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Musculoskeletal Disorders in Rural Population of Kaliawas, India

India is the fastest growing economic country still health care and its related economy are one of the major concerns.  Rural health care is one of the biggest challenges with 70% population living in rural areas and low- level health facilities. In terms of collective growth of the society as a whole their health status needs to emphasise on various aspects which are: prevalence of diseases and disorders; level of literacy; accessibility, affordability and availability of timely medical intervention can save lives and improve the standard of rural population life style. India accounts for the largest maternity deaths, majority of these are in rural areas where maternal health care is poor.

Musculoskeletal disorders (MSD) are among the most common work related complaint. Musculoskeletal disorders have been reported as one of the most common and important health problems in working populations, generating social and economic implications.

The rural people are still unaware of the MSD due to their work load at the farms and fields. Health education needs to be promoted at community level so that the morbidity associated with MSD will be reduced and the quality of life of rural population improves.

A study has been done by the Faculty of Physiotherapy of SGT University to find prevalence of musculoskeletal problem and associated risk factors on rural population. This study was done by Dr Gurpreet Singh , Assistant professor along with three scholars students on the population of Kaliawas Village. Study was done on 300 participants by filling two Questionnaires viz.; Standardized Nordic Musculoskeletal Questionnaire and Self Structured Questionnaire .

According to the study 62% of the participants were diagnosed with MSD. The result also demonstrated that most commonly affected regions were lower back (29%) followed by knee joint (21%) and then the  ankle joint , neck , shoulder , elbow , and wrist are affected. There was an equal percentage of MSD among male and females. A striking finding of this study was 87 % of subjects with MSD were aged below 60 years.

 

Graphical representation of Prevalence of affected area in Kaliawas village

An age wise distribution of musculoskeletal disorders also demonstrated different percentage of MSDs among different age group were: 30-40 (26%); 40-50 (35%), 50-60(27%) and 60-70(12%). Results showed that musculoskeletal disorders were more prevalent in 40-50 age group participants.

In this study it was found that risk factors such as prolonged exertion, awkward posture, twisting, excessive bending, monotonous work, lifting of heavy weight and the exposure to vibration force while driving tractors for long hours, seems to play a major role in the development of MSDs. In this study it was found that 26% of the population had physiotherapy awareness.

There was a high prevalence of musculoskeletal disorder among rural population of Kaliawas with men and women equally affected (50%). The most common complaint were low backache followed by osteoarthritis, plantar fasciitis, cervical spondylitis etc. squatting, bending, lifting heavy weight were found the risk factors associated with MSDs.

Therefore, there is a necessity of proper awareness and assessment of MSDs among rural as well as in urban population. As the MSDs also reduces the ability to work. In rural populations due to illiteracy, they preferred home remedies and local bone setter which may worsen their condition.

Dr Gurpreet
Assistant Professor
Faculty of Physiotherapy

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Physiotherapy Education in India

Physiotherapy education varies in different states of India. Universities which run the undergraduate and postgraduate courses in India do not have any universal regulatory body to get affiliated. Some medical colleges/universities run these course under the physiotherapy or allied health department, while others are affiliated with university/ colleges accredited by UGC or state council. There are various state councils which have their own requirements to run the course in their respective states.

However, there is no regulatory body that governs the uniform quality of these courses across India. Indian association of physiotherapy (IAP) offers affiliation to some these courses but its membership is not essential to practice physiotherapy in India. This non-uniformity has lead to a compromise in the quality of education across India and in turn, affects the medical health care provided to the patients.

A study was initiated by scholar students of faculty of Physiotherapy under the guidance of Dr. Mohit Gulati to compare the educational system required to practice as a legal physiotherapist in developed and developing countries with Indian physiotherapy educational system at SGT University Gurugram, Haryana. These countries were India, USA, UK, Canada, Australia, Singapore and New Zealand. Physiotherapy educational system was compared in these countries in the following domains- minimum eligibility course to practice, course accreditation agency and its goals, minimum eligibility criteria for entry in the course and license examination after completing the course in their respective countries. Data for the above domains was collected from the official Physiotherapy councils/ associations websites of their respective countries.

Upon analysis it has been observed that all the countries except India had at least one uniform accreditation agency. Developed countries like UK, Canada and US has more than one accreditation agencies which work in collaboration with each other. Only USA and Canada has license exam where in Canada there is also a practical examination along with theory exam.

Other countries like UK, Australia, New Zealand and Singapore only require candidate to register with their council to practice physiotherapy.

In comparison to these countries, Indian physiotherapy system lacks council and a uniform accreditation agency for undergraduate or postgraduate courses. There is no licenser examination in India upon completion of the course or to practice clinically.

