International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 3(9), September, 2011

Pages: 96-102

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THE EFFECTIVENESS OF REPETITIVE BILATERAL LEG TRAINING IN IMPROVING LOWER EXTRIMITY MOTOR FUNCTION OF HEMIPARETIC ACUTE MIDDLE CEREBRAL ARTERY STROKE PATIENTS.

Author: Sasidharan Tapan, N. Rajeev

Category: Healthcare

Abstract:Objective: The objective of the study was to find the effectiveness of repetitive bilateral leg training on improving lower extremity motor functions of hemi paretic patients in the geriatric age group Methods: An experimental approach, with pre test and post test control group design was used. 30 acute middle cerebral artery(MCA) stroke patients were conveniently selected and randomly distributed in to group A and Group B. Group A received conventional physiotherapy and group B received repetitive bilateral leg training in addition to conventional physiotherapy. Groups were assessed on first and the sixth week .Tool used for outcome measurement was Fugl-Meyer lower extremity physical performance scale(FMA) for measuring lower extremity motor function . Statistical analysis of data was done using student t test with SPSS software package. Result: It was found that lower extremity function and ADL improved significantly more in the experimental group (Group A) in comparison to control group (Group B). Conclusion: Repetitive bilateral leg training is a clinically simple and cost effective method for improving lower extremity motor and ADL functions of post MCA stroke hemi paretic geriatric patients .

Keywords: Repetitive bilateral leg training, Middle cerebral artery stroke, Geriatric population.

Full Text:

INTRODUCTION

Stroke is defined as a neurological deficit of cerebro vascular cause that persists beyond 24 hours or is interrupted by death within 24 hours1 . It is one of the most common causes of death and disability worldwide and leaves the survivors with significant physical and mental disability thus creating a major social and economical burden. The incidence of stroke increases dramatically with age , doubling every decade after 55. For the American white men aged 65-74 the incidence is about 14.84% , above 75 it is 24.6% and for 85 and older it is 27%.Incidence of stroke dramatically increases with age and increase in age is the single most powerful risk factor for stroke2 .By 2025 the world population is expected to include over 830 million people above 65 and most will live in developing countries like India, making it a major concern for the nation3 . The middle cerebral artery (MCA) is the single most common site of stroke. The term cardio vascular accident(CVA) is used interchangeably with stroke very often. Stroke can be of either ischemic or hemorrhagic variety. MCA stroke is characterized by common features such as contra lateral spastic hemi paresis or hemiplegia and sensory deficit of face, arm and leg with face and arm more involved than the leg. Lesions of the parieto-occipital cortex of the dominant hemisphere can produce aphasia .Motor deficits are characterized by either hemiplegia or hemi paresis typically on the side of body opposite to the site of lesion4 . Stroke is the largest consumer of rehabilitation services. Stroke is the third leading cause of death and there is a great need of physical rehabilitation in the initial phase after stroke5 . Physiotherapists have a major role in the hospital based ?inpatient‘ rehabilitation setting and in the community based rehabilitation settings6 . Re education of motor and functional abilities are the main targets of treatment by the physiotherapist. However the traditional methods have shown to improve the function only minimally and bilateral leg training was found to be an effective method in improving upper limb motor function7 . So in this study the investigator checks the effectiveness of repetitive bilateral leg training in improving the lower extremity motor function in post stroke hemi paretic patients of geriatric age group.

MATERIALS

Knee hammer

Standard 2 inch and .5 inch straps Static cycle Fugl Meyer Lower Extremity score Data collection sheet Essential stationary materials METHODOLOGY Prior sanction was obtained from the authorities, including ethical clearance, to conduct the study under the supervision of a consultant neurologist in PVS hospital, Calicut. Subjects were informed about the purpose of proposed research study .Referred patients with either left or right hemi paretic stroke were conveniently selected for the study on the basis of inclusion and exclusion criterias. Using random sampling subjects were then divided in to Group A or control group and Group B or experimental group. Both groups were assessed on the first day of treatment and after completion of their course of treatment. The control group was given 40 minutes of conventional physiotherapy for 6 days a week for 6 weeks. Outcome measures used were Fugl Meyer scale for assessing lower extremity motor performance. Experimental group was given 40 minutes of bilateral leg training in addition to conventional physiotherapy and a rest period of 1 minute was provided after each single group of exercises. Conventional physiotherapy group underwent 4 different types of exercises. Each single movement was repeated 10 times in patient‘s comfortable speed. First group of exercises were Active assisted range of motion(ROM) exercises for both upper and lower limbs which included 1)Elevation-depression, protraction- retraction of shoulder girdle.2)Abduction-adduction , Flexion-extension of glenohumeral joint.3)Flexion extension of elbow joint.4) supination-pronation of radio-ulnar joints.5) Flexion-extension and radial-ulnar deviations of wrist joint.6)Flexion- extension of metacarpophalangeal joint.7)Flexion-extension exercises of interphalangeal joint. In the lower limb following exercises were performed in patient‘s comfortable speed. 1) Flexion-extension in side lying, abduction-adduction and internal-external rotation in supine lying of hip joint.2) Flexionextension of knee joint.3) Dorsi-plantar flexion of ankle joint.4) Inversion-eversion of sub talar joints. Second group of exercises were Functional mobility exercises which included 10 repetitions of following movements. Third group was functional mobility exercises which included 1) Bed mobility exercises including rolling to affected side, rolling to un affected side, bridging of pelvis, prone on elbows, prone on hands, supine lying to sitting.2)Sitting to standing without assistance.3) Walking on parallel bar,4)Walking without support/assistive devices,5)Stair climbing exercises(five steps with assistance or support rails).Third group of exercises included Peg board activities for upper limb .Fourth group was balance training exercises including forward back ward steeping on wobble board ,braiding, manual perturbations sideways forwards and back words. The experimental group received bilateral leg training in addition to conventional physiotherapy. Bilateral leg training was given on supine lying, sitting positions and on a bicycle. The movements were started as active assisted movements and then progressed to active movements and to resisted movements depending on the improvements shown by patients. Each treatment session lasted for around 40 minutes and a rest period was provided after a single joint movement. Bilateral training consisted of two segments; ROM exercise and static cycling. ROM exercises included both symmetrical and asymmetrical movements of flexion-extension, abductionadduction, and medial-lateral rotation of hip joint. Both symmetrical and asymmetrical movements were repeated for 20 times and static cycling performed for 15-20 minutes. Statistical methods Statistical test used was students t Test. With in groups Pre and post test scores were compared using paired t test and between groups pre and post test scores were compared using unpaired t test. Level of significance was kept at .05. Data was analyzed using SPSS version 17.

