International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 11 Issue 11, JUNE, 2019

Pages: 05-10

Date of Publication: 10-Jun-2019


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Combined Effectiveness of Mirror Therapy and Motor Imagery on Gait in Stroke Patients

Author: Neha Hatwar, Suchetha PS, Dhanesh Kumar KU

Category: Healthcare

Abstract:Aim: The purpose of the study was to evaluate the combined effectiveness of lower limb mirror therapy and motor imagery on gait in stroke patients.
Methods: A total number of 38 patients were recruited for the study. They were divided into two groups: Group A (n=19) and Group B (n=19). Group A was given motor imagery and conventional rehabilitation while Group B was given lower limb mirror therapy, motor imagery, and conventional rehabilitation. The interventions were given for 2weeks (5days/week). The values of Dynamic Gait Index (DGI) and Lower limb component of Fugl Meyer Assessment (FMA-LE) were taken both at baseline and after 2 weeks of intervention.
Result: Both Group A and Group B showed significant improvements in DGI and FMA-LE after 2 weeks of intervention (p value< 0.001). The comparison of DGI difference between the two groups did not show a statistically significant difference (p value=0.09). Also, comparison of FMA-LE difference between the two groups did not show a statistically significant difference (p value=0.412)
Conclusion: Based on the above results it can be concluded that the combination of mirror therapy with motor imagery is equally effective as motor imagery alone in improving gait and function in stroke patients.

Keywords: Gait disturbances, Mirror Therapy, Motor Imagery, Stroke

Full Text:

INTRODUCTION

According to WHO, stroke is defined as ‘rapidly developing clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than the vascular origin [1]. It is one of the leading causes of disability in India, the prevalence being 84-262/100000 in rural and 334-424/100000 in urban areas[2].

It is estimated that nearly 80% of stroke patients have an upper limb or lower limb functional deficit[3]. The inability to walk properly due to lower limb impairment is a major problem confronted by many stroke patients [4].

The common abnormal gait patterns seen in stroke patients are circumduction, genu recurvatum, and spastic paretic stiff-legged gait. The deviations include decreased gait speed, decreased cadence, decreased stride length, increased step width and increased time spent in double limb support compared to healthy adults [5].

Gait restoration is one of the major goalsin post-stroke rehabilitation.For the planning of appropriate rehabilitation, the mechanism behind gait control should be understood. Spinal cord (central pattern generators) initiates rhythmic walking and the voluntary modifications are made by the cerebral cortex. In stroke patients, the cerebral cortex function is disrupted while that of the spinal cord is protected. Thus, the ability of the spinal cord of producing rhythmic walking can be used to reorganize the cerebral cortex to improve walking ability in post-stroke patients[6]. Mirror therapy and motor imagery are such methods which help in reorganizing the motor cortex.

Mirror therapy is a type of intervention which creates a reflection of the non-affected limb by using a mirror to trick the brain to think that movement has occurred in the affected extremity[3]. Mirror therapy is based on the principle of visual illusion. Mirror therapy works by activating the ipsilateral motor cortex and the premotor and sensorimotor areas which control contralateral movements. This enhances communication between the hemispheres and results in appropriate motor recovery. Mirror therapy has proved to be effective for the recovery of the upper limb after stroke. Studies regarding the effectiveness of mirror therapy on lower limb recovery after stroke are few[7].

Motor imagery is a type of therapy in which the patient rehearses the movement without actually performing it[8]. More recovery is seen when motor imagery is followed by the performance of physical activities. Systematic reviews done earlier have demonstrated that motor imagery enhances upper extremity functions in stroke patients. Recently motor imagery associated with lower limb functions has also been investigated and is found to be effective[9].

The retrieved works of literature have proved that mirror therapy and motor imagery are effective in improving the motor functioning of the upper limb and lower limb after

stroke[3,8]. Mirror therapy and motor imagery are proved to be effective in improving gait function when given isolation[10,11]. Though, there are several studies done on the use of mirror therapy on upper limb function in a stroke patient, very few studies done on the effectiveness of lower limb mirror therapy. Also, there is paucity in the literature on the combined effect of mirror therapy and motor imagery on gait in post-stroke patients. Therefore, this study has been taken up to evaluate whether mirror therapy has additional effectiveness combined with motor imagery in the improvement of post-stroke gait.

