Cross-sectional study.

Department of Physical Medicine and Rehabilitation (PMR), Regional Institute of Medical Sciences, Imphal.

Two years October 2011- September 2013.

To measure the pain and disability in patients suffering from adhesive capsulitis of shoulder and its relation with stages of adhesive capsulitis.

Idiopathic adhesive capsulitis patients attending PMR Department who fulfilled the inclusion criteria.

Fifty-six patients suffering idiopathic adhesive capsulitis of the shoulder were included in the study. The mean age of the study population was 56.30±8.17 (range 40-70) years, male comprised 57.1% while female 42.9%. Shoulder ROM showed rotation most restricted followed by abduction, flexion and extension. Mean VAS pain score was highest in stage 1 (80.36±8.42) and lowest in stage 4 (38.33±7.42) and it was found to be statistically significant (p< 0.001). Mean SPADI disability score was highest in stage 3 (68.56±5.79) and lowest in stage 1 (41.14±7.90) and found to be statistically significant (p<0.001).

Stages of adhesive capsulitis are found to be closely related to pain and functional disability of the patient. SPADI can be used in recording pain and disability in patients suffering from adhesive capsulitis and can be useful in planning the treatment of such patients in local context.

This study was undertaken with the aim to compare the effects of home-based habilitation programmes with the effects of hospital-based habilitation programme for children with cerebral palsy (CP) on motor performance and daily functioning.

The study was conducted on a sample of 60 children with cerebral palsy. First group included 30 children, 5 to 12 years old, who had a continued physical home treatment and education in public/special school. The second group consisted of 30 children, from Banja Luka region, who continued inpatient habilitation programme and training. Habilitation outcomes were analysed by measuring muscle tone (using original Tardieu Scale), muscle strength, range of motion (ROM), gross motor functions (gross motor function measure-88) and the Barthel Index of activities of daily living (ADL).

The proportion of clinically significant change in gross motor functions, ADLs, ROM and muscle strength didn't show major differences between the two groups.

There were no significant differences in effectiveness between home-based and hospital-based habilitation programmes according to the treatment outcomes. The effectiveness of home-based programme increases when supplemented by frequent consultations with the rehabilitation team members and occasional out-patient physical therapy treatment, education as well as counselling and support for parents.

India has eradicated leprosy as per WHO norms but the cases with residual deformities will persist for long. With this idea, a study was undertaken on consecutive 70 patients coming to the outpatient section of Physical Medicine and Rehabilitation Department of Safdarjang Hospital, New Delhi to study various deformities and bony changes. All the patients were leprosy cured but attending hospital for their deformities only. Specific bony changes were seen in multibacillary patients, while the non-specific and osteoporotic changes were seen in all types of patients. Patients appeared more willing to get the deformities treated than hiding the same from the society.

Case report.

To describe an unusual case of deep diving followed by spinal cord injury due to decompression sickness (DCS).

Princess Royal Spinal Injuries Centre, Sheffield Teaching Hospitals NHS Foundation Trust, England.

Description and observation of management and outcomes, of spinal decompression sickness (DCS).

The patient's symptoms and signs developed after she surfaced after a deep sea diving event. She was managed and treated in a tertiary level care hospital. MRI performed within 24 hours, showed signs of increased signal intensity in the cervical and thoracolumbar regions. She was treated with hyperbaric oxygen which improved her pain symptoms but there was no immediate resolution in motor sensory deficits. Repeat MRI done after a week showed resolution if hyperintensity in the cervical region but not in the thoracolumbar region. Patient progressed to have significant neurological recovery in the next 6 months. She became ambulant with unilateral ankle foot orthotic and a pair of crutches, she continued to have bladder incontinence at 1 year follow-up interval.

Central nervous involvement is not uncommon in decompression sickness in divers. Early diagnosis and proper management can reduce acute symptoms and prevent further complications of permanent neurological disability. Primary prevention by education and adhering to standard diving guidelines is needed to reduce mortality and morbidity in decompression sickness.

Post polio syndrome, a well-recognised clinical entity now, has become a great challenge to the medical and surgical rehabilitation professionals, as more and more paralytic polio survivors age into fourth to sixth decades of their lives. Early diagnosis and timely rehabilitation of a person with post polio syndrome is important because at around this age one is just reaching the prime of one's productive life and starts consolidating socio-economic status of self and the family. There is paucity of literature or case reports on post polio syndrome from India. Here we report three cases of post polio syndrome in their forties and early fifties, attending outpatient rehabilitation programme. Their clinical presentation, rehabilitation management and outcome have been discussed. Diagnostic criteria and possible pitfalls in diagnosis in the light of available literature have been emphasised.