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Biomedical subjects

C Manigandan

Publications and source records attributed to C Manigandan.

18 recordsLinked to original sources

Leisure satisfaction and psychiatric morbidity among informal carers of people with spinal cord injury.

STUDY DESIGN: Cross sectional survey. OBJECTIVE: To examine the nature and prevalence of common mental disorders among informal carers of people with Spinal Cord Injury (SCI) and the association with their leisure satisfaction. SETTING: Christian Medical College, Vellore, Tamilnadu, India. METHODS: A cross-sectional survey of informal carers of people SCI at the Department of Physical Medicine and Rehabilitation. Fifty-three informal carers of people with SCI were interviewed using the Revised Clinical Interview Schedule to assess psychiatric morbidity, and using the Leisure Satisfaction Scale to measure leisure and contentment. Data on carers with psychiatric morbidity were compared to those without common mental disorders using univariate and multivariate statistics. RESULTS: Study reported a high morbidity (53%), with most consistent diagnoses of depression and anxiety. Carers who were spouses, women, currently married and those with lower education had greater psychiatric morbidity and lesser leisure satisfaction, even after adjusting for age and education using logistic/linear regression. Age, occupation, residence, socioeconomic status, type and duration of SCI were not associated with either morbidity or leisure satisfaction. CONCLUSION: Many carers of people with SCI suffer from psychiatric morbidity and also have low scores on leisure satisfaction.

Adult↗

Re-emphasising the efficacy of the multi-purpose, self-adjustable, aeroplane splint for the splinting of axillary burns.

This article re-emphasises the efficacy of the previously described multi-purpose, self-adjustable, aeroplane splint for the splinting of axillary burns. This superior to the commonly used contoured splint for various reasons namely (i) its usability during the acute burn care rehabilitation, (ii) its cost effectiveness, (iii) its durability, and (iv) its strength. Above all due to its easy maneuverability this splint provides easy accessibility around environmental barriers. Though we acknowledge that there is a possibility of 'chord of circle' development due to the use of this splint, we have been successful in preventing such a complication simply by prescribing pressure garment concomitantly with this splint. Thus this article highlights the efficacy of earlier described multi-purpose, self-adjustable, aeroplane splint for the splinting of axillary burns.

Acute Disease↗

Adjustable aesthetic aeroplane splint for axillary burn contractures.

Managing axillary burns with an Aeroplane Splint has been known for its effectiveness for years. However, poor compliance in using the various models of currently available aeroplane splints leads to an inadequate outcome, because of the discomfort produced not only in wearing but also while ambulating within the community. In developing countries like India the biggest barrier to environmental accessibility is the presence of multiple permanent structures like narrow thoroughfares, entry/exit sites of public transport, and narrow aisles. These pose a challenge to rehabilitation professionals while prescribing large splints. An attempt to target these problems was made by Manigandan et al, but aeroplane splints, even the one described by them does not deal with the major problem of aesthetic appeal as identified by many of our patients. Accordingly this article presents a new model of the aeroplane splint with innovative changes, focussing on aesthetic appeal while maintaining all the benefits of the splint described by Manigandan et al.

Activities of Daily Living↗

Efficacy of leisure intervention groups and their impact on quality of life among people with spinal cord injury.

Leisure is an important component in the lives of persons with disabilities and it is often associated with life satisfaction, self-esteem and depression. However, leisure specialists have all but ignored the leisure patterns and needs of people with disabilities. Thus this study attempts leisure intervention through groups by altering the attitude of patients towards leisure and subsequently finding out the effect on leisure satisfaction and quality of life. This study was a clinical trial conducted for patients with spinal cord injury who were evaluated using both the World Health Organization quality of life scale and the leisure satisfaction scale prior to intervention and afterwards. The experimental group had five 1 h-long group sessions as intervention while the control group had none. Twenty-five clients with paraplegia were included in both the experimental and the control groups. The mean ages of clients in both the groups were 33.40 and 37.24 years respectively. Significant improvements were observed in all domains of quality of life and leisure satisfaction in the experimental group as compared with the control group. The data show the definite impact of leisure satisfaction on quality of life. It is evident from the study that leisure intervention groups facilitate both leisure satisfaction and improved quality of life. Such an assertion definitely requires further research, corroboration and substantiation.

