Introduction: Lateral epicondylitis (LE) is a painful condition of the elbow, resulting from non-inammatory tendinopathy along the extensor origin of the lateral epicondyle. PRP and ESWT are commonly used therapies for the treatment of chronic lateral epicondylitis. But the superiority of treatment over one another is not known. This study is conducted to compare between platelet rich plasma injection and ESWT therapy in the improvement of pain and function in chronic lateral epicondylitis. Materials and Methods: A randomized controlled study was conducted in Department of Sports Medicine, Imphal on patients with chronic lateral epicondylitis comparing the effectiveness of PRP (Study group) and ESWT(control group). Data were collected from a sample size of 84 patients fullling the inclusion criteria. Analysis was done by using mean, SD, chi square test and independent t-test. Results: VAS and DASH score were used as outcome measures which was measured at baseline, 4 weeks,12 weeks and 24 weeks. VAS score improved from 7.13 ± 0.48 to 3.25 ± 1.20 and DASH score improved from 88± 0.9 to 34.16± 0.6 in the study group at 24 weeks follow up. Conclusion:There was signicant improvement in all outcome measures with p-value of <0.05 in study group. Hence, PRP is a promising technique for the treatment of chronic lateral epicondylitis.

Background: Ankle sprain is the most common injury in the world of sports and anterior talofibular ligament (ATFL) is most commonly affected. It is often underestimated, mismanaged and often result in delayed treatment, prolonged recovery times and long-term sequela. PRP may have enhancing effect on healing of partial tear of ATFL. Thus, the purpose of this study is to determine the role of PRP on partial tear of ATFL. Methods: A randomized controlled trail was done among athletes with partial tear of ATFL who visited Department of Sports Medicine, RIMS, Imphal during January 2021 – June 2022. Patients with MRI diagnosed partial tear of ATFL (N=48) randomized into PRP injection plus rehabilitation, (n=24) and rehabilitation alone, (n=24) groups. The outcomes were compared using Foot and Ankle Disability Index (FADI) score for function and Visual analogue scale for pain at baseline, 2nd, 6th, 12th and 24th weeks respectively. Results: Baseline characteristics were not statistically significant. There was statistically significant improvement seen in within the group comparison from baseline to 2nd, 6th, 12th and 24th weeks in both FADI and VAS in both the groups. There were statistically significant difference in mean changes of VAS and FADI score between the two groups from baseline to 2nd (p=0.007);(p=0.012), 6th (p=0.018);(p=0.009) and 12th (p=0.004); (p=0.001) follow-ups respectively with PRP group having more improvement however no significant difference at 24th weeks. Conclusion: Ultrasound guided PRP injection along with standard rehabilitation program might be a treatment of choice for partial ATFL tear. Keywords: ATFL tear, PRP, FADI, VAS, USG-guided.

Objective Study of effectiveness of shoulder elbow wrist hand orthosis in the management of glenohumeral subluxation in post-stroke hemiplegic patients. Methods Design: Randomised control trial. Setting Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences (RIMS), Imphal. Participants Post-stroke hemiplegic patients (n=120) having glenohumeral subluxation (GHS) as confirmed by x-ray. Duration One and half years (August 2010 to January 2012). Intervention Control group (n=60) received routine rehabilitation programme for hemiplegic practice in the Department of PMR, RIMS while the experiment group (n=60) received shoulder elbow wrist hand orthosis in addition to rehabilitation programme. Outcomes Grade of glenohumeral subluxation using x-ray. Results Experiment group showed reduction in the glenohumeral subluxation which is statistically significant when compared to control group (p<0.001). Conclusions Use of upper limb orthosis in addition to routine rehabilitation programme can effectively reduce glenohumeral subluxation in post-stroke hemiplegic patients.

BACKGROUND The most significant impact on a stroke survivor is longterm disability. Patients with hemiplegia often develop abnormal patterns in the paretic limbs, primarily affecting the flexors and pronators of upper limb. Spasticity is the most common identified problem and is difficult to treat. There are very few documents on the role of wrist hand orthoses (hand splints) in the management of spasticity. The objective of this study was to determine the effectiveness of wrist hand orthoses in the reduction of spasticity of upper limb in post stroke hemiplegia. MATERIALS AND METHODS All hemiplegic patients aged 35 to 75 years, who attended PMR OPD during August 2013 to July 2015 were included in the study. Only those cases with history of stroke less than six weeks duration, unable to extend the wrist actively and spasticity of ≤ grade 2 were included in the study. Block randomisation was used to randomise the patients into intervention and control groups. A reduction in spasticity was the main outcome measure and it was measured by Modified Ashworth Scale (MAS).

Context: De Quervain's disease tenosynovitis is a painful inflammation of tendons on the side of the wrist at the base of the thumb. The most common cause is chronic overuse. It can be self-limited and may resolve without intervention. For those individuals with persistent symptoms, nonsurgical modalities such as rest, massage, cold and heat application, splinting, physical therapy, systemic anti-inflammatory drugs, and corticosteroid injections have been tried with variable success. Aims: The aim of this study was conducted to compare the efficacy of thumb abduction orthosis with local methylprednisolone acetate injection for the management of De Quervain's tenosynovitis. Settings and Design: A randomized controlled study was conducted from September 2017 to August 2019, in the Physical Medicine and Rehabilitation Department of a tertiary hospital in Imphal, Manipur. Subjects and Methods: In Group 1, thumb abduction orthosis was applied, and in Group 2, injection methylprednisolone acetate was given in the first dorsal compartment. Treatment effectiveness was measured by visual analog Scale (VAS) for pain and Quick disabilities score of the Arm, Shoulder, and Hand (quick DASH) for functional assessment. Follow-up assessment was done at 1 month, 3 months, and 6 months. Statistical Analysis: Chi-square test, independent t-test, and paired t-test were used for analysis. Results: Out of the total 60 patients, 51 patients were females and 9 were males. There was a significant improvement in both mean VAS scores and Quick DASH scores in both the groups. At 1-month of follow-up, VAS and Quick DASH score in control group significantly improved compared to study group (P < 0.05). However, there was no statistically significant differences between the two groups at 3 months and 6 months follow-up period (P > 0.05). Conclusions: Although methylprednisolone acetate injection has an excellent outcome, thumb abduction orthosis can be an alternative treatment option for De Quervain's disease.