Sujana, S (2012) A study to analyse the effects of hold relax technique in increasing shoulder range of motion and quality of life in chronic COPD patients having secondary postural deformities: An Experimental study. Masters thesis, K.G. College of Physiotherapy, Coimbatore.
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Abstract
INTRODUCTION: Chronic Obstructive Lung Disease (COPD) is a lung disease characterized by chronic obstruction of lung air flow that interferes with normal breathing and it is not fully reversible. GOLD(Global initiative for Chronic Obstructive Lung Disease), defines COPD as a “preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with abnormal inflammatory response of lungs to noxious particles or gases”. COPD is common worldwide, contributes to major disability as well as economic and social burden. By 2020 COPD is expected to be the third leading cause of death. 14 Million Indians are suffering from COPD (Indian Journal Chest Disability and Allied Sciences). In India the 5% of Adults are affected and men are affected more than women. OBJECTIVES: The objective of my study is to determine: 1. Whether the specific H-R technique is capable of reversing the effect of pectorals major muscle tightness by increasing shoulder horizontal extension range of motion. 2. Whether the specific H-R technique is capable of reducing the secondary postural deformities, thereby improving Quality of Life in the same population. 3. Whether the free exercises of upper limb are capable of increasing shoulder range of motion and quality of life. METHODOLOGY: Study Design: Two group Pre & Post test Experimental study design. Study Setting: Study was conducted at the Department of Pulmonology, K.G Hospital, Coimbatore. Study Duration: Study was conducted for a period of 3 months (12 weeks). Sampling Technique: Simple Random Sampling by lot method. Criteria for Selection Inclusion Criteria: • Patients classified as having mild COPD by the physicians were taken for the study. • Ability to perform exercises. • Both sexes. • Patient in age group between 40-55years. Exclusion Criteria: • Patients with any associated problems of COPD. • Recent acute exacerbation of disease. • Conditions that contraindicate the application of hold and relax techniques. • Secondary musculoskeletal disorders. • Recent fractures or injury to the ribs, clavicle or upper limb. • Recurrent subluxation or dislocation of either shoulder. • Inability to perform isometric contraction. • Connective tissue disorder. • Ischemic heart diseases. • Uncontrolled hyper tension. • Moderate to severe osteoporosis. • Addtional conditions restricting chest expansion (e.g. Obesity, severe scoliosis, ankylosing spondylitis). • Systemic disease muscles and joints (e.g. Rheumatoid arthritis). • Radical mastectomy with removal of the pectoralis major muscle. • Recent chest or abdominal surgery. RESULT AND CONCLUSION: This study was focused on analyzing the effects of hold – relax technique in improving the restrictive component of COPD, and extensibility of pectoralis major muscle and possibly overcome some of the postural change of COPD. About 30 subjects after fulfilling the inclusive criteria were divided into experimental and control group with 15 subjects in each group. Experimental group subjects underwent hold – relax technique and control group underwent free exercises. Based on statistical analysis, Student ‘t’ test at 5% level of significance P value is less than 0.05 and calculated value is greater than the tabulated value thereby showing significant improvement in shoulder extension range of motion and quality of life. The demographic representations of the groups are given in Table I (Pg-30). Age group of the participants varies from 40 years to 55 years and about 20 % from 40—43 years, 23% from 44—47 years, 33% from 48—52 years and 24% from 53—55 years. The first Paired ‘t’ test analysis for the pre test and post test variable for measuring the Right Shoulder horizontal extension range of motion in Group A and Group B is shown in Table II (pg-32) and III (pg-34). Both the groups shows a significant difference between the pre test and post test values. The ‘t’ value for the Group A is 16.58 the ‘t’ value for the Group B is 15.28 and it shows a significant percentile difference of 64% and 27% in Group A and B respectively. The Paired ‘t’ test analysis for the pre test and post test variable for measuring the Left Shoulder horizontal extension range of motion in Group A and Group B is shown in table V (pg-39) and VI (pg-41). Both the groups shows a significant difference between the pre test and post test values. The ‘t’ value for the Group A is 22.20 the ‘t’ value for the Group B is 21.37 and it shows a significant percentile difference of 53% and 26% in Group A and B respectively. The unpaired ‘t’ test analysis for the Post test variables for Both groups for the Shoulder horizontal extension Range Of Motion is shown in the table IV (right side) (pg-36) and table VII (left side) (pg-43). There was a significant difference shown between the Groups. Group B subjects show improvement than Group A. The ‘t’ value for the post test variables for both groups is 4.1583 (Right shoulder ROM) and 4.1275 (Left shoulder ROM). The second Paired ‘t’ test analysis for the pre test and post test variable for measuring the Quality of Life in Group A and Group B is shown in table VIII (pg-45) and IX (pg-47). Both the groups shows a significant difference between the pre test and post test values. The ‘t’ value for the Group A is 13.048 the ‘t’ value for the Group B is 11.521 and it shows a significant percentile difference of 29% and 14% in Group A and B respectively. The unpaired ‘t’ test analysis for the Post test variables for Both groups for the Quality of Life is shown in the table X(pg-50). There was a significant difference shown between the Groups. Group B subjects show improvement than Group A. The ‘t’ value for the post test variables for both groups is 3.4774 This study therefore rejects the null hypothesis and accepts the alternate hypothesis . Compared to Group B : Group A showed significant improvement in shoulder horizontal extension range of motion and quality of life in subjects with chronic COPD. This study concluded that hold – relax technique , based on PNF given to chronic COPD patients having secondary postural deformity reversed the effect of tight chest wall muscles by increasing shoulder horizontal extension range of motion and this in turn helped the subjects in improving their quality of life.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No: 27102217 |
| Uncontrolled Keywords: | hold relax technique, increasing shoulder range of motion, quality of life, chronic COPD patients, secondary postural deformities, experimental study. |
| Subjects: | PHYSIOTHERAPY > Physiotherapy in Cardio-Respiratory |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Jan 2020 04:05 |
| Last Modified: | 15 Jan 2020 06:20 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11790 |
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