Adult↗

Efficacy of support groups for spouses of patients with spinal cord injury and its impact on their quality of life.

The need for a sound social support system, and its positive impact on physical, mental and behavioural health in the ever-increasing spinal cord injury (SCI) clientele, is undeniable. It is evident from recent research that spousal support should be weighed as an important contributing factor to the ongoing health and well-being of their SCI partners. Stress (severe depressive symptoms) to the care-giving spouses, and implications on their health and thereby the SCI partner, is often underestimated. Thus the present study is an attempt to treat this highly susceptible population through the provision of support groups. This study was a two-group experimental design. The study results bring to light the definite impact of SCI on the spouse's well-being. Thus it is essential to direct research towards life domains designed to improve the quality of life of these individuals. This research demonstrates the unquestionable positive effect of group therapy on the impact of well-being of spouses of SCI survivors. This finding may only be the tip of the iceberg and further research with a larger sample size must be conducted for the adequate generalization of this study.

Adaptation, Psychological↗

Functional Independence Score in Haemophilia: a new performance-based instrument to measure disability.

Morbidity in haemophilia has been described predominantly in terms of musculoskeletal dysfunction and assessed by the clinical and radiological joint scores. These scores document changes in a particular joint, but do not reflect the impact of these changes on the individual in terms of his overall musculoskeletal function. Several self-assessment instruments have been used to measure musculoskeletal function but none have been specifically validated for use in haemophilia. In order to objectively assess musculoskeletal function of patients with haemophilia, we developed Functional Independence Score in Hemophilia (FISH), a performance-based instrument. FISH measures the patient's independence in performing seven activities under three categories: self-care (grooming and eating, bathing and dressing), transfers (chair and floor) and mobility (walking and step climbing). Each function is graded from 1 to 4 depending on the amount of assistance needed in performing the function. We evaluated 35 patients who were over 10 years old and had had at least three major bleeds per year. All subjects were scored for clinical (World Federation of Hemophilia, WFH score) and radiological changes (Pettersson's score). Functional independence of the patient was assessed using the Stanford Health Assessment Questionnaire (HAQ) and the FISH. Correlation of the FISH score was modest with both the WFH clinical score (r = -0.68) and the radiological score (r = -0.44). While there was good correlation between FISH and HAQ (r = -0.90), FISH had better internal consistency than HAQ (Cronbach's alpha 0.83 vs. 0.66). FISH appears to be a promising disease-specific instrument for assessing overall musculoskeletal function in haemophilia. It requires evaluation in different patient populations.

Activities of Daily Living↗

An innovative, cost-effective, pressure-relieving device for burned ears.

Cosmetic disfigurement is a common result of facial burn injuries. Next to judicious wound care and timely wound closure, the application of pressure to maturing facial scars is a key factor in minimizing disfigurement. This is not true for ear burns, where pressure is contraindicated at all phases of recovery, thus making it mandatory to provide pressure-relief over the ears throughout rehabilitation. Though such a need has been understood since long ago, the availability of such a device is very rare in any developing nation. Moreover the cost of such splints is too expensive. This report presents an innovative idea to protect the ear with a low-cost splinting technique.

Burns↗

A cost-effective, adjustable, femoral socket, temporary prosthesis for immediate rehabilitation of above-knee amputation.

Early ambulation after lower extremity amputation has profound benefits on the functional, psychological outcomes and enhanced prosthetic compliance among this clientele. The various potential risks of immobility--pain, oedema, muscle atrophy, phantom sensations, contractures, aerobic de-conditioning, and the like, are reduced due to early ambulation. Moreover, it assists in accelerated wound healing, preservation of postural reflexes and, above all, achievement of better psychological well-being. Though such benefits have been observed in the history of prosthetic rehabilitation, a cost-effective prosthesis for such an early management among Third World nations is still unavailable. Therefore, this article is an attempt to present an indigenously developed temporary prosthesis designed to make the above benefits possible at a lower cost. This prosthesis helps in myriad ways--immediate prosthetic fitting, early weight bearing, early ambulation--and also has the added advantage of being adjustable to anthropological variations. The ischial weight bearing, lateral opening socket reduces the pressure and shear over the stump, thus avoiding stump complications. This increases the prosthetic acceptance by the client due to early involvement in the rehabilitation. Above all, it is cost effective and comfortable, thus enhancing compliance and superior outcome in prosthetic rehabilitation, especially among the clients in Third World nations.

