ISSN P - 0973-5666 ISSN E - 0973-5674 Volume 4
Number 1
January - March 2010
Indian Journal of Physiotherapy and Occupational Therapy
An International Journal
website: www.ijpot.com
www.ijpot.com
Contents Volume 4, Number 1
January - March 2010
1
Dynamic balance and mobility in females with knee osteoarthritis Abha Sachdev, Savita Tamaria
4
Effect of strength training of muscles of lower limb of young children with cerebral palsy on gross motor function Aditya Kumar, Samim Kabeer, Ruby Aikat, Monika Juneja
8
Comparison of three different treatment protocols of low-energy radial extracorporeal shock wave therapy for management of chronic plantar fasciitis Afaf A.M. Shaheen
13
The effect of insole on ground reaction forces of two-legged vertical jumping for heading ball in flexible flat foot male subjects Ali Asghar Arastoo
17
Adaptability in nature – Are lungs moldable? Amrith Pakkala
19
Effect of performing a cognitive task on gait performance in patients with hemiparesis following stroke of greater than three months duration Angusamy R., Chandbibi. M.Y.
24
Awareness on diabetes mellitus and physical activity level among Malaysian public Ayiesah R., Nur Hidayah A. B., Nor Azura A.
29
Effect of high voltage healthron device on blood pressure and plasma glucose of normal subjects – A technical report Onigbinde Ayodele.T., Adedoyin Rufus. A.
32
Site specificity of sports injuries seen during the interschool competations held at belgaum an observational study Motimath B.S., Ganesh B.R., Murakibhavi V.G.
35
Mental imagery–A review Chaya Garg
38
Incidence of brachial plexus injuries during cardiac surgeries - A review of literature Darshpreet Kaur, Nidhi Billore
43
Family caregivers of Nigerian–African stroke survivors: Their knowledge and beliefs about stroke Tal-Hatu K. Hamzat, Oyedunni S. Arulogun, Salim A. Akindele
47
Efficacy of modified constraint-induced movement therapy in children with spastic hemiparetic cerebral palsy Mahotra Pardeep, Senthilkumar C. B., Shankar Mamta
54
Effectiveness of muscle energy technique on quadratus lumborum in acute low back painrandomized controlled trial Prachi N. Patil, Basavaraj Chandu, Santosh Metgud, Subhash Khatri
59
Paraplegic can walk: A case report and review of literature Rajni Arora, Pradipta Tripathy, Santhosh Kumar
62
Stretching procedures for posterior shoulder tightness– randomized clinical trial Ranjeet Sharma, Ganesh B.R., Vijay B. Kage, Subhash M. Khatri
68
Effects of local vs global stabilizer strengthening in chronic low back pain Priyanka Goel, Zubia Veqar, Nishat Quddus
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Comparative analysis of stretching vs mobilization on posterior shoulder tightness in cricketers Shaji M.S. John, Rohit Chachra
80
The efficacy of monochromatic infrared photo-thermal energy therapy in rehabilitation: A pilot study report Stanley Paul, Yuanlong Liu, Robert McAlister
Indian Journal of Physiotherapy and Occupational Therapy. January - March 2010, Vol. 4, No. 1
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INDIAN JOURNAL OF PHYSIOTHERAPY AND OCCUPATIONAL THERAPY Editor Dr. Archna Sharma Head, Dept. of Physiotherapy, G.M. Modi Hospital, Saket, New Delhi - 110 017 E-mail :
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National Editorial Advisory Board Prof. U. Singh, New Delhi Dr. Dayananda Kiran, Indore Dr. J.K. Maheshwari, New Delhi Dr. Nivedita Kashyap, New Delhi Dr. Suraj Kumar, New Delhi Dr. Renu Sharma, New Delhi Dr. Veena Krishnananda, Mumbai Dr. Jag Mohan Singh, Patiala Dr. Anjani Manchanda, New Delhi Dr. M.K. Verma, New Delhi Dr. J.B. Sharma, New Delhi Dr. N. Padmapriya, Chennai Dr. G. Arun Maiya, Manipal Prof. Jasobanta Sethi, Bangalore Prof. Shovan Saha, Manipal Prof. Narasimman S., Mangalore Prof. Kamal N. Arya, New Delhi Dr. Nitesh Bansal, Noida Dr. Aparna Sarkar, Noida Dr. Amit Chaudhary, Faridabad Dr. Subhash Khatri, Belgaum Dr. S.L. Yadav, New Delhi Dr. Vaibhav Aggarwal, Meerut Dr. Sohrab A. Khan, Jamia Hamdard, New Delhi Print-ISSN: 0973-5666 Electronic - ISSN: 0973-5674, Frequency: Quarterly (4 issues per volume). “Indian journal of physiotherapy and occupational therapy” An essential indexed peer reviewed journal for all Physiotherapists & Occupational therapists provides professionals with a forum to discuss today’s challenges - identifying the philosophical and conceptual foundations of the practics; sharing innovative evaluation and tretment techniques; learning about and assimilating new methodologies developing in related professions; and communicating information about new practic settings. The journal serves as a valuable tool for helping therapists deal effectively with the challenges of the field. It emphasizes articles and reports that are directly relevant to practice. The journal is now covered by INDEX COPERNICUS, POLAND. The journal is indexed with many international databases. The journal is registered with Registrar on Newspapers for India vide registration DELENG/2007/20988
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Editor Dr. Archna Sharma Aster-06/603, Supertech Emerald Court Sector – 93 A, Expressway NOIDA 201 304, UTTAR PRADESH Printed, published and owned by Dr. Archna Sharma Printed at Process & Spot C-112/3, Naraina Industrial Area, Phase-I New Delhi-110 028 Published at Aster-06/603, Supertech Emerald Court, Sector – 93 A, Expressway, NOIDA 201 304, UTTAR PRADESH
