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Fulltext Effectiveness of hospital-based pulmonary rehabilitation programme as compared to home-based pulmonary programme in improving the condition of the chronic obstructive pulmonary disease (COPD) patients. [Perbandingan antara rehabilitasi pulmonari di rumah dengan di hospital bagi pesakit COPD dalam memperbaiki status fungsi paru-paru]

Ayiesah Ramli, Roslina Abdul Manap, Joseph, Leonard

Jurnal Sains Kesihatan Malaysia, 2008;6(1):95-108.
MyJurnal

This study was aimed at identifying the effectiveness of hospital-based pulmonary rehabilitation programme as compared to home-based pulmonary programme in improving the condition of the chronic obstructive pulmonary disease (COPD) patients of Universiti Kebangsaan Malaysia Hospital. A total of 35 patients aging between 17 to 78 years old were randomised either to hospital (48.6%, n = 20) or home (43%, n = 15) -based pulmonary rehabilitation by the Physiotherapists. For the hospital-based rehabilitation programme, the patients were scheduled to come to the hospital twice a week for eight weeks. For home-based rehabilitation programme, subjects were scheduled to come to the Physiotherapy Department twice to learn on the exercises that need to be carried out before they are allowed to do on their own at home. Each subject was given a diary to record the exercises that have been done. A telephone call is made once a week for monitoring purpose. Assessment of lung function, six-minute-walk test and Borg score were carried out before and after the eight-week rehabilitation is conducted. The Results showed that there was no significant change in lung function for both groups before and after rehabilitation. There is a significant different (p < 0.05) in 6MWT before and after rehabilitation for hospital-based pulmonary rehabilitation patients. However, the difference is not significant (p > 0.05) for home-base pulmonary rehabilitation patients. The results also show that there exist no significant correlation between lung function and 6MWT even though there is an increase in walking distance at baseline or the eighth week. In conclusion, hospitalbased pulmonary rehabilitation is more effective than the home-based pulmonary rehabilitation in improving the exercise endurance which would helps in reduce dyspnoea among COPD patients.
Keywords: Home-based pulmonary programme; Hospital-based pulmonary programme; COPD; Lung function
Chest wall stretching exercise as an adjunct modality in post operative pulmonary management

Vikram, M., Joseph, Leonard H., Kamaria, K.

Journal of Surgical Academia, 2012;2(1):39-41.
MyJurnal

Emphysematous pyelonephritis is a form of infection of the kidney. Chest physiotherapy was executed on a 15-year-old girl who had complications such as secretion retention and pleural effusion following percutaneous pigtail nephrostomy in addition to oxygen therapy and medical management to promote respiratory functions. The processes to increase chest wall mobility includes particular passive stretching and mobilization. Chest mobility exercises composed of an intercostal stretch on a determined intercostal space using index fingers, thoracic rotation and anterior compression with stretching in sitting position to improve respiratory functions. These exercises were suggested to the patient as a regular daily treatment along with low-level incentive spirometry breathing exercises. Following 9th sessions of treatment patient demonstrated satisfactory improvement by means of increasing in chest expansion and reduction in dyspnea level without using supplemental oxygen. The results expressed a substantial clinical improvement in reduction of dyspnea level and improvement in chest expansion
Fulltext Test–retest reliability of the malay version job content questionnaire ((M-JCQ) among linemen working in the electrcity sector

Padmanathan, Vinothini, Baharrudin Omar, Joseph, Leonard

Malaysian Journal of Public Health Medicine, 2016;16(1):99-105.
MyJurnal

This cross sectional study investigated the test –retest reliability of the Malay Version Job Content
Questionnaire (M- JCQ) among electricity linemen. The M-JCQquestionnaire was administered to 10
electricity linemen working in private sub-contract company. The data were collected at two occasions
with one week interval of time between each sessions. Intraclass Correlation Coefficient (ICC) and Bland
Altman plot were used to analyze the reliability of the M-JCQ. The ICC for the ‘psychological demand’,
‘decision latitude’, ‘work related social support’ and ‘job insecurity’ scale were 0.96, 0.52, 0.99 and 0.55
respectively. The Bland Altman plot indicated that the tests and retest score for all the four scales had an
acceptable agreement. These findings indicated that the M- JCQ is reliable and consistent for assessing
work related psychosocial risk factors among electricity linemen.
Fulltext The effects of hospital based respiratory physiotherapy an intervention study among COPD patient in Al-Zawia city, Libya

