restricted age group. AIM: The purpose of this investigation was to examine the reliability of IdFAI across different age groups in adults. MATERIALS AND METHODS: One hundred and twenty participants in the age group of 20-60 years consisting of 30 individuals in each age group were asked to complete the IdFAI on two occasions. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC2,1). RESULTS: The study revealed that IdFAI has excellent test-retest reliability when studied across different age groups. The ICC2,1 in the age groups 20-30 years, 30-40 years, 40-50 years and 50-60 years was 0.978, 0.975, 0.961 and 0.922, respectively with Cronbach's alpha >0.9 in all the age groups. CONCLUSION: The IdFAI can accurately predict if an individual meets the minimum criterion for FAI across different age groups in adults. Thus, the questionnaire can be applied over different age groups in clinical and research set-ups.