Department of Occupational Therapy - Publication 2016-17
- Mirror Therapy in Management of Somato-Sensory Impairment among Post-stroke. Vikas, Kamal Narayan Arya, Shanta Pandian, Tinu Sethi, Saren Kumar Samal. (Abstract) International Journal of Stroke 2016 Vol.11(3S) 132-133.
- Shoulder Subluxation as a Challenge in Stroke: A Systematic Review. Vikas, Kamal Narayan Arya, Shanta Pandian, Tinu Sethi. (Abstract) International Journal of Stroke 2016 Vol.11(3S) 132-133.
- Rivermead Visual Gait Assessment: A Reliable and Valid Post-Stroke Gait Measure in Developing Countries. Vikas, Kamal Narayan Arya Shanta Pandian, Tinu Sethi, Saren Kumar Samal. (Abstract) International Journal of Stroke 2016 Vol.11(3S) 132-133.
- Task-based Mirror Therapy Enhances Ipsilesional Motor Functions In Stroke: A Pilot Study Kamal Narayan Arya, Shanta Pandian & Dharmendra Kumar. Journal of Body work & Movement therapy April 2017;21(2):334-341.
- Does an association exist between the hierarchical motor components of upper and lower limbs in stroke? Kamal Narayan Arya, Shanta Pandian & Dharmendra Kumar. Journal of Body work & Movement therapy July 20(3):504-11; 2016
- Minimal Clinically Important Difference of the lower-extremity Fugl–Meyer Assessment in Chronic-Stroke. Shanta Pandian, Kamal Narayan Arya & Dharmendra Kumar. Topics in stroke rehabilitation, August 2016;23(4):233-9
- Development, validity and reliability of the ‘Sitting Balance Measure’ (SBM) in spinal cord injury. Gunjan Wadhwa and Ruby Aikat. Spinal Cord. 2016 April; 54: 319-323.
Department of Occupational Therapy - Presentations 2016 -2017
- Autism Spectrum Disorder & Occuational therapy: Available evidences to look forward. Shanta Pandian & Kamal Narayan Arya. Presented & Published in Abstarct-Book in Seminar on Therapeutic Intervention in Autism Spectrum Disorder, Pt. Deendayal Upadhyaya National Institute for Physical Disabilities, 29th & 30th March 2017, at New Delhi.
- Mirror illusion for Sensory-Motor training in stroke: An RCT. Vikas, Kamal Narayan Arya, Shanta Pandian. Presented & Published in Conference Souvenir – 54th Annual National Conference of All India Occupational Therapist Association, 17th to 19th February 2017, at Jaipur.
- Predictors of shoulder subluxation in post-stroke hemiparesis. Vikas, Kamal Narayan Arya, Shanta Pandian. Presented & Published in Conference Souvenir – 54th Annual National Conference of All India Occupational Therapist Association, 17th to 19th February 2017, at Jaipur.
- Utilization of Synergistic Linkage in Motor Rehabilitation of Stroke: A pilot Study. Shanta Pandian, Kamal Narayan Arya, Tinu Sethi, Vikas, Vinod Puri. Presented & Published in Conference Souvenir – 54th Annual National Conference of All India Occupational Therapist Association, 17th to 19th February 2017, at Jaipur.
- Mirror Therapy for Post-Stroke Deficits in Elderly Population: An RCT” Vikas, Kamal Narayan Arya, Shanta Pandian, Vinod Puri. Presented & Published in Congress Souvenir – 4th World Congress of Gerontology and Geriatrics 23-25th November 2016, Bengaluru.
- Conducted workshop on Stroke rehabilitation: Translating Evidence to Practice at Pt. Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi on 19th November 2016.
- Mirror Therapy in Management of Somato-Sensory Impairment among Post-stroke. Vikas, Kamal Narayan Arya, Shanta Pandian, Tinu Sethi, Saren Kumar Samal. Presented & Published in Congress Souvenir 10th World Stroke Congress 26-29th October 2016 Hyderabad.
- Shoulder Subluxation as a Challenge in Stroke: A Systematic Review. Vikas, Kamal Narayan Arya, Shanta Pandian, Tinu Sethi. Presented & Published in Congress Souvenir 10th World Stroke Congress 26-29th October 2016 Hyderabad.
- Rivermead Visual Gait Assessment: A Reliable and Valid Post-Stroke Gait Measure in Developing Countries. Vikas, Kamal Narayan Arya Shanta Pandian, Tinu Sethi, Saren Kumar Samal. Presented & Published in Congress Souvenir 10th World Stroke Congress 26-29th October 2016 Hyderabad.
- Task Based Mirror Therapy Augments Motor Recovery, Gait, Balance in Stroke. Kamal Narayan Arya, Shanta Pandian, Vikas, Tinu Sethi, Saren Kumar Samal. Presented & Published in Congress Souvenir 10th World Stroke Congress 26-29th October 2016 Hyderabad.