METHODOLOGY

Approval from the scientific committee and institutional ethics committee was obtained before the commencement of the study. Participants with stroke were recruited from Justice K S Hegde charitable hospital, Mangalore. These participants were screened based on inclusion criteria and consent was taken from selected participants. The participants were included based on the following criteria: a) Patients who are less than 6 months post-stroke b) Age- 45-65 years c) Ability to walk with minimal assistance (functional ambulation category less than or equal to 3.) d) No remarkable cognitive deficit (an outcome more than 25 on mini-mental status examination). The exclusion criteria were: a) Any musculoskeletal disorder impeding lower limb functionb)Any neglect of space on the affected side, or any other neurological disease or auditory or visual c) Any psychiatric disorders.

The participants were divided into two groups. Group A was given 15 minutes of mirror therapy,15 minutes of motor imagery and 30 minutes of conventional treatment whileGroup B was given 15 minutes of motor imagery and 45 minutes of conventional treatment. The interventions were given for 2 weeks (5 days a week).  Fugl Meyer assessment of lower extremity (FMA-LE) and Dynamic Gait Index (DGI) values were taken at baseline and after 2 weeks of intervention (Figure 1).

In mirror therapy, the patient was made to sit and a mirror was mounted in between the legs of the patient in such a way that the paretic leg was on the non-reflective side of the mirror while the non-paretic limb was facing the reflective side of the mirror. The patient was made to perform the following exercises using the non-paretic leg (Figure 2 and 3):

  • Hip flexion

  • knee flexion

  • ankle flexion

  • Knee extension with ankle dorsiflexion

  • Full knee flexion

Components of gait which were missing were focussed more.

In motor imagery therapy, the patient was made to sit on a chair with eyes closed in a quiet room. He was then made to listen to motor imagery scripts through headphones. The patients were made to imagine all gait specific lower limb movements (Figure 4). The scripts were recorded in local languages.

Conventional treatment was given according to patient’s requirements which included stretching, active and passive range of motion exercises, weight bearing, balance and coordination exercises.

RESULTS

SPSS software version 16.0. was used to assess the data obtained. To compare the pre and post measurements for Dynamic Gait Index(DGI) andFugl Meyer Assessment -lower extremity (FMA-LE), paired ‘t' test was used for group A and Group B. To compare the effectiveness of intervention between two groups, independent sample ‘t' test was used. The p-value less than 0.05, was regarded as significant for the study.

The comparison of age distribution between the two groups was done using the independent t-test. The mean age for group A is 57.42±8.03 and for group B is 52.95±9.16.The p-value is 0.118 which is not statistically significant. Hence, age was homogenously distributed (Table1)

The comparison of gender distribution between group A and group B was done utilizing chi-square test. The p-value is 0.118 which is not statistically significant. Hence, gender was homogenously distributed between the two groups (Table 2).

Within the group analysis for the outcome measures DGI and FMA-LE was done using a paired t-test (Table3)

 For Group-A, Pre DGI, mean value is 9.31±4.40 and Post DGI mean value is 18.84±3.26. On comparison of the mean values of Pre DGI and Post DGI, the mean values of Post DGI are higher with a difference of 9.125.  The p-value is less than 0.001 which is statistically significant. Pre FMA-LE mean value is 74.44±3.18 and Post FMA-LE mean value is 81±4.25.On comparison of the mean values of Pre FMA-LE and Post FMA-LE, the mean values of Post FMA-LE are higher with a difference of 6.563 and the p-value is less than 0.001 which is statistically significant.

For Group-B, Pre DGI mean value is 18±10.11 and Post DGI mean value is 18±21.28. On comparison of the mean values of Pre DGI and Post DGI, the mean values of Post DGI are higher with a difference of 11.167 and the p-value is less than 0.001 which is statistically significant.Pre FMA-LE mean value is 75.67±4.39 and Post FMA-LE mean value is 83.06±3.94. On comparison of the mean values of Pre FMA-LE and Post FMA-LE, the mean values of Post FMA-LE are higher with a difference of 7.389 and the p-value is less than 0.001 which is statistically significant.

Between the group comparison for DGI was done using an independent t-test (Table 4).

Comparison of the Pre DGI between the two groups shows that Pre DGI is higher in group B (mean=10.42±5.54) with a t value of -0.319. The p-value is 0.752 which is not statistically significant.A comparison of the Post DGI between the two groups shows that Post DGI is higher in group B (mean=21.28±3.73) with a t value of -2.345. The p-value is 0.025 which is statistically significant. A comparison of the DGI difference between the two groups shows that DGI difference is higher in group B (mean=11.17±4.55) with a t value of -1.725. The p-value is 0.097 which is not statistically significant (Graph 1)

Between group comparison for FMA-LE was done using independent t-test (table 5).

