Lived experiences of caregivers and survivors of paediatric spinal cord injury: A scoping review of qualitative studies.

CONTEXT: Paediatric Spinal Cord Injury (SCI) has an impact on a child's dynamic development, disrupting their participation in school, community, and social relationships while simultaneously causing repercussions on their caregiver's life. The rare nature of paediatric SCI calls for a detailed inspection of the literature from the perspective of children and their caregivers. OBJECTIVE: This scoping review of qualitative research determines the extent of literature from perspective of caregivers and individuals with paediatric SCI. METHODS: 9351 full-text published articles were identified from CINAHL, Ovid, PubMed, and Scopus between 2001 and 2021. After duplicate deletion, 8354 articles were left, and 103 full-text articles were assessed for their eligibility. Finally, eight articles were assessed for their relevance. Key themes that emerged from the data were summarized, compared, and synthesized. RESULTS: Six studies were from the perspectives of individuals with SCI and two from caregiver's perspective. Three major themes were identified from caregivers' opinion studies: "Obstacles to community participation"; "Unmet needs related to a child with SCI"; and "Radiating effect on caregivers' lives"; whereas five were obtained from individuals with paediatric SCI opinion studies: "Adjusting to life with SCI"; "Hardships & hardiness"; "Peers & family/emotional support"; "Perception of self & body-image post injury"; and "Transitioning into post-traumatic life". CONCLUSION: There is a need for more specialized rehabilitation centers and an accessible environment in public spaces. Also, the review sheds some light on the discriminatory attitude of society as a whole, which can be improved by providing proper knowledge and awareness of SCI.

The level of perceived stress, burnout, self-efficacy, and coping strategies among physiotherapy academicians during the COVID-19 lockdown.

BACKGROUND: During the coronavirus 2019 (COVID-19) pandemic, academicians were juggling their personal and professional life amid lockdown while trying to deliver maximum knowledge through online classes. This chronic stress is emotionally draining and can eventually lead to burnout. OBJECTIVE: To examine the levels of perceived stress and burnout and examine the effects of self-efficacy and coping in reducing stress and preventing burnout in academicians during the COVID-19 lockdown. METHODS: This survey included 63 physiotherapy academicians from various physiotherapy colleges in India. Assessments used to collect data were the Perceived Stress Scale, Oldenburg Burnout Inventory, General Perceived Self-Efficacy Scale, and the Brief Resilient Coping Scale. The data was collected through Google Forms and sent through an online mode via various social media apps. RESULTS: This study revealed that the majority of the physiotherapy academicians were experiencing moderate levels of stress eventually leading to burnout. Stress levels were higher in academicians with more than 10 years of experience. Also, self-efficacy and resilient coping were negatively correlated with perceived stress and burnout. CONCLUSION: Academicians experienced increasing amounts of stress during the COVID-19 pandemic, which, if not addressed on time, can lead to job burnout.

Combined Effect of Pelvic Proprioceptive Neuromuscular Facilitation with Core Strengthening on Trunk Control, Balance, and Gait in Paraplegia.

Spinal cord injury (SCI) has deleterious effects on quality of life and vocation. A partial or complete loss of sensory and motor functions below the site of injury is a potential clinical sign of SCI. Trunk and pelvic control are crucial for balance and gait to perform vocational tasks of daily living. In this case report, a 40-year-old male with traumatic incomplete paraplegia (AIS Grade C, neurological level T6) received 45 min of intervention per session, which included pelvic proprioceptive neuromuscular facilitation combined with core strengthening exercises 5 times a week for 4 weeks. Baseline and postassessments were done for trunk control with the trunk control test for SCI, balance with the Berg Balance Scale (BBS) and the SCI-functional ambulation inventory (SCI-FAI), and gait with the walking index for SCI II (WISCI). After 4 weeks of intervention, there were significant differences between baseline and postintervention scores on the trunk control test for SCI (16-18), WISCI (Level 1-2), SCI-FAI (03-06), and BBS (04-08). This is the first case report that enabled and promoted potentiate intervention to improve trunk control, balance, and gait in paraplegics. This outcome motivates additional research on its therapeutic potential and mechanism.

Study Protocol titled as "Effectiveness of neural mobilization in improving the ankle ROM and plantar pressure distribution in patients with diabetic peripheral neuropathy: A single group, pre post, quasi experimental study protocol".

Objectives: Diabetic Peripheral Neuropathy (DPN) is the commonest complication in individuals with type 2 diabetes mellitus affecting 50% of total diabetic population. The ankle mobility is seen to be significantly reduced along with alteration in plantar pressure distribution. Neural mobilization is a neoteric technique that is being used to treat various conditions of neural involvement. It is hypothesized that the application of neural mobilization will improve ankle mobility and plantar pressure distribution in individuals with DPN by restoring the mechanical and neurophysiological functions of the tibial and common peroneal nerves. Methods: A single group pre-post, quasi experimental, same subject design will be used. Participants with prior diagnosis of DPN will be selected according to eligibility criteria. The ankle ranges of motion (Both Active & Passive) and plantar pressure distribution at six foot regions will be taken as the outcome measures. All the participants will receive neural mobilization of tibial & common peroneal nerves (3 sets of 30 repetitions in 2 min with 1 min break in between) for 3 times/ week for 4 weeks. Outcome measurements will be taken at the baseline and after completion of the intervention. Conclusion: This study will be investigating the possible advantageous effects of neural mobilization in improving ankle joint ranges of motion and plantar pressure distribution in patients with DPN and will help the clinicians and researchers develop preventive measures to reduce the burden of diabetic ulcers.CTRI/2022/04/042187 [Registered on: 27/04/2022].

