1.Influence of Sitting and Prone Lying Positions on Proprioceptive Knee Assessment Score in Early Knee Osteoarthritis
Vijay Batra ; Vijai Prakash Sharma ; Meenakshi Batra ; Girdhar Gopal Agarwal ; Vineet Sharma
Malaysian Journal of Medical Sciences 2011;18(2):40-46
Background: Knee proprioception is compromised in knee osteoarthritis. There are several
ways of measuring proprioceptive acuity, but there is lack of consensus over the ideal testing
position. The study aimed to evaluate the influence of 2 testing positions (sitting versus prone lying)
on proprioceptive knee assessment score in patients with early knee osteoarthritis.
Methods: The study included 70 subjects who came to the Out-Patient Department with a
diagnosis of early knee osteoarthritis. The subjects were assessed for their proprioceptive acuity
scores in both the test positions at 30° and 60° of knee flexion using proprioceptive knee assessment
device. They were asked to perform 5 trials in both testing positions with appropriate rest intervals.
After initial assessment, the subjects were randomly allocated among group 1 and group 2. Treatment
implementation was done for 8 weeks followed by re-evaluation: group 1 received context-specific
proprioceptive retraining along with multijoint coupling strategies and group 2, conventional
treatment.
Results: The subjects were compared using difference of pre- and post-treatment
proprioceptive acuity scores. The difference of proprioceptive acuity impairment scores of the left
knee at 30° and 60°, and the right knee at 60° in prone lying position were statistically significant,
with P value ranging from less than 0.001 to 0.028.
Conclusion: It was found that the prone lying testing position was more sensitive than sitting
position for assessing proprioceptive acuity for knee osteoarthritis.
2.Modulating Tone to Promote Motor Development Using a Neurofacilitation of Developmental Reaction (NFDR) Approach in Children with
Vijay Batra ; Meenakshi Batra ; Ravindra Mohan Pandey ; Vijai Prakash Sharma ; Girdhar Gopal Agarwal
Malaysian Journal of Medical Sciences 2015;22(5):50-56
Objective: To compare the efficacy of a Neurofacilitation of Developmental Reaction
(NFDR) approach with that of a Conventional approach in the modulation of tone in children with
neurodevelopmental delay.
Methods: Experimental control design. A total of 30 spastic children ranging in age from 4
to 7 years with neurodevelopmental delay were included. Baseline evaluations of muscle tone and
gross motor functional performance abilities were performed. The children were allocated into two
intervention groups of 15 subjects each. In groups A and B, the NFDR and conventional approaches
were applied, respectively, for 3 months and were followed by subsequent re-evaluations.
Results: Between group analyses were performed using independent t test for tone and
primitive reflex intensity and a Mann-Whitney U test for gross motor functional ability. For the
within-group analyses, paired t tests were used for tone and primitive reflex intensity, and a Wilcoxon
signed-rank test was used for gross motor functional ability.
Conclusion: The NFDR approach/technique prepares the muscle to undergo tonal modulation
and thereby enhances motor development and improves the motor functional performance abilities
of the children with neurodevelopmental delay.