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Indian Journal of Physiotherapy and Occupational Therapy. January - March 2010, Vol. 4, No. 1
Mental imagery–A review Chaya Garg Head, Banarsidas Chandiwala Institute of Physiotherapy, New Delhi
Mental imagery was defined by Denis1 in 1985 as "a psychological activity which evokes the physical characteristics of an object either permanently or temporarily absent from the perceptual field." The process can apply to static or dynamic events, past, recent or yet to be accomplished. Mental imagery, also called visualization and mental rehearsal, is the experience that resembles perceptual experience, but which occurs in the absence of the appropriate stimuli for the relevant perception. Whenever one imagines himself performing an action in the absence of physical practice, he is said to be using imagery. Mental imagery involves the efferent activation of visual areas in prestriate occipital cortex and parietal and temporal cortex, with these areas representing the same kinds of specialized information in imagery as in perception. Various modes of Mental Imagery include: 1. Visual mode (most commonly used) 2. Auditory mode and 3. Kinesthetic mode
Types Imagery is classified into two types External Imagery: which is predominantly visual and characterized as a third-person perspective i.e. seeing oneself performing Internal (motor) Imagery: which is kinesthetic and explained as a first-person perspective i.e. feeling oneself performing2 Research has demonstrated that the two types of imagery were physiologically distinct by observing greater muscle activity during internal imagery2,3,4. Furthermore it has been determined that the internal version is more effective when used in connection with motor performance5.
Mechanisms During mental practice, correlative activations occur at the cortical level as well as in the musculature imagined as being used. For example, Breitling and colleagues7 reported similar activity in the motor execution cortical areas when subjects imagined finger movements in a relaxed state as when they actually performed the movements7. Studies measuring electromyographic (EMG) activity, cortical motor evoked potentials, and cerebral blood flow also have shown that the appropriate neuromotor pathways imagined as being used are actually being used and that metabolic activity of neurons is increased during mental practice as if the activity is actually being performed8,9,10,11. Mental practice and physical practice also lead to plastic changes in the motor cortex area of the brain12. Other authors13 have determined that identical cerebellar control mechanisms are used in mental practice as are used in actual movement.
Jeanerrod and Frak6 found that neuron discharges in the parietal and premotor cortices ‘map’ a pattern of action even when the given action is not being physically performed. Further, they asserted that motor imagery could be a potent tool in improving the function of the motor system.
Development plan (Sports) Sport psychologist Rainer Martens suggested a three stage development plan to develop a systematic approach to using imagery Stage I: Sensory Awareness First step towards use of imagery is to develop sensory awareness. A fundamental point that must be made at this juncture is that visualisation and imagery are not one and the same; imagery should involve far more than visualisation, including the feelings of movements, sounds, emotions and, in some cases, even smells. A cricket batsman, for example, might attempt to become more aware of sensory process by recalling the important visual environmental features, as well as the sound of the bowler running-in and the noise the ball made through the air. He may recall the feel of swinging the bat and making contact with the ball. The subsequent sounds of bat on ball and the call of his partner to run may also be considered. The sense of control as the ball reached the boundary, a feeling of determination and the smell of freshly mown grass may help to stimulate all the senses. Therefore first stage is dedicated to appreciating things that the individual may have come to take for granted. Stage II: Develop Vividness The next step is to develop vividness. It is true that some people are able to recall or create very clear and vivid images, while others may struggle to get an image at all. With practice, though, most people are able to sharpen their images so that recognisable sensory experiences are evident. This is the stage to be creative and experiment by using scenes and experiences that are very familiar to you. These exercises do not need to be sport-specific at first, as the general idea is to promote overall clarity. Stage III: Control The final stage of the development plan involves control. If one is mentally rehearsing what he/she is going to do, it is important to have control over the images. This is because imagery can be destructive as well as helpful. If, for example, a golfer is imagining the path of the ball on the green but continually sees herself missing the putt, this is hardly likely to help. The great thing about imagery is that, even if the golfer has missed putts in reality, imagery provides an opportunity to correct errors.