Zafar Ahmed, Sharifa Ezat Wan Puteh, Aisha Abdussalam, Mahmud Hanesh, Suriati Sukeri, Joseph, Leonard

Int J Public Health Res, 2012;2(1):65-74.
MyJurnal

OBJECTIVE. Chronic obstructive pulmonary disease (COPD) is a one of the major cause of death and disability worldwide. This study aimed to compare the quality of life (QOL), Activity of Daily Living (ADL), Pulmonary Function Test (PFT) and general health symptoms pre and after hospital-based respiratory physiotherapy program among COPD patients. METHODS. Pre and post intervention study was conducted between January and July 2010. A total of 54 subjects aged between 30 to 40 years old were recruited for this study using universal sampling method from Alzawia Teaching Hospital, Libya. Data collected were socio-demographic data, QOL (before and after the intervention) using the Short Form-36 (SF-36) questionnaire, ADL using the Barthel Index and the General Health Symptoms.
RESULTS.. The mean SF-36 score for QOL is 30.13 (SD = 8.06) and 63.46 (SD = 13.53) before and after the physiotherapy respectively (with the p <0.0001). Patients’ Activity of Daily Living mean scores are 70.18, (SD = 16.50) and mean = 88.89 (SD = 13.28) before and after program (p< 0.0001). The general medical condition mean score after respiratory physiotherapy is 3.72 as compared to 4.96 before the respiratory physiotherapy (p< 0.0001). Pulmonary Function Test shows improvement in actual/predicted FEV1 ratio in all 54 cases with mean improvement from 55.85 before to 81.67 after the pulmonary physiotherapy (with the p <0.0001).
CONCLUSION. Hospital based respiratory physiotherapy program had significantly improved QOL, pulmonary function and activities of daily living among the subjects.
Fulltext Learning pathways during clinical placement of physiotherapy students: a Malaysian experience of using learning contracts and reflective diaries

Ramli A, Joseph L, Lee SW

J Educ Eval Health Prof, 2013;10:6.
PMID: 23997897 DOI: 10.3352/jeehp.2013.10.6

Learning contracts and reflective diaries are educational tools that have been recently introduced to physiotherapy students from Malaysia during clinical education. It is unclear how students perceive the experience of using a learning contract and reflective diary. This study explores the learning pathways of the students after using a learning contract and a reflective diary for the first time in their clinical placement.
Fulltext Prophylactic Effects of Sauna on Delayed-Onset Muscle Soreness of the Wrist Extensors

Khamwong P, Paungmali A, Pirunsan U, Joseph L

Asian J Sports Med, 2015 Jun;6(2):e25549.
PMID: 26446307 DOI: 10.5812/asjsm.6(2)2015.25549

High-intensity of exercise or unaccustomed eccentric exercise can cause the phenomenon of Exercise-Induced Muscle Damage (EIMD) which usually results in cramps, muscle strain, impaired muscle function and delayed-onset muscle soreness.
Feasibility of telemedicine or telephone-based family intervention for rural paediatric obesity: Cluster randomized control trial

Mani S, Joseph LH, Sharma S

J Telemed Telecare, 2016 06;22(4):264-5.
PMID: 26362563 DOI: 10.1177/1357633X15601524
Posture correction exercises and posture measurement in adolescents

Muniandy Y, Omar B, Joseph LH

Man Ther, 2016 Apr;22:e1.
PMID: 26386911 DOI: 10.1016/j.math.2015.09.001
Fulltext Ergonomic Intervention for Musculoskeletal Disorders in Construction Workers