RESULTS

Pre test scores didn‘t show significant difference between two groups proving the homogeneity of the groups (t=2.010, sig=.145).Group A did show significant difference between pre and post test scores (t=7.858 sig=.05).Similarly group B also did show significant difference between pre and post test scores (t=11.1847, sig=.05). On comparison of post test scores between two groups also there was significant difference (t=2.4772, sig=.05).

DISCUSSION

Statistical tests proved that there was significant difference between pre test and post test groups of both experimental and control groups. But post test score of experimental group was found to significantly higher than that of control group proving that bilateral leg training is a superior method to conventional physiotherapy in improving lower limb motor function in acute hemi paretic MCA stroke patients. The better results obtained in the experimental group may be justified by the following findings. Practicing bilateral movements in synchrony and in alteration may result in facilitation effect from non paretic limb to paretic limb. When bimanual movements are initiated simultaneously, the limbs act as s unit that supersedes the individual limb action indicating that both limbs are strongly linked as coordinated unit in the brain8,9.Another proposed mechanism that is relevant here is neural plasticity. It refers to the fact that brain is malleable like plastic than being bare wired as previously thought. Researches shown that even a simple novel thumb movement sequence repeated over a time induced lasting cortical representation changes and these changes enlarge as learning occurs10- 12. Similarly other task specific repetitive practice regimens like constraint induced movement therapy too produced such kind of improvements. Another factor known as ?entraint‘ is suggested to be an important factor behind the effectiveness of bilateral training. It is better demonstrated by an example. Imagine signing ones first name on a chalk board using the non dominant hand at normal speed, but moving in direction opposite to normal. Even with practice this is very difficult to master. When attempting the task again with simultaneously writing using the dominant hand, it becomes easier. More importantly two hands appear to be locked together as the experiment demonstrates our limb; both upper and lower are indeed locked in what is commonly termed as entrainment13 . Related research suggested that limbs are spatially and temporally entrained that may be reason bilateral training is useful in relearning activities that are mutually bilateral such as walking14,15 . Role of contra lateral hemisphere is another important factor behind the effectiveness of bilateral training. Functional MRI studies had shown that damaged hemisphere had increased blood flow when bilateral movements were made. These data are consistent with the idea that activity of undamaged hemisphere might support damaged hemishere16.Similarly proprioceptive and visual feedback from the unaffected side is a very important factor in stroke rehabilitation. When performing bilateral training a patient can use the unaffected extremities neurologically intact afferent and efferent signals and look and feel of that movement within that limb, to promote similar movement in the affected limb17 . This study Suggests that a bilateral training program for the lower extremities of post stroke hemi paretic patients leads to significant gain in motor functions. This method appears simple and so it will be a useful training method in home for many stroke patients. What aspects of bilateral training lead to brain changes are still not very clear. So the future goal should be to systematically determine the most effective protocol for each patient.

References:

1. World Health Organization (1978). Cerebrovascular Disorders (Offset Publications). Geneva: World. ISBN 9241700432. OCLC 4757533

2. O‘Sullivan S B, Schmitz Thomas J , Physical rehabilitation-Assessment and treatment. 5th Ed. New Delhi: Jaypee brothers; 2007.PP 705-707,711-713.

3. Beers M.H, Berkow R, editors. The Merck manual of geriatrics.3rd Ed. White house station ( Nj): Merck research laboratories ;2003.

