Displaying all 14 publications

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  1. Ajit Singh DK, Bailey M, Lee R
    Muscle Nerve, 2011 Jul;44(1):74-9.
    PMID: 21488056 DOI: 10.1002/mus.21998
    Loss of lumbar extensor muscle strength and fatigue resistance may contribute to functional disability.
  2. Harithasan D, Ajit Singh DK, Omar B
    MyJurnal
    Plantar pressure, force and contact area information may provideinsights regarding stresses imparted to the foot when performing functional tasks. There is limited information regarding plantar pressure, force and contact area when carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using one hand between adults with and without low back pain (LBP). The aim of our study was to investigate the changes in the plantar pressure, force and contact area when carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using one hand between adults with and without low back pain (LBP). A total of 20 adults with non-specific LBP and 20 matched individuals without LBP were recruited according to the predefined recruitment criteria. Plantar pressure (PP), maximum force (MF) and contact area (CA were measured in standing position and during walking while carrying incremental loads (no load, 5 kg, 7.5 kg and 10 kg) using their right hand on a Matscan pressure assessment system. A two-way mixed analysis of variance (group× load) was conducted to analyse the data. No significant main effectof group was demonstrated on both the right and left foot during standing (PP: p = 0.74, p = 0.32; MF: p = 0.17, p = 0.67; CA: p = 0.25, p = 0.24) and walking (PP: p = 0.61, p = 0.48; MF: p = 0.19, p = 0.06; CA: p = 0.16, p = 0.26. Similarly, there was no interaction effect between the loads and groups on the PP (p = 0.89, p = 0.47), MF (p = 0.76, p = 0.83) and CA (p = 0.88, p = 0.20) on theright and left foot, respectively during standing. However, a significant interaction effect (p < 0.05), between the loads and groups was demonstrated on the PP, MF and CA on the left foot during walking. The results of our study suggest that stresses imparted to the foot alters during dynamic postures and this may be a compensatory mechanism. Plantar pressure, force and contact area were similar in adults both with and without LBP when standing and walking. Further biomechanical information that includes both kinematic and kinetic data in lumbopelvic and lower limbs in relation to the foot may be required to justify for prevention and management strategies among adults with LBP.
  3. Mohd Nordin NA, Ajit Singh DK, Lim K
    Sains Malaysiana, 2014;43:423-428.
    Identification of associated risk factors is important to enable successful implementation of low back pain prevention strategies. To date, there is limited research data on back pain among young adults in Malaysia despite an increasing incidence of this disabling condition worldwide. A cross-sectional survey was conducted to determine the incidence of low back pain (LBP) and associated factors among health science undergraduates. A self-administered questionnaire was distributed to full time students of a main public university. One hundred and forty undergraduates; mean age 21.4±1.3 years, 70% female, 60% in year 3 of study, participated in the survey. The results showed that 31% spent between 6 and 8 h and another 31% spent more than 9 h sitting in a day. Twelve percent of the undergraduates rated their fitness level as ‘poor’. The incidence of LBP was 40.3% among the undergraduates. LBP incidence was associated with age (X2=12.1, p=0.007), years of study (X2=8.7, p=0.03), self-rated physical fitness (X2=7.0, p=0.02) and hours spent sitting (X2 =8.7, p=0.03). Gender, body mass index and hours spent in sports and physical activity were not associated with LBP. The findings from this study demonstrate that physical fitness and sitting duration is associated with low back pain among health science undergraduates. Health science undergraduates should improve their physical fitness, practice frequent breaks and stretching during sitting. This will help to minimize LBP related to decreased fitness levels and prolonged sitting.
  4. Se To PL, Ajit Singh DK, Whitney SL
    J Vestib Res, 2022;32(1):79-86.
    PMID: 34151874 DOI: 10.3233/VES-190731
    BACKGROUND: Adults with unilateral posterior canal benign paroxysmal positional vertigo (BPPV) may continue to present with residual dizziness and balance impairments after the canalith repositioning maneuver (CRM). Customized Vestibular rehabilitation (VR) in addition to the standard CRM may improve postural control in adults with BPPV. However, the effectiveness of this intervention for improving dyanmic gait measures in adults with BPPV is unknown.

    OBJECTIVE: We aimed to determine the effectiveness of customized VR in addition to the standard CRM on dynamic gait measures among adults with unilateral posterior canal BPPV.

