Asian Journal of Medical Research

Assessment of Effect of TENS, EMS, Active and Passive Exercises in Chronic Hemiplegic Stroke Patients Using Modified Ashworth Scale

Shilpa Hardaha — 2022-09-21

Background: The aim is to assess effect of TENS, EMS, active and passive exercises in chronic hemiplegic stroke patients using Modified Ashworth Scale. Subjects and Methods: All were divided into 4 groups of 20 each. Group A hemiplegic subjects were given TENS, group B hemiplegic subjects were given EMS, group C hemiplegic participants were subjected to active and passive exercise and group D hemiplegic participants were subjected to active and passive exercise along with TENS and EMS. Spasticity was calculated by the MAS. The Timed Up and Go (TUG) test was used to evaluate dynamic balance. Results: The mean pre- treatment FMA value in group A was 26.5 and post- treatment FMA was 41.7, in group B pre- treatment FMA value was 26.8 and post- treatment FMA value was 42.2, in group C pre- treatment FMA value was 26.8 and post- treatment FMA value was 43.8 and in group D pre- treatment FMA value was 26.9 and post- treatment FMA value was 45.1. The mean pre- treatment NDS value in group A was 25.6 and post- treatment NDS was 18.4, in group B pre- treatment NDS value was 25.8 and post- treatment NDS value was 20.7, in group C pre- treatment NDS value was 25.4 and post- treatment NDS value was 17.3 and in group D pre- treatment NDS value was 25.8 and post- treatment NDS value was 15.2. The mean pre- treatment MAS value in group A was 2.67 and post- treatment MAS was 2.04, in group B pre- treatment MAS value was 2.80 and post- treatment MAS value was 2.70, in group C pre- treatment MAS value was 2.82 and post- treatment MAS value was 1.98 and in group D pre- treatment MAS value was 2.67 and post- treatment MAS value was 1.82. The mean pre- treatment TUG value in group A was 26.1 and post- treatment TUG was 21.4, in group B pre- treatment TUG value was 25.4 and post- treatment TUG value was 22.8, in group C pre- treatment TUG value was 26.8 and post- treatment TUG value was 25.8 and in group D pre- treatment TUG value was 26.6 and post- treatment TUG value was 20.2. Conclusion: Physiotherapy is one of effective management in retaining strength, spasticity and range of movement in post stroke patients. Early rehabilitation such as TENS, EMS and active and passive exercise, in patients with acute CVA, body balance and movement coordination training can help them improve their ability to move their hemiplegic lower extremity.

Comparative Analysis of Impact of TENS and EMS on Treatment of Patients with Chronic Hemiplegia Caused by Stroke Using Fugl-Meyer Assessment Scale

Shilpa Hardaha — 2022-09-21

Background: The aim is to compare impact of TENS and EMS on treatment of patients with chronic hemiplegia caused by stroke using Fugl-Meyer assessment scale. Subjects and Methods: Subjects were divided into 2 groups of 20 each. Group A were hemiplegic subjects who were given TENS and group B were hemiplegic subjects who were given EMS. FMA, NDS and BI value were compared. Results: Left side was involved in 8 patients in group A and 11 in group B and right side in 12 in group A and 9 in group B. Type of stroke was ischemic in 5 in group A and 8 in group B and haemorrhagic in 15 patients in group A and 12 in group B. SBP was 120.4- and 68.4-mm Hg in group A and 124.6 and 70.2 mm Hg in group B. The mean pre- treatment FMA value in group A was 26.5 and post- treatment FMA was 41.7, in group B pre- treatment FMA value was 26.8 and post- treatment FMA value was 42.2. The mean pre- treatment NDS value in group A was 25.6 and post- treatment NDS was 18.4, in group B pre- treatment NDS value was 25.8 and post- treatment NDS value was 20.7. The mean pre- treatment BI value in group A was 32.5 and post- treatment BI was 50.2, in group B pre- treatment BI value was 33.2 and post- treatment BI value was 54.7. Conclusion: Physiotherapy is one of effective management in retaining strength and spasticity in stroke patients. Both TENS and EMS can help them improve their ability to move their hemiplegic lower extremity.

Functional and Radiological Outcome of Long Bone Fractures in Children (5-14 Years) Using Flexible Intramedullary Nail (FIN)

Deepak Singh — 2022-09-21

Background: Treating fractures of long bones in children presents special challenges to the orthopaedic surgeons. In addition to smaller size, the presence of open physis and immature vascular patterns must be considered. Flexible intramedullary nailing (FIN) or titanium elastic nail (TEN) are preferred over conservative and other operative managements like traction, splints/ orthosis, plaster casts, external fixation, and open reduction and internal fixation using plates and screws nails for various long bone fractures in children older than five years. The purpose of the study was to find out clinical, functional and radiological outcome of long bone fractures in children between the age of 5 to 14 years treated using flexible intramedullary nail and report the complications associated with same. Subjects and Methods: A total 40 patients in the age group of 5-14 years with fractures of femur, tibia, humerus and radius/ulna were stabilized using flexible nailing. Clinical and radiological follow-up was done for a period of 3 years from October 2014 to October 2017. The functional results were analysed by using range of motion (ROM) in various joints and limb length and Radiological union was assessed by the identification of bridging callus at 3 cortices on antero-posterior and lateral radiographs. Results: Mean age at surgery was 9.77 years (range 7.29-12.25 years). The mean duration of surgery was 53 (35-90) minutes and the range of duration of hospital stay was 2-20 days. Delayed union (n=2) was the most common complication followed by superficial infection (n=1). 92.5% of cases achieved full range of motion, 82.5% cases were found radiological union within five weeks of operation. Conclusion: Based on our experience and results, we conclude that flexible intramedullary technique (FIN) as a minimal invasive procedure appears to be safe and reliable method that has good long-term results in the treatment of pediatric diaphyseal fractures of long bones in children aged 5-14 years. Early range of motion with bony union is achieved in most of patients but still require studies with larger data to validate the findings of this study.