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This stage is more sport specific and should incorporate the desired outcome. One should feel the movement and see a positive result, such as the golf ball following the correct path and entering the hole. If one does start imagining negative outcomes, one should try to recall a previous success – or even watch another person successfully complete the skill and try to replicate this in your mind, with yourself in the role of successful performer. Although the most obvious application of imagery is in the learning and performing of sport skills, there are many other ways to use the technique. For example, imagery can also be used to practise strategies, manipulate levels of arousal, manage stress, build confidence, deal with pain and periods of injury and develop an appropriate focus.
Categories of imagery For maximum effect, athletes should match the content or type of imagery with the desired outcome. Athlete should think carefully about the components of his imagined experiences and the aim of using imagery. Various aims may include facilitating learning and performance of skills and strategies, or attempting to build confidence or to motivate. The five main categories of imagery have been identified as follows: 1. Motivational-specific (MS): This involves seeing oneself winning an event, receiving a trophy or medal and being congratulated by other athletes. MS imagery may boost motivation and effort during training and facilitate goalsetting, but is unlikely on its own to lead directly to performance benefits. 2. Motivational general-mastery (MG-M): This is based on seeing oneself coping in difficult circumstances and mastering challenging situations. It might include maintaining a positive focus while behind, and then coming back to win. MG-M imagery is important in developing expectations of success and self-confidence. 3. Motivational general-arousal (MG-A): This is imagery that reflects feelings of relaxation, stress, anxiety or arousal in relation to sports competitions. MG-A imagery can influence heart rate – one index of arousal – and can be employed as a ‘psych-up’ strategy. 4. Cognitive specific (CS): This involves seeing yourself perform specific skills, such as a tennis serve, golf putt or triple-toe-loop in figure skating. If learning and performance are the desired outcomes, evidence suggests that CS imagery will be the most effective choice. 5. Cognitive general (CG): This involves images of strategy and game plans related to a competitive event. Examples could include employing a serve-and-volley strategy in tennis or a quick-break play in basketball. Case studies support the use of this type of imagery, although controlled experimental evidence is still needed. Clearly there is potential for these types of imagery to overlap if, for example, one imagines specific sports skills, such as a golf putt (CS), with the accompanying positive outcome and tournament-clinching result (MS). However, if one chooses the wrong type of imagery, she may not achieve any benefits. For example, Cognitive specific imagery significantly improves sit-up performance, while 36
Motivational general-mastery imagery is ineffective. Conversely, Motivational general-mastery imagery is more effective than Cognitive specific imagery for boosting selfconfidence. The trick is to decide what it is you want to achieve, then make the imagery content match your goals.
Effects & uses Mental practice (also known as "imagery"), when combined with physical practice, accelerates motor learning and improves subsequent physical performance15,16,17,18. Because of its positive effects on strength,19,20 endurance,21 and aim and precision,22,23 mental practice is frequently used by professional and amateur athletes24,25. Mental practice has also been suggested to be a viable tool for improving motor learning and performance in rehabilitative settings14,26. Some studies27,28 have demonstrated the effectiveness of mental practice in therapeutic settings in improving motor performance when it is combined with physical practice. Randomized controlled studies by Fansler et al27 and Linden and colleagues,29 for example, demonstrated greater improvements on balance tasks (eg, one-legged standing) among elderly women who combined mental practice with physical practice than those who participated only in physical practice. Fairweather and Sidaway30 reported that a 3-week mental practice program, when combined with physical practice, improved posture of individuals with abnormal curvature of the spine. In addition to using randomized controlled methods, all of these studies had independent evaluators and significant effects.