    METHODS: In this double blind, randomized controlled trial, 28 adults with BPPV were randomized to either control (n = 14, age: 54.36±8.55) or experimental (n = 14, age: 50.71±9.88) groups. The experimental and control groups received customized VR plus standard CRM for six weeks and standard CRM for two weeks respectively. Dynamic gait measures (duration of a complete gait cycle, stride velocity, turning duration and number of steps while turning) were recorded using a portable mobility sensor (iTUG) at baseline, week 4 and 6. A mixed model ANOVA was used to estimate the main effects of the interventions.

    RESULTS: During walking, a group effect was demonstrated on gait duration, stride velocity, turning duration and number of steps while turning (p 

  5. Mohd Nordin NA, Yusoff NAH, Ajit Singh DK
    PMID: 31783575 DOI: 10.3390/ijerph16234746
    Although exercise is proven as an effective strategy to combat post-stroke complications and the risk of stroke recurrence, many stroke survivors fail to engage in this activity following rehabilitation. In this study, we assessed the feasibility and usefulness of a low-frequency group exercise to determine its suitability as an approach to facilitate exercise engagement among stroke survivors. Forty-one stroke survivors, mean (SD) age 59.34 (10.02) years, mean time post-stroke 17.13 (17.58) months, completed a 90 minute, once per week, group exercise supervised by therapists for 12 weeks. The exercise outcomes were measured using standardized clinical tests. We observed improvement in the group's physical performance; balance score by 3 units (Z = -3.88, p < 0.001), speed of repetitive sit to stand by 3.4 s (Z = -4.69, p < 0.001), and walking speed by 8.22 m/min (Z = -3.25, p < 0.001). Scores of seven out of 14 Berg's balance scale items increased significantly, indicating better balance ability among the survivors. In conclusion, a 12-week, once per week group exercise session seems feasible and sufficient to improve the physical performance of community dwelling stroke survivors. This exercise arrangement may be offered to stroke survivors to facilitate exercise practice following rehabilitation.
  6. Sia LL, Sharma S, Kumar S, Ajit Singh DK
    Digit Health, 2024;10:20552076241248916.
    PMID: 38665882 DOI: 10.1177/20552076241248916
    OBJECTIVE: This study explored the perceived benefits, barriers, and recommendations of telerehabilitation for musculoskeletal disorders among physiotherapists in Malaysia.

    METHODS: This study employed an exploratory qualitative methodology to gather the perceptions of government-employed physiotherapists in Malaysia regarding the benefits, barriers, and recommendations for telerehabilitation in treating musculoskeletal disorders. The researchers conducted semistructured focus group discussions (FGDs) via Google Meet, which were recorded, transcribed, and analyzed using thematic analysis.

    RESULTS: Five FGDs were conducted with 24 participants, 37.5% of whom had prior experience with telerehabilitation. The data analysis returned three main themes: (1) perceived benefits, (2) barriers, and (3) recommendations. Four subthemes were derived from perceived benefits: (1a) saving time and money, (1b) convenience, (1c) clients responsible for their treatment, and (1d) alternatives for infectious diseases. Perceived barriers revealed three subthemes: (2a) technology, (2b) organization, and (2c) personal barriers. Finally, participants provided recommendations for improving telerehabilitation services, including training programs to facilitate greater acceptance of this modality.

    CONCLUSION: The findings of this study offer crucial insights into the evolving landscape of telerehabilitation in Malaysia. These findings revealed a greater prevalence of barriers to enablers among Malaysian physiotherapists, potentially influenced by varying experience levels. Despite the prevailing lack of experience among participants, this research underscores the significance of identifying barriers and enablers in implementing telerehabilitation with participants offering recommendations for integrating telerehabilitation into their practices. This study provides clear insights and a roadmap for stakeholders aiming to shape the future of telerehabilitation among physiotherapists in Malaysia.