4. Carr J.H, Shepherd R B. Motor relearning program for stroke. 1st Ed .Woburn (MD): Butterworth and Heinman; 2000.

5. Gordon Mcir Gites, Jo Clarck Wilson. Brain injury rehabilitation-A neurofunctional approach. London: Chapman and Hall; 1993.

6. Harrison M. A, Ashburn. Physiotherapy in stroke management.1st Ed. London: Churchill Livingstone; 1995. PP 273-74.

7. Myers RS. Saunders manual of physical therapy practice. 1st Ed. Philadelphia: WB Saunders Company; 1995. PP 385-392.

8. Classen J. Liepest J et al. Rapid plasticity of human cortical representation induced by practice. J Neurophysiol .1998; 79(2):117- 1123.

9. Colleen A, Hanton B.S et al. New brain networks are active after right MCA stroke when moving the ipsilateral arm. Neurology.Jan2005:114-120.

10. Crammes SC, Bastings EP. Mapping clinically relevant plasticity after stroke. Neuropharmacology. 2000:39; 842-851.

11. Joachim L, Heike B et al. Treatment induced cortical reorganization after stroke in humans. Stroke. 2000:31; 1210.

12. Lenois GN, Wagner A et al. Experimental stroke therapy linked to brain changes. Stroke. June2005.

13. Neurophysiological and behavioural adaptations to a bilateral training intervention in individuals following stroke. Clinical Rehabilitation: Vol 18, Feb 2004; 48-59.

14. SJ Page, P Levine et al.A randomized efficacy and feasibility study of imagery in acute stroke. Clinical rehabilitation. 2001. 

15. Jong SH, Kin Y et al. Cortical reorganization induced by task oriented training in chronic hemiplegic stroke patients. Neuro report. 2003:14(1) 137-141.

16. Staines WR, Mclloy WE et al. Bilateral movement enhances ipsilateral cortical activity in acute stroke- A pilot functional MRI study. Neurology 2001:56(3); 401-404.

17. Paje SJ, Peter Levine. Bilateral training aids rehabilitation progression. Biomechanics.Sept 2005.

18. Paje sJ, Johnson M, Levin P et al. Modified constraint induced therapy after sub acute stroke. A preliminary study. Neurorehabil neurorepair. 2002:16(3); 290-295.

Announcements

Dr. Pramod Kumar Manjhi joined Editor-in-Chief since July 2021 onwards

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SCOPUS indexing: 2014, 2019 to 2021


Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A study by Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.
A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13
A Study by Mokhtar M Sh et al. entitled "Prevalence of Hospital Mortality of Critically Ill Elderly Patients" is awarded Best Article for Vol 14 issue 12
A Study by Vidya S. Bhat et al. entitled "Effect of an Indigenous Cleanser on the Microbial Biofilm on Acrylic Denture Base - A Pilot Study" is awarded Best Article for Vol 14 issue 11
A Study by Pandya S. et al. entitled "Acute and 28-Day Repeated Dose Subacute Toxicological Evaluation of Coroprotect Tablet in Rodents" is awarded Best Article for Vol 14 issue 10
A Study by Muhammad Zaki et al. entitled "Effect of Hemoglobin Level on the Severity of Acute Bronchiolitis in Children: A Case-Control Study" is awarded Best Article for Vol 14 issue 09
A Study by Vinita S & Ayushi S entitled "Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding" is awarded Best Article for Vol 14 issue 08
A Study by Prabhu A et al. entitled "Awareness of Common Eye Conditions among the ASHA (Accredited Social Health Activist) Workers in the Rural Communities of Udupi District- A Pilot Study" is awarded Best Article for Vol 14 issue 07
A Study by Divya MP et al. entitled "Non-Echoplanar Diffusion-Weighted Imaging and 3D Fiesta Magnetic Resonance Imaging Sequences with High Resolution Computed Tomography Temporal Bone in Assessment and Predicting the Outcome of Chronic Suppurative Otitis Media with Cholesteatoma" is awarded Best Article for Vol 14 issue 06
A Study by Zahoor Illahi Soomro et al. entitled "Functional Outcomes of Fracture Distal Radius after Fixation with Two Different Plates: A Retrospective Comparative Study" is awarded Best Article for Vol 14 issue 05
A Study by Ajai KG & Athira KN entitled "Patients’ Gratification Towards Service Delivery Among Government Hospitals with Particular Orientation Towards Primary Health Centres" is awarded Best Article for Vol 14 issue 04
A Study by Mbungu Mulaila AP et al. entitled "Ovarian Pregnancy in Kindu City, D.R. Congo - A Case Report" is awarded Best Article for Vol 14 issue 03
A Study by Maryam MJ et al. entitled "Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers" is awarded Best Article for Vol 14 issue 02
A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01
A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24
A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
A Study by Karimova II et al. entitled "Changes in the Activity of Intestinal Carbohydrases in Alloxan-Induced Diabetic Rats and Their Correction with Prenalon" is awarded Best Article of Vol 13 issue 22
A Study by Ashish B Roge et al. entitled "Development, Validation of RP-HPLC Method and GC MS Analysis of Desloratadine HCL and It’s Degradation Products" is awarded Best Article of Vol 13 issue 21
A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20
A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19
A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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