Padmanathan V, Joseph L, Nawawi R

Saf Health Work, 2016 Mar;7(1):86-7.
PMID: 27014497 DOI: 10.1016/j.shaw.2015.06.006
Fulltext Prevalence of musculoskeletal disorders and related occupational causative factors among electricity linemen: A narrative review

Padmanathan V, Joseph L, Omar B, Nawawi R

Int J Occup Med Environ Health, 2016;29(5):725-34.
PMID: 27518883 DOI: 10.13075/ijomeh.1896.00659

Occupational tasks of linemen are highly associated with the development of work related musculoskeletal disorders (WRMDs). Although linemen are prone to develop WRMDs, there is paucity of information on the prevalence of WRMDs and related occupational causative factors. Therefore, the present review was conducted to report on the prevalence of WRMDs and to outline causative risk factors within occupational tasks in the lineman profession. Literature search was conducted in various databases such as Scopus, PubMed and ScienceDirect for articles published between 1996-2013. The articles were analyzed, selected and retrieved based on predetermined objectives, inclusion criteria and Medical Subject Headings (MeSH). In the review process only articles published in English were considered. The review identified moderate to high prevalence of WRMDs among the linemen population. Back and shoulder regions were highly affected compared to the other body regions. The review also reported occupational tasks such as bar installation, insulator fixation and manual handling of tools as high risk tasks that lead to the development of WRMDs. In addition, occupational tools such as ladders, manual cutters and manual presses were also identified as a potential ergonomic hazard. In conclusion, the current review identified that WRMDs are common in the back and shoulder regions among linemen. Also, a number of occupational risk factors were identified to be associated with WRMDs among the linemen. Hence, future research on prevention and intervention studies concerning lineman profession population in order to develop a good job practice are recommended. Int J Occup Med Environ Health 2016;29(5):725-734.
Fulltext Effects of Document Holder on Postural Neck Muscles Activity among Computer Users: A Preliminary Study

Ambusam S, Omar B, Joseph L, Deepashini H

J Res Health Sci, 2015;15(4):213-7.
PMID: 26728905

Computer users are exposed to work related neck disorders due to repetitive movement and static posture for prolonged period. Viewing document and typing simultaneously are one of the contributing factors for neck disorders.
Perception of lower extremity loading in stroke

Kumar SN, Joseph LH, Pharmy Jalil A

Clin Neurophysiol, 2015 Jul;126(7):1453-4.
PMID: 25468242 DOI: 10.1016/j.clinph.2014.09.031
Validity and reliability of Internet-based physiotherapy assessment for musculoskeletal disorders: a systematic review

Mani S, Sharma S, Omar B, Paungmali A, Joseph L

J Telemed Telecare, 2017 Apr;23(3):379-391.
PMID: 27036879 DOI: 10.1177/1357633X16642369

Purpose The purpose of this review is to systematically explore and summarise the validity and reliability of telerehabilitation (TR)-based physiotherapy assessment for musculoskeletal disorders. Method A comprehensive systematic literature review was conducted using a number of electronic databases: PubMed, EMBASE, PsycINFO, Cochrane Library and CINAHL, published between January 2000 and May 2015. The studies examined the validity, inter- and intra-rater reliabilities of TR-based physiotherapy assessment for musculoskeletal conditions were included. Two independent reviewers used the Quality Appraisal Tool for studies of diagnostic Reliability (QAREL) and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool to assess the methodological quality of reliability and validity studies respectively. Results A total of 898 hits were achieved, of which 11 articles based on inclusion criteria were reviewed. Nine studies explored the concurrent validity, inter- and intra-rater reliabilities, while two studies examined only the concurrent validity. Reviewed studies were moderate to good in methodological quality. The physiotherapy assessments such as pain, swelling, range of motion, muscle strength, balance, gait and functional assessment demonstrated good concurrent validity. However, the reported concurrent validity of lumbar spine posture, special orthopaedic tests, neurodynamic tests and scar assessments ranged from low to moderate. Conclusion TR-based physiotherapy assessment was technically feasible with overall good concurrent validity and excellent reliability, except for lumbar spine posture, orthopaedic special tests, neurodynamic testa and scar assessment.
Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain

Paungmali A, Joseph LH, Sitilertpisan P, Pirunsan U, Uthaikhup S

Pain Pract, 2017 11;17(8):1008-1014.
PMID: 28042685 DOI: 10.1111/papr.12552

BACKGROUND: Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain.
METHODS: A within-subject, repeated-measures, crossover randomized controlled design was conducted among 25 participants (7 males and 18 females) with chronic nonspecific low back pain. All the participants received 3 different types of experimental interventions, which included LPST, the passive automated cycling intervention, and the control intervention randomly, with 48 hours between the sessions. The pressure pain threshold (PPT), hot-cold pain threshold, and pain intensity were estimated before and after the interventions.
RESULTS: Repeated-measures analysis of variance showed that LPST provided therapeutic effects as it improved the PPT beyond the placebo and control interventions (P < 0.01). The pain intensity under the LPST condition was significantly better than that under the passive automated cycling intervention and controlled intervention (P < 0.001). Heat pain threshold under the LPST condition also showed a significant trend of improvement beyond the control (P < 0.05), but no significant effects on cold pain threshold were evident.
CONCLUSIONS: Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain.
Tilt table practice improved ventilation in a patient with prolonged artificial ventilation support in intensive care unit

Hashim AM, Joseph LH, Embong J, Kasim Z, Mohan V

Iran J Med Sci, 2012 Mar;37(1):54-7.
PMID: 23115431

Patients who are on prolonged ventilator support in critical care unit present wide variety of complications, which range from reduction in oxygen uptake to various musculoskeletal impairments. Early mobilization and rehabilitation are encouraged to manage these complications effectively. Use of tilt table to motivate early mobilization in the intensive care unit for ventilator practices is not a usual practice. However, this new technique has attracted involvements of clinicians and therapists for its therapeutic benefits to the patient. Herein we describe a case of a seventy eight-year-old male patient who suffered Motor car accident, and was on ventilator support in intensive care unit for more than one month. He underwent treatment using a tilt table protocol with other routine treatment, which benefited him based on clinical as well as physiological variables. For practitioners in intensive care units, this report may offer perceptivity into the alternate practice of early mobilization using tilt table, and for investigators it may promote interest for further studies.
Fulltext Intra-Rater Reliability and Minimal Detectable Change of Vertical Ground Reaction Force Measurement during Gait and Half-Squat Tasks on Healthy Male Adults

Fairus FZ, Joseph LH, Omar B, Ahmad J, Sulaiman R

Malays J Med Sci, 2016 Mar;23(2):21-7.
PMID: 27547111 MyJurnal

The understanding of vertical ground reaction force (VGRF) during walking and half-squatting is necessary and commonly utilised during the rehabilitation period. The purpose of this study was to establish measurement reproducibility of VGRF that reports the minimal detectable changes (MDC) during walking and half-squatting activity among healthy male adults.
Fulltext Evaluation of limb load asymmetry using two new mathematical models

Kumar SN, Omar B, Joseph LH, Htwe O, Jagannathan K, Hamdan NM, et al.