Comparison of the Pre FMA-LE between the two groups shows that Pre FMA-LE is higher in group B (mean=75.54±4.28) with a t value of -1.044. The p-value is 0.303 which is not statistically significant. Comparison of the Post FMA-LE between the two groups shows that Post FMA-LE is higher in group B (mean=83.06±3.94) with a t value of -1.46. The p-value is0.154 which is not statistically significant. A comparison of the FMA-LE difference between the two groups shows that the FMA-LE difference is higher in group B (mean=7.39±3.18) with a t value of -0.831. The p-value is 0.412 which is not statistically significant (Graph 2).

DISCUSSION

Cerebrovascular accidents or stroke may occur either due to blood clots which impair blood flow to the brain or any trauma which ruptures the blood vessels causing leakage of blood around the brain. It can adversely disrupt the functioning of the limbs which in turn causes restriction of activity and participation in day to day life. Disability caused by stroke may persist lifelong if proper rehabilitative measures are not taken.

In the present study, Group A received only motor imagery for lower limbs while group B received both motor imagery and mirror therapy for lower limbs for 2 weeks.

Previously, studies have been done in which mirror therapy was combined with other forms of therapies such as action observation therapy, neuromuscular electrical stimulation. Lee et al suggested that action observation therapy and mirror training with conventional rehabilitation significantly improved patient’s gait[12]. Xu et al demonstrated that mirror therapy combined with neuromuscular electrical stimulation caused improvement in spasticity and walking ability of stroke patients[13]. No study is being done till now combining mirror therapy with motor imagery. So, this study was taken up.

In group A (MI), there was significantly improved both gait and motor function of lower limbs after 2 weeks of intervention. Both DGI and FMA-LE showed statistically significant differences (p-value <0.001) after within the group analysis.

In group B (MI+MT) also, a statistically significant difference was seen in both DGI and FMA-LE values (p-value <0.001) after 2 weeks of intervention after within group analyses.Thus, motor imagery alone or with combination with mirror therapy improved gait and lower limb function in post-stroke patients.

The improvement which is seen in motor function and gait by motor imagery is supported by Lacourse et al, who suggested that the cortical and subcortical motor areas are simultaneously activated during motor imagery learning which indicates that motor imagery is effective in rehearsing and learning skilled movements[14].

Also, Oostra et al suggested that motor imagery may have a beneficial effect on enhancing gait function in sub-acute stroke which is matching the results of this study; however, longer-term confirmation is required[11]. However, a meta-analysis done by Guerra et al reported a high heterogeneity in methodological quality of the included randomized control studies and con?icting results. They concluded that more high-quality studies and greater standardization of interventions are needed to determine the value of motor imagery for persons with stroke[15].

Improvements which are seen in gait and function due to mirror therapy are supported by Arya et al, who demonstrated that activity-based mirror therapy accelerates lower limb motor recovery and reduces gait deviations amongst chronic poststroke subjects[7].

A systematic review by Li et al demonstrated that the use of mirror therapy in addition to some form of rehabilitation appeared promising for some areas of lower limb function, which is similar to the results obtained in this study, but there is no sufficient evidence to suggest when and how this therapy should be given[16].

In the present study, when the DGI difference was compared between the two groups, it was found that the DGI difference was higher in group B (mean=11.17±4.55) than group A (mean=9.13±1.99). But the difference was not statistically significant (p value=0.097>0.005). Also, when the FMA-LE difference was compared between the two groups, it was found that FMA-LE difference was higher in group B (mean=7.39±3.18), than group A (mean=6.56±2.5). But the difference was not statistically significant (p value=0.412>0.005). Hence, it can be concluded that the combination of mirror therapy with motor imagery has not caused any additional improvement on gait and lower limb function in stroke patients. Thus, it can be inferred that the combination of mirror therapy with motor imagery is equally effective as motor imagery alone in improving gait and function in stroke patients.

CONCLUSION

The present study demonstrates that motor imagery combined with mirror therapy improved gait and lower limb function in stroke patients. Also, motor imagery alone improved gait and lower limb function in post-stroke patients. When the results of both the groups were compared with each other, there was no statistically significant difference. But on comparing the mean difference of both the groups, motor imagery combined with mirror therapy was superior to motor imagery alone. 

Hence, it can be inferred that the combination of mirror therapy with motor imagery is equally effective as motor imagery alone in improving gait and function in stroke patients.

LIMITATIONS

  • The study had a small sample size

  • The intervention period was only for two weeks

  • long term follow up was not taken

SCOPE FOR FUTURE WORK

  • A similar kind of study can be carried out with large sample size. Also, the interventions can be given for a longer period.