Knowledge and awareness among physiotherapy students to combat COVID-19: A questionnaire based study.

OBJECTIVE: Despite the various preventive guidelines and recommendation for infection control, the COVID-19 is spreading very extensively. So it becomes essential for healthcare professionals to have proper knowledge and awareness of it. The objective of this study was to assess the level of knowledge and Awareness among Physiotherapy students to combat COVID-19. METHODS: A total of 203 participants from MMIPR, MM(DU), Mullana completed a questionnaire based survey on the Knowledge and Awareness among Physiotherapy students to Combat COVID-19. The questionnaire was self-administrated and distributed through WhatsApp. Convenient sampling method was used for data collection and the distributions of responses were presented as frequencies and percentages. RESULTS: A total of 203 physiotherapy students participated in this survey (143 females & 60 males), forming a response rate of 53.4% (203 participated out of 380). The overall awareness for all the participants was adequate with 73.1% reporting correct answers. The findings of this study revealed that 93% of subjects (score more than 60%) have good knowledge and awareness to combat COVID-19. However, only 49% knew the correct name of the virus causing COVID-19 infection, only 41% of participants were aware about the diagnostic measures, and only 25.6% were aware of the treatment strategies. 91% of the respondents uses 'Aarogya Setu' app, while 85% says agrees that it helps to know more about the social distancing. CONCLUSION: We conclude that physiotherapy students of MMIPR, MM(DU), Mullana (Ambala) were well aware about the knowledge on COVID-19 infection and its preventive measures.

Effectiveness of Neurodynamic Mobilization versus Conventional Therapy on Spasticity Reduction and Upper Limb Function in Tetraplegic Patients.

STUDY DESIGN: The study employed a pre- and post-test experimental design. PURPOSE: This study was designed to assess the effect of neurodynamic mobilization of the median nerve on upper limb spasticity in tetraplegic patients. OVERVIEW OF LITERATURE: Spasticity is a common and potentially disabling and bothersome complication in patients with spinal cord lesion; this disorder can negatively influence the quality of life by restricting the patient's ability to perform activities of daily living. Neural mobilization is currently used for reducing the spasticity in individuals with neurological disorders. METHODS: Twenty subjects with traumatic spinal cord injury (level C5-C8) and upper limb spasticity in the finger and wrist flexors were enrolled. They were randomly allocated to two different groups using a computer-generated randomization schedule: group I comprised the neurodynamic mobilization group (n=11) and group II was the conventional therapy group (n=9); the subjects were administered therapy for 5 days every week for a period of 4 weeks. Upper limb spasticity was assessed using the Modified Ashworth Scale for wrist and finger flexors; F-wave amplitude, latency, and F-wave/M-wave amplitude ratio (F/M ratio) were examined using the F-wave scores of the median nerve; and upper limb function was determined using the Capabilities of Upper Extremity (CUE) Questionnaire. RESULTS: After 4 weeks of intervention, between-group comparisons showed a significant difference in the pre-intervention and postintervention scores on the Modified Ashworth Scale score for wrist flexors (-1.64±0.67), Modified Ashworth Scale score for finger flexors (-1.00±0.63), F-wave amplitude (-154.09±220.86), F/M ratio (-0.18±0.24), and CUE scores (17.82±13.49). CONCLUSIONS: These results suggest that neurodynamic mobilization of the median nerve may be effective for upper limb spasticity control and upper limb functional improvement in tetraplegic patients.

Integrating large mammal behaviour and traffic flow to determine traversability of roads with heterogeneous traffic on a Central Indian Highway.

Roads impact wildlife in multiple ways, most conspicuous amongst which are animal-vehicle collisions (AVCs). Mitigation measures to reduce AVCs at the local scale are often centred on species-specific crossing zones and collision hotspots. However, at the road network scale, consideration of interactions among road, species and traffic characteristics influencing AVC occurrence is required to design effective mitigation strategies. We modelled traversability-the probability of an animal successfully crossing a road- across an Indian highway for six large mammal species under different scenarios of road and traffic characteristics. Among the study species, group-living and slow-moving animals had higher AVC probabilities that increased significantly with increasing traffic volume and proportions of heavy vehicles in the traffic flow. The risk of AVC was higher for species that were active near roadside habitat during peak traffic hours. Our approach could help identify roads that pose potential mortality risks to animals using empirical data on animal and traffic characteristics. Results suggest that regulating traffic volume and heterogeneity on existing road stretches could potentially reduce animal mortality and barrier effect. Mitigation on roads expected to carry heavy traffic loads passing through ecologically-sensitive areas should be prioritised to ensure traversability for animal communities.

A machine learning approach to integrate big data for precision medicine in acute myeloid leukemia.

Cancers that appear pathologically similar often respond differently to the same drug regimens. Methods to better match patients to drugs are in high demand. We demonstrate a promising approach to identify robust molecular markers for targeted treatment of acute myeloid leukemia (AML) by introducing: data from 30 AML patients including genome-wide gene expression profiles and in vitro sensitivity to 160 chemotherapy drugs, a computational method to identify reliable gene expression markers for drug sensitivity by incorporating multi-omic prior information relevant to each gene's potential to drive cancer. We show that our method outperforms several state-of-the-art approaches in identifying molecular markers replicated in validation data and predicting drug sensitivity accurately. Finally, we identify SMARCA4 as a marker and driver of sensitivity to topoisomerase II inhibitors, mitoxantrone, and etoposide, in AML by showing that cell lines transduced to have high SMARCA4 expression reveal dramatically increased sensitivity to these agents.