Glob J Health Sci, 2015;7(2):1-7.
PMID: 25716372 DOI: 10.5539/gjhs.v7n2p1

Quantitative measurement of limb loading is important in orthopedic and neurological rehabilitation. In current practice, mathematical models such as Symmetry index (SI), Symmetry ratio (SR), and Symmetry angle (SA) are used to quantify limb loading asymmetry. Literatures have identified certain limitations with the above mathematical models. Hence this study presents two new mathematical models Modified symmetry index (MSI) and Limb loading error (LLE) that would address these limitations. Furthermore, the current mathematical models were compared against the new model with the goal of achieving a better model. This study uses hypothetical data to simulate an algorithmic preliminary computational measure to perform with all numerical possibilities of even and uneven limb loading that can occur in human legs. Descriptive statistics are used to interpret the limb loading patterns: symmetry, asymmetry and maximum asymmetry. The five mathematical models were similar in analyzing symmetry between limbs. However, for asymmetry and maximum asymmetry data, the SA and SR values do not give any meaningful interpretation, and SI gives an inflated value. The MSI and LLE are direct, easy to interpret and identify the loading patterns with the side of asymmetry. The new models are notable as they quantify the amount and side of asymmetry under different loading patterns.
Fulltext Reliability, agreement, and validity of digital weighing scale with MatScan in limb load measurement

Kumar SN, Omar B, Htwe O, Joseph LH, Krishnan J, Jafarzedah Esfehani A, et al.

J Rehabil Res Dev, 2014;51(4):591-8.
PMID: 25144172 DOI: 10.1682/JRRD.2013.07.0166

Limb loading measurements serve as an objective evaluation of asymmetrical weight bearing in the lower limb. Digital weighing scales (DWSs) could be used in clinical settings for measurement of static limb loading. However, ambiguity exists whether limb loading measurements of DWSs are comparable with a standard tool such as MatScan. A cross-sectional study composed of 33 nondisabled participants was conducted to investigate the reliability, agreement, and validity of DWSs with MatScan in static standing. Amounts of weight distribution and plantar pressure on the individual lower limb were measured using two DWSs (A, B) and MatScan during eyes open (EO) and eyes closed (EC) conditions. The results showed that intra- and interrater reliability (3, 1) were excellent (0.94-0.97) within and between DWS A and B. Bland-Altman plot revealed good agreement between DWS and MatScan in EO and EC conditions. The area under the receiver operating characteristic curve was significant and identified as 0.68 (p = 0.01). The measurements obtained with DWSs are valid and in agreement with MatScan measurements. Hence, DWSs could be used interchangeably with MatScan and could provide clinicians an objective measurement of limb loading suitable for clinical settings.
Fulltext Accuracy of a digital weight scale relative to the nintendo wii in measuring limb load asymmetry

Kumar NS, Omar B, Joseph LH, Hamdan N, Htwe O, Hamidun N

J Phys Ther Sci, 2014 Aug;26(8):1205-7.
PMID: 25202181 DOI: 10.1589/jpts.26.1205

[Purpose] The aim of the present study was to investigate the accuracy of a digital weight scale relative to the Wii in limb loading measurement during static standing. [Methods] This was a cross-sectional study conducted at a public university teaching hospital. The sample consisted of 24 participants (12 with osteoarthritis and 12 healthy) recruited through convenient sampling. Limb loading measurements were obtained using a digital weight scale and the Nintendo Wii in static standing with three trials under an eyes-open condition. The limb load asymmetry was computed as the symmetry index. [Results] The accuracy of measurement with the digital weight scale relative to the Nintendo Wii was analyzed using the receiver operating characteristic (ROC) curve and Kolmogorov-Smirnov test (K-S test). The area under the ROC curve was found to be 0.67. Logistic regression confirmed the validity of digital weight scale relative to the Nintendo Wii. The D statistics value from the K-S test was found to be 0.16, which confirmed that there was no significant difference in measurement between the equipment. [Conclusion] The digital weight scale is an accurate tool for measuring limb load asymmetry. The low price, easy availability, and maneuverability make it a good potential tool in clinical settings for measuring limb load asymmetry.
Clinical evaluation of the anterior translation of glenohumeral joint using ultrasonography: an intra- and inter-rater reliability study

Joseph LH, Hussain RI, Pirunsan U, Naicker AS, Htwe O, Paungmali A

Acta Orthop Traumatol Turc, 2014;48(2):169-74.
PMID: 24747625 DOI: 10.3944/AOTT.2014.3184

The aim of this study was to investigate the intra- and inter-rater reliability of ultrasonography (US) to measure anterior translation of the humeral head (ATHH) among healthy subjects and patients with sacroiliac joint dysfunction.

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