  7. Ajit Singh DK, Ngu ACY, Ahmad MA, Mohd Padzil FA, Hendri ENM, Kamsan SS
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):229-230.
    MyJurnal
    Knee osteoarthritis (KOA) is a major cause of disability and significantly reduce quality of life (QOL). There is limited information about knee associated problems and functional mobility among Malaysian adults with KOA. The aim of our study was to examine knee associated problems and functional mobility among this population. Forty-five (45) adults with KOA with mean age of 65.02 ± 8.083 were recruited from Hospital Canselor Tuanku Muhriz, UKM. Knee associated problems and functional mobility were measured using Knee injury and Osteoarthritis Outcome Scores (KOOS) and Timed-Up and Go (TUG) test respectively. The mean score and standard deviation for TUG test was 11.44 ± 2.69 seconds. Median scores (with interquartile ranges [IQR]) for the KOOS subscale domains were; Symptoms: 80.56, (69.44 to 91.67); Pain: 71.43 (50 to 78.57); Functional Activities of Daily Living: 82.3 (67.65 to 86.76); Sports and Recreation Function: 30 (20 to 60); and Knee-Related Quality of Life: 50 (25 to 75). Generally, participants’ TUG test performance showed that time taken to complete the test was higher than the reference values (7.14 to 8.43 seconds) identified among Malaysian community dwelling older adults with low to high risk of falls. The KOOS scores in adults with KOA in our study is similar to previous reports with Sport and Recreation Function and QOL domains been the most affected. It is important to improve functional mobility and balance in order to decrease falls risk and optimise sport and recreation function and QOL among adults with KOA.
    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  8. Ajit Singh DK, Ng ES, Ng CP, Ab Rahman NNA, Pannir Selvam SB
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):225-226.
    MyJurnal DOI: 10.17576/JSKM-2018-35
    Falls is a global health issue among older adults. Identifying measuring tools that can predict falls risk among older adults can assist in early falls risk detection and prevention. Best measuring tools that can predict falls risk among Malaysian community dwelling older adults is not known. The objective of our study was to determine if Timed Up and Go (TUG) test and Activities-Specific Balance Confidence (ABC) scale could be used as a falls risk predictor tools among Malaysian community dwelling older adults. Hundred and six (n = 106) community dwelling older adults who were attending Klinik Kesihatan Cheras participated in this cross sectional study. Falls incidence in the past one year was obtained from the participants. TUG test was performed and ABC scale was administered. Data was analysed using binomial logistic regression and receiver operating curves (ROC). The cut off values identified for TUG test and ABC scale were 9.02 seconds (area under the curve, AUC was 0.711; 95% CI 0.577-0.844) and 82.81% (area under the curve, AUC was 0.682; 95% CI 0.562-0.802) respectively. Hence, older adults with a score of above 9.02 seconds for TUG test and a score of below 82.81% for ABC scale were noted to have a higher risk of falls. Results of this study demonstrated that both TUG test (p < 0.001) and ABC scale (p < 0.01) were significant predictors of falls risk. Our study results indicated that both mobility (TUG test) and fear of falls (ABC scale) measuring tools, with the present cut off values can be used to identify community dwelling older adults who are at a higher risk of falls. Identifying older adults with higher risk of falls can assist the health professionals to optimise falls prevention and management approaches.
  9. Mohd Nordin NA, Aziz NA, Abdul Aziz AF, Ajit Singh DK, Omar Othman NA, Sulong S, et al.
    BMC Health Serv Res, 2014;14:118.
    PMID: 24606911 DOI: 10.1186/1472-6963-14-118
    The importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable.
  10. Vanoh D, Shahar S, Yahya HM, Che Din N, Mat Ludin AF, Ajit Singh DK, et al.
    Clin Interv Aging, 2021;16:161-175.
    PMID: 33531799 DOI: 10.2147/CIA.S266587
    Purpose: Use of dietary supplements by older adults has been increasing for improving micronutrient deficiencies, cognitive function, and overall health status. Thus, the objective of this secondary investigation is to explore the longitudinal association of baseline supplement intake in improving cognitive function, biochemical parameters, anthropometric variables and physical fitness among older adults.

    Methods: Towards Useful Aging (TUA) is a three-year longitudinal study conducted at baseline (2013-2014) and at follow-up (2015-2017) surveys. The number of participants dropped from 2322 during baseline study to 1787 and 1560 during the 18th and 36th month follow-up, respectively. Data on socio-demography, use of dietary supplement, biochemical indices, anthropometry, cognitive function, physical fitness and depressive symptoms were obtained. Longitudinal associations were done using the linear mixed model analysis among 1285 subjects with complete data.

    Results: The most common vitamin and mineral supplementations consumed were multivitamin, B-complex, and calcium. Meanwhile, the herbal supplements consumed by participants were Eurycoma longifolia, Morinda citrifolia and Orthosiphon aristatus. Longitudinal analysis adjusted for multiple covariates showed improvement in both supplement users and non-users for global cognitive function, working memory, visual memory, 2-minute step test, chair stand test, chair sit and reach and time up and go test, waist circumference and hip circumference in both the supplement users and non-users.

    Conclusion: Our findings indicated that dietary supplement intake is not associated with cognitive function, physical fitness, nutritional status, depressive symptoms or biochemical indices since improvement in the parameters was observed among both supplement users and non-users.