Amputation, Surgical↗

Construction of exercise attitude questionnaire-18 to evaluate patients' attitudes toward exercises.

The importance of exercise for health and the long-term management of various diseases is now well documented and established. However, the challenge is the lack of patient compliance to exercises, which is true for almost all diseases, from acute back pain to chronic arthritis. One of the factors for compliance is the perception that exercises are effective in ameliorating unpleasant symptoms. Precisely, people's perception and their attitude towards exercises matter the most in determining the treatment outcome in such conditions. Unfortunately, the psychology of exercise initiation and adherence in the patient population is seriously under-researched. Recent literature has identified the need to consider various similar factors like motivation, barriers to exercise, exercise-related beliefs, attitudes, and the formulation of self-perceptions and self-identity towards exercises. However, no good instrument exists that is sensitive and standardized to evaluate people's attitude towards exercises, which is fundamental and crucial in determining the final outcome of exercise-treatable diseases. Hence we have attempted to design a questionnaire to 'evaluate the level of people's attitude towards exercises'.

Attitude↗

'MYNI's orthosis': a self-adjustable, dynamic knee extension orthosis for quadriceps weakness in haemophilia rehabilitation.

In developing countries like India, where walking is the primary, preferred and feasible mode of transport, the implications following quadriceps weakness poses a serious threat to ones functional independence. This has been a challenge for professionals while ambulating individuals with haemophilia, where quadriceps weakness is very common. Although external splinting has been understood for many years, as a means of support in haemophilia, there is still a dearth of knowledge in making an appropriate splint to assist or to take over the weak quadriceps during ambulation. This newly designed 'MYNI's orthosis' helps in versatile ways in addition to assisting the weak quadriceps. It provides prolonged stretch to contracted tissue, allows for being used as a serial cast in improving the knee range and is cosmetically acceptable. Above all, it is user-friendly, thus enhancing compliance and superior outcome in haemophilic knee rehabilitation.

Developing Countries↗

A multi-purpose, self-adjustable aeroplane splint for the splinting of axillary burns.

External splinting has been acknowledged for many years as a useful approach for preventing and correcting burn contractures. Though this practice could be traced back many centuries, there is still a dearth of knowledge regarding a good splint to serve these purposes for axillary burns. The newly designed multi-purpose, self-adjustable aeroplane splint presented in this report helps in various ways, such as improving compliance, and positioning during preoperative, postoperative and rehabilitative phases of axillary burn management. It acts as a splint that provides circumferential pressure for scar management, provides prolonged stretch to contracted tissue and acts as a serial cast in increasing the shoulder range. Most of all, it is very much user-friendly, thus enhancing compliance and giving a good outcome in axillary burns.

Axilla↗

The wrist in axillary burns--a forgotten focus of concern.

Need for splinting of the wrist in axillary burns is a question of great importance especially when there is no marked burns on the wrist and hand. This article presents various potential problems due to non-splinting of the wrist, various promising solutions for those problems and a better way of splinting a client with axillary burns. Modification in axillary splinting will definitely lead to a rewarding upshot in increasing the client compliance with no major complications not only in managing axillary burns but also in managing an array of disease conditions with shoulder limitations.

Axilla↗

Psychological wellbeing among carers of people with spinal cord injury: a preliminary investigation from South India.

STUDY DESIGN: A cross-sectional study that assessed people with spinal cord injury (SCI) and their carers who attended the 3-day health care program. OBJECTIVES: The study examined the nature and prevalence of the factors associated with psychological morbidity among carers of people with SCI. SETTING: A community reintegrated population of persons with SCI and their carers attended the 3-day program in the Department of Physical Medicine and Rehabilitation, Christian Medical College Hospitals, Vellore, South India. METHODS: Thirty-eight people with SCI and their carers participated in this cross-sectional study. RESULTS: Thirty (78.9%) carers of people with SCI were psychologically distressed. While carers were distressed, they were not significantly depressed. Educational level of carers and suicidal behavior of people with SCI were significantly associated with psychological distress. CONCLUSION: The findings of this study suggest that health care workers should have a high index of suspicion of psychological morbidity, in carers of people with SCI. Identification of risk factors may lead to useful target interventions.

Adaptation, Psychological↗