openAccessArticle: TruePage Range: 99-99doi: 10.1016/j.hkpj.2012.06.001Harvest Date: 2016-01-12 15:11:45issueName:cover date: 2012-12-01pubType: Research Repor

The aim of the present study was to analyze the diagnostic accuracy of the commonly used provocative tests in the diagnosis of lateral epicondylitis (LE). Cozen's test, Mills test and Maudsley test are most widely used. Till date no studies have been reported on the diagnostic accuracy of these tests. Musculoskeletal ultrasonography serves as a gold standard tool in the diagnosis of LE. Thirty subjects participated in the study. Baseline measurements of pain severity, elbow joint mobility, hand grip strength and three provocative tests were recorded by the principal investigator. A second investigator accompanied the subjects for musculoskeletal ultrasonography who was blinded of the test results. The thickness of common extensor tendon, echo texture and lateral epicondyle bony contour was measured. The test results of the three provocative tests with ultrasonographic findings were analyzed. The sensitivity for Cozen's test, Maudsley test and Mills test was found to be 84%, 88% and 53% respectively. The specificity for Cozen's Maudsley and Mills test was found to be 0%, 0% and 100% respectively. Mills test showed significant area under receiver operator curve (ROC) i.e. (0.769), which explains that the test has good diagnostic accuracy. This validation study, concludes that Mills test has an excellent diagnostic value for ruling in LE.

Introduction: Total knee replacement (TKR) surgery has become the most successful surgery for patients with severe debilitating arthritis. The guidelines for rehabilitation progression should be tailored respecting the tissue healing parameters. Hence, the current literature states a need for protocol to mitigate these impairments and ultimately result in improved functional outcomes.Objective: The present study aimed to validate the content of TKR rehabilitation protocol in Indian population. Materials and Methods:The process of content validation involves development stage and expert judgment stage. The protocol was designed into three stages with extensive review of literature. After designing the protocol, nine experts in field of musculoskeletal Physiotherapy performed the judgemental process. The process of validation includes rating of experts in a 5 point likert grading on two parameters namely relevance and ease of performance. Based on expert's inputs on TKR protocol, the level of agreement, content validation index and kappa value was calculated. Results:The three staged TKR protocol almost exhibited an excellent agreement on all stages. However, muscle activation exercises (except Vastus medialis obliques activation), stretching, strengthening program and functional training showed 100% agreement than other stages. Conclusion:The structured TKR protocol exhibited excellent content validity to its use in Indian population.

Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression) on functional outcome in neck pain. Methods:A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis.Result: There was no statistical significance between groups (p≥0.05). But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01) in relation to all parameters. Conclusion:Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in pain pressure threshold and functional outcome in neck pain.

Background: Mechanical neck pain is most prevalent in middle age and a common condition affecting 22 % to 70% of the general population. While the exact aetiology of the pain is unknown, most of the mechanical pain is due to mechanical factors such as sprains and strains of the neck muscles or ligaments. Methods: 60 subjects (male 33, female 27) with mechanical neck pain who fulfilled the inclusion criteria were chosen. After baseline evaluation of history, NPRS, cervical range of motion and Deep Cervical Flexor Endurance (DCF), the subjects were allocated into three groups which received DCF training by modifying the use of pressure biofeedback. Group 1 received DCF Training with Visual Pressure Biofeedback 10 repetition for three sets. Group 2 received DCF training without Visual Pressure Biofeedback 10 repetition three sets. And Group 3 received DCF training with Pressure Biofeedback (without visual input) 3 set of 10 repetitions. After 15 days of intervention, post-intervention measures of the variables were obtained.Results: Data were analyzed using SPSS 1 version. Between-group analyses showed that subjects in Group 1 have a statistically and clinically significant improvement (p-value< .005), pain (NPRS), cervical ROM, DCF endurance and Neck Disability Index when compared to the Group 2 and 3. The pre and post values for all the three groups within the group analysis showed a statistical and clinically significant difference. Conclusion:Deep Cervical Flexor Training with Visual Pressure Biofeedback provides better clinical improvement in terms of pain reduction, cervical flexion and extension ROM, DCF endurance, and Neck Disability Index score.