  11. Ahmad MA, Ajit Singh DK, Chua WQ, Abd Rahman NNA, Mohd Padzil FA, Hendri ENM
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):171-177.
    MyJurnal
    Knee osteoarthritis (OA) is a common chronic joint disease that results in pain and disability in many people. Cultural practice may influence patients’ views about their condition, its related issues and management. The aim of our study was to explore the perspective about knee OA and its related issues among Malaysian patients with knee OA. Twelve patients diagnosed with knee OA (8 females and 4 males) attending physiotherapy sessions at a University Hospital, mean age (SD): 67.1(9.4) years and median visual analog scale score of 5/10 participated in this qualitative study. One to one in-depth interviews were conducted, audio recorded and later transcribed verbatim. Three main themes were identified from the transcribed data; knee pain and its’ related issues (reason and aggravating factors of knee pain, coping strategies), impact of knee pain (impact on daily activities and emotions) and physiotherapy management (effects and expectations of physiotherapy, compliance and adherence towards home exercises). Most participants expressed that their knee pain was aggravated by certain movements that had an effect on their daily activities namely squatting. The findings also suggested that physiotherapy management was perceived as secondary prevention rather than a cure. Findings from this study provides information about the perceptions and related issues of patients with knee OA. This information may help health professionals in tailoring patient-centered care and provide better management.
    Study site: Physiotherapy department, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  12. Ahmad MA, Yusof A, Hamid MSA, Zulkifli Amin FH, Kamsan SS, Ag Daud DM, et al.
    J Res Health Sci, 2023 Mar;23(1):e00569.
    PMID: 37571940 DOI: 10.34172/jrhs.2023.104
    BACKGROUND: Home-based exercise (HBE) and patient education (EDU) have been reported as beneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous trials mostly examined the effects of HBE and EDU separately. Thus, this study aimed to evaluate the effects of a structured combined HBE and EDU program in addition to usual KOA rehabilitation on pain score, functional mobility, and disability level.

    STUDY DESIGN: A parallel-group, single-blinded randomized controlled trial.

    METHODS: Eighty adults with KOA were randomly allocated to experimental (n=40) and control (n=40) groups. All participants underwent their usual physiotherapy care weekly for eight weeks. The experimental group received a structured HBE+EDU program to their usual care, while the control group performed home stretching exercises to equate treatment time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) for the disability level, visual analogue scale (VAS) for pain, and timed up-and-go test (TUG) for mobility were measured pre-post intervention.

    RESULTS: After eight weeks, the experimental group demonstrated significant improvements in the KOOS (all subscales), pain VAS, and TUG scores compared to baseline (P<0.001); meanwhile, only KOOS (activities of daily living and sports subscales) was significant in the control group. Relative to the control, the experimental group presented higher improvements (P<0.001) by 22.2%, 44.1%, and 15.7% for KOOS, pain VAS, and TUG, respectively.

    CONCLUSION: Integrating the HBE+EDU program into usual KOA rehabilitation could reduce pain and disability, while it improved functional mobility. The finding of this study suggests a combination of a structured HBE and EDU program to be considered as part of mainstream KOA management.

  13. Malek Rivan NF, Yahya HM, Shahar S, Ajit Singh DK, Ibrahim N, Mat Ludin AF, et al.
    Nutrients, 2021 Jan 25;13(2).
    PMID: 33503860 DOI: 10.3390/nu13020353
    This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.
  14. Seow SR, Mat S, Teoh JJ, Mohamad Yusup A, Rajab NF, Ismail IS, et al.
    J Rehabil Med, 2024 Sep 03;56:jrm39986.
    PMID: 39225040 DOI: 10.2340/jrm.v56.39986
    OBJECTIVE: This study delves into the intriguing connection between knee osteoarthritis and diabetes in Malaysia. Specifically, the exacerbation of knee osteoarthritis in the presence of diabetes in terms of symptoms, physical performance, physical activity, psychological status, social participation, and quality of life was discussed.

    DESIGN: This cross-sectional study recruited adults aged 50 and above by convenient sampling and grouped them into: knee osteoarthritis-diabetes-, knee osteoarthritis+diabetes-, knee osteoarthritis-diabetes+, and knee osteoarthritis+diabetes+.

    SUBJECTS/PATIENTS: Of 436 recruited participants, 261 (59.8%) participants reported knee osteoarthritis.

    METHODS: Handgrip strength, Timed Up and Go test, 6 Meter Walk Test, and 5 Times Sit to Stand Test were measured using standardized procedures. Six questionnaires were administered for the remaining parameters.

    RESULTS: Across groups, there were significant differences: 6 Meter Walk Test (p = 0.024), Timed Up and Go test (p = 0.020), and 5 Times Sit to Stand Test (p 

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