- Effect of Interlimb Coupling on Recovery and Gait in Post-Stroke Hemiparesis. Kamal Narayan Arya, Saren Kumar Samal, Shanta Pandian, Vikas, Tinu Sethi. Presented & Published in Congress Souvenir 10th World Stroke Congress 26-29th October 2016 Hyderabad.
Completed Projects 2016-17
1. Synergy based motor therapy program for Stroke patients (July 2015 to September 2016).
2. Principal Investigator - Ms. Shanta Pandian, Lecturer OT
Funded by Department of Health Research, Ministry of Health & Family Welfare, Govt. of India
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Synergy, working together of muscles in a coordinated fashion, is a normal neurophysiological mechanism. Abnormal stereotyped motor behaviour appears in post stroke hemiparesis patients. Facilitation of normal synergy and dissociation of abnormal synergy may influence motor recovery. The application of synergy concept in stroke rehabilitation is sparse.
Setting: Rehabilitation Institute
Participants: 50 (29 males, 40 to 60 years, 28 ischemic) chronic poststroke hemiparetic subjects
Design: Pre test post test single group, Phase I trial
Interventions: Considering the relation between normal and abnormal synergies, a motor therapy protocol using various tasks / activities was developed. Synergistic movements were selected on the basis of quality, quantity and association of the available movements. For example, shoulder external rotation with elbow extension was utilized to dissociate strong elbow flexion.
Outcome measures: Fugl-Meyer Assessment (Upper Extremity)(FMA-UE) - to assess the voluntary motor control, mRS scale and Barthel Index to measure functional use of the upper limb.
Results: The motor rehabilitation protocol using synergy concept was feasible among all the participants and across all the stages of motor recovery. Post-intervention subjects exhibited significant (p=0.02) change on FMA-UE (37.75+ 16.93 to 42.5+19.37).
Conclusion: Synergy based motor rehabilitation is beneficial in improving motor and functional recovery in stroke patients. The utilization of synergistic linkage should be explored in stroke rehabilitation.
Publication / presentation
- Abstract published in conference souvenir: Scapular Motor control: A key to Upper Limb recovery in stroke. Tinu Sethi, Shanta Pandian, Kamal Narayan Arya, Vikas, Dharmendra Kumar – 53rd Annual National Conference of All India Occupational Therapist Association, 29th to 11th January 2016, at Chennai.
- Shoulder Subluxation as a Challenge in Stroke: A Systematic Review. Vikas, Kamal Narayan Arya, Shanta Pandian, Tinu Sethi – Presented at World Stroke Congress, Hyderabad, October 2016 & Abstract Published in International Journal of Stroke; 11 (3S) 2016.
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4. Interlimb coupling in post-stroke rehabilitation (December 2015 to November 2016).
5. Principal Investigator – Dr. Kamal Narayan Arya, Lecturer (OT)
Funded by Indian Council of Medical Research, New Delhi
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In India, stroke incidence has been registering an upward trend in the last few decades. Disability due to motor impairment of the limbs is the most common and challenging manifestation of stroke. Interlimb coordination, a relative timing of events between the four limbs during functional performance gets hampered after stroke. In spite of motor recovery, the post stroke hemiparetic subjects are not able to use their limbs in daily tasks efficiently; thus, increasing their disability level.
There is a neural cross talk between 2 brain hemispheres modulates task-specific actions, leading to a complex intra- & interlimb joint interaction. The concept can be explored and utilized in stroke rehabilitation.
The intervention based on the principles of interlimb coordination and coupling found to be feasible for stroke subjects. The regime comprises movements of either upper limbs or lower limbs or all 4 limbs using various therapeutic devices. The movements may be provide in various combination of the upper and lower limbs such as bilateral, ipsilateral, contralateral, symmetrical, and asymmetrical.
In a randomized controlled trail on 50 subjects, the interlimb coupling program exhibited significant improvement of motor recovery of the upper and lower limbs as measured by Fugl-Meyer assessment [p< 0.001; 95% CI mean of difference = 8.83 (7.60 – 10.06)]. The gait deviation on Rivermead Visual gait assessment reduces significantly [p< 0.001; 95% CI of mean difference = 6.32 (7.51 – 5.13)]. 50% of the experimental subject could reach to the highest level of functional ambulation. 15% experimental-participants demonstrated considerable change of disability level (Modified ranking scale 2 from stage 3 or 4) in comparison to the controls.
In summary, the interlimb coupling based stroke rehabilitation may enhance motor recovery and functional ambulation while reducing gait deviation and level of disability. The concept may be incorporated in post stroke management.
Publications / Presentations:
- Effect of Interlimb coupling on motor recovery and gait among post-stroke hemiparesis. S Samal, Arya KN, Pandian S, Vikas, Sethi T, Puri V. Presented & Abstract published in congress proceedings at World Stroke Congress, October 2016 at Hyderabad, India.
- Rivermead Visual Gait Assessment: A Reliable and Valid Post-Stroke Gait Measure in Developing Countries. Vikas, Kamal Narayan Arya Shanta Pandian, Tinu Sethi, Saren Kumar Samal. (Abstract) International Journal of Stroke 2016 Vol.11(3S) 132-133.
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