References 1. Denis, M.V. (1985) Visual imagery and the use of mental practice in the development of motor skills. Canadian Journal of Applied Sport Science 10, 45-165. 2. Epstein, M.L. (1980) The relationship of mental imagery and mental rehearsal to performance of a motor task. Journal of Sport Psychology 2, 211-220. 3. Jacobson, E. (1932) Electromyography of mental activities. American Journal of Psychology 44, 677-694. 4. Shaw, W. A. (1940) The distribution of muscular action potentials to imagined weight lifting. Archives of Psychology, 247, 1-50. 5. Weinberg, R. S. (1982) The relationship between mental preparation strategies and motor performance: a review and critique. Quest 33, 195-213. 6. Jeannerod, M. and Frak, V. (2001) Mental imaging of motor activity in humans. Institute of Cognitive Sciences, Working Paper 99-8, 5-7. 7. Breitling D, Guenther W, Rondot P. Motor responses measured by electrical activity mapping. Behav Neurosci.1986; 100:104–116. 8. Bakker FC, Boschker M, Chung J. Changes in muscular activity while imagining weightlifting using stimulus or response propositions. J Sport Exerc Psych.1996; 18:313–324. 9. Livesay JR, Samras MR. Covert neuromuscular activity of the dominant forearm during visualization of a motor task. Percept Mot Skills.1998; 86:371–374. 10. Roth M, Decety J, Raybaudi M, et al. Possible involvement of the primary motor cortex in mentally simulated movement: a functional magnetic resonance
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imaging study. Neuroreport.1996; 17:1280–1284. 11. Weiss T, Hansen E, Beyer E, et al. Activation during mental practice in stroke patients. Int J Psychophys.1994; 17:91–100. 12. Pascual-Leone A, Dang N, Chen LG, et al. Modulation of muscle responses evoked by trans-cranial magnetic stimulation during the acquisition of new fine motor skills. J Neurophysiol.1995; 74:1037–1045. 13. Ito M. Movement and thought: identical control mechanisms by the cerebellum. Trends Neurosci.1993; 16:453–454. Breitling D, Guenther W, Rondot P. Motor responses measured by electrical activity mapping. Behav Neurosci.1986; 100:104–116. 14. Carr J, Shephard R. Neurological Rehabilitation: Optimizing Motor Performance. Oxford, England: Butterworth-Heinemann;1998. 15. Burhans RS, Richman CL, Burgey DB. Mental imagery training: effects on running speed performance. Int J Sport Psych.1988; 19:26–31. 16. Yaguez L, Nagel D, Hoffman H, et al. A mental route to motor learning: improving trajectoral kinematics through imagery training. Behav Brain Res.1998; 90:95–106. 17. Bachman K. Using mental imagery to practice a specific psychomotor skill. J Cont Ed Nurs.1990; 21:125–128. 18. Hird JS, Landers DM, Thomas JR, Horan JJ. Physical practice is superior to mental practice in enhancing cognitive and motor task performance. J Sport Exerc Psych.1991; 13:281–293. 19. Shelton TO, Mahoney MK. The content and effect of"psyching-up" strategies in weightlifters. Cog Ther Res.1978; 2:275–284.
20. Tynes LL, McFatter RM. The efficacy of"psyching" strategies on a weightlifting task. Cog Ther Res.1987; 11:327–336. 21. Lee C. Psyching up for a muscular endurance task: effects of image content on performance and mood state. J Sport Exerc Psych.1990; 12:66–73. 22. Murphy SM, Woolfolk R. The effects of cognitive interventions on competitive anxiety and performance on a fine motor skill task. Int J Sport Psych.1987; 18:152–166. 23. Wrisberg CA, Anshel MH. The effect of cognitive strategies on the free throw shooting performance of young athletes. Sport Psychologist.1989; 3:95–104. 24. Nicklaus J. Golf My Way. New York, NY: Simon & Schuster;1974 25. Wrisberg CA. An interview with Pat Head Summitt. Sport Psychologist.1990; 4:180–191. 26. Warner L, McNeill ME. Mental imagery and its potential for physical therapy. Phys Ther.1988; 68:516–521. 27. Fansler CL, Poff CL, Shephard KF. Effects of mental practice on balance in elderly women. Phys Ther.1985; 65:1332–1337. 28. Page SJ. Imagery improves motor function in chronic stroke patients with hemiplegia: a pilot study. Occup Ther J Res. In press. 29. Linden CA, Uhley JE, Smith D, et al. The effects of mental practice on walking balance in an elderly population. Occup Ther J Res.1989; 9:155–169. 30. Fairweather MM, Sidaway B. Ideokinematic imagery as a postural development technique. Res Q Exerc Sport.1993; 64:385–392.
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