Another aspect of this profession is treatment; it is very difficult to judge for commoners, which clinician to visit due to this disparity in profession. Dr Kirit P Solanki, Member of Parliament (MP) in India, introduced central council of Physiotherapy bill as private member bill in August 2018. Such an ingenious step may build a platform for Physiotherapy to reach a required height, the profession deserves.

TABLE REPRESENTING THE MINIMUM REQUIREMENT TO PRACTICE PHYSIOTHERAPY IN THESE COUNTRIES

S.No. Country Course and Duration Educational Accreditation Course Entry Requirements License
1. India B.P.T (4 and ½ years) Indian Association of Physiotherapy / University grant Comission Higher secondary qualified with 50% in subjects including Physics, chemistry, Biology No exam required to Practice, valid BPT degree required.
2. USA DPT (3-4.5 years) Commission on Accreditation in Physical Therapy Education (CAPTE)
  • GPA 3.0- 4.0 Graduate record examination (GRE)
  • 3 LOR
  • Pre-requisite courses
National Physical therapy examination (NPTE)
3. UK M.SC yea Physiotherapy (4 Years) Charted Society of Physiotherapy
  • Good academic record
  • Occupational health screening
  • Disclosure and barring services
  • English proficiency test
Registration with Health and Care Professions Council (HCPC).
4.      Canada M.P.T (2 years) Canadian Council of Physiotherapy
  • B.P.T  (3-4 years)
  • Good GPA
  • GRE
  • English language test
  • Prerequisite courses
Physiotherapy Competency Examination (PCE) Theory + Practical
5. Australia B.P.T (4years)/ B.Sc (3years) + MPT(2 Years) / DPT (3 Years) Australian Physiotherapy Council
  • Good academic background
  • Requisite subjects
  • English Test
  • Police check
  • Working with children check
Registration with Physiotherapist Board of Australia
6. Singapore B.Sc Physiotherapy (3 Years 8 months) Allied Health Professions Council (AHPC)
  • Good pass in two of the following subjects: Biology, Chemistry, Physics and Mathematics.
  • General Knowledge
  • Language requirements
Register with the Allied Health Professions Council (AHPC)
7. New Zealand Bachelor of Physiotherapy (BPhty) Physiotherapy Board of New Zealand Health Practitioners Competence Assurance Act (HPCA Act) requirements Physiotherapy Board of New Zealand

Dr Mohit Gulati(PT)
Assistant Professor
Faculty of Physiotherapy

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Ayurveda- The Eternal Science of Life

As the years pass the scientific community is forced to republish their works on the average life expectancy and other bodily parameters due to health compromising culture of daily life. The incidence rate of morbidity and mortality though has been in tug of war with contemporary practices of health, medicine and research, this havoc of morbidity has been infesting humans since the beginning of mankind. Science of Ayurveda has forecasted the decline in the quality of life thousands of years before. Ayurveda commonly designated as the science of life, has strived all odds against invasions, including the changes in extremist approach from rational to spiritual in terms of diagnosis and intervention. The good old science of Ayurveda is beyond the materialistic science of medicine, where cream of philosophy has been incorporated with time tested science for the understanding of manifest from unmanifest, physiology of human mind and body, anatomy, pathology and its understanding for health management and so on. Ayurveda focuses on maintaining health in a healthy individual and preventing diseases and intervening diseases in an afflicted individual. Ayurveda believes the root cause of disease as abnormal perception of senses coupled with mind, which the contemporary science struggles to find an foot hold through objective parameters. Daily regimen including food and drinks to be consumed, garments to be worn, etc. has been beautifully explained in the initial verses of classical Ayurveda literature. Ayurveda also covers the knowledge of multiple disciplines such as basic principles of Ayurveda, Anatomy, Physiology, Pathology, Pharmaceutics, knowledge on pharmacokinetics and dynamics, pharmacology, Gynecology & Obstetrics, Surgery, ENT & Supraclavicular disorders, Paediatrics, Panchakarma, General Medicine, Forensics and Toxicology, etc. Apart from this gross division, Ayurveda deals with various interesting concepts and practices, making it a unique science dealing the life. It has been proved through authentic research practices medications and therapies in Ayurveda has been seen very effective in neurological disorders, musculoskeletal disorders, hepatobiliary disorders, integumentary system disorders and so on, that seems to be challenging for the contemporary science. Ayurveda gives immense importance to mind, hence the science is sturdy not just in intervening somatic disorders, but psychocological and psychosomatic disorders are approached successfully with its understanding on Dosha (body humors), Dhatu (tissues), Mala (metabolic waste), etc. This makes Ayurveda as an effective science to tackle health related problems in the 21st century and a future science, where more research works are demanded for revalidating and implementing for the benefit of mankind and science.

Dr Ravindrakumar Arahunsi
Dean, Faculty of Ayurveda
SGT University, Gurugram

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