  • A follow-up study can be conducted to determine the long-term effects of the interventions.

  • Further studies can be conducted comparing mirror therapy with motor imagery

SOURCES OF FUNDING

Nil

CONFLICTS OF INTEREST

None

References:

  1. Sacco R, kasner S, Broderick J, Caplan L, Culebras A, Elkind M et al. An Updated Definition of Stroke for 21st Century. A Statement for Health Care Professionals from the American Heart Association/American Stroke Association.Stroke. 2013;44:2064-89.

  2. Pandian J, Sudhan P. Stroke Epidemiology and Stroke Care Services in India. J Stroke. 2013;15(3):128-34.

  3. Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. Mirror Therapy for Improving Motor Function After Stroke. Stroke. 2012;44(1):e1-e2.

  4. Beyaert C, Vasa R, Frykberg G. Gait post-stroke: Pathophysiology and rehabilitation strategies. Clin Neurophysio. 2015;45(4-5):335-55.

  5. Oh Y, Kim H, Woo Y. Effects of Rhythmic Auditory Stimulation Using Music on Gait With Stroke Patients. Phys Ther Korea. 2015;22(3):81-90.

  6. Verma R, Arya K, Sharma P, Garg R. Understanding gait control in post-stroke: Implications for management. J Body Mov Ther. 2012;16(1):14-21.

  7. Arya K, Pandian S, Kumar V. Effect of activity-based mirror therapy on lower limb motor-recovery and gait in stroke: A randomized controlled trial. NeuropsycholRehabil. 2017;1-18.

  8. García D, Aboiti J. Effectiveness of motor imagery or mental practice in functional recovery after stroke: a systematic review. Neurología. 2016;31(1):43-52.

  9. Li R, Li Z, Tan J, Chen T, Lin W. Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized control trials. Complement Ther Clin Pract. (2017); 28:75-48.

  10. Ji S, Kim M. The effects of mirror therapy on the gait of subacute stroke patients: a randomized controlled trial. Clin Rehabil. 2014;29(4):348-54.

  11. Oostra K, Oomen A, Vanderstraeten G, Vingerhoets G. Influence of motor imagery training on gait rehabilitation in sub-acute stroke: A randomized controlled trial. J Rehabil Med. 2015;47(3):204-09.

  12. Lee H, Kim Y, Lee D. The effects of action observation training and mirror therapy on gait and balance in stroke patients. J Phys Ther Sci. 2017;29(3):523-26.

  13. García D, Aboiti J. Effectiveness of motor imagery or mental practice in functional recovery after stroke: a systematic review. Neurología. 2016;31(1):43-52.

  14. Lacourse M, Orr E, Cramer S, Cohen M. Brain activation during execution and motor imagery of novel and skilled sequential hand movements. NeuroImage. 2005;27(3):505-19.

  15. Guerra Z, Lucchetti A, Lucchetti G. Motor Imagery Training After Stroke. J Neurol Phys Ther. 2017;41(4):205-14.

  16. Li Y, Wei, Q, Gou W, He C. Effects of mirror therapy on walking ability, balance and lower limb motor recovery after stroke: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2018;32(8):1007-21

  17. Sacco R, kasner S, Broderick J, Caplan L, Culebras A, Elkind M et al. An Updated Definition of Stroke for 21st Century. A Statement for Health Care Professionals from the American Heart Association/American Stroke Association.Stroke. 2013;44:2064-89.

  18. Pandian J, Sudhan P. Stroke Epidemiology and Stroke Care Services in India. J Stroke. 2013;15(3):128-34.

  19. Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. Mirror Therapy for Improving Motor Function After Stroke. Stroke. 2012;44(1):e1-e2.

  20. Beyaert C, Vasa R, Frykberg G. Gait post-stroke: Pathophysiology and rehabilitation strategies. Clin Neurophysio. 2015;45(4-5):335-55.

  21. Oh Y, Kim H, Woo Y. Effects of Rhythmic Auditory Stimulation Using Music on Gait With Stroke Patients. Phys Ther Korea. 2015;22(3):81-90.

  22. Verma R, Arya K, Sharma P, Garg R. Understanding gait control in post-stroke: Implications for management. J Body Mov Ther. 2012;16(1):14-21.

  23. Arya K, Pandian S, Kumar V. Effect of activity-based mirror therapy on lower limb motor-recovery and gait in stroke: A randomized controlled trial. NeuropsycholRehabil. 2017;1-18.

  24. García D, Aboiti J. Effectiveness of motor imagery or mental practice in functional recovery after stroke: a systematic review. Neurología. 2016;31(1):43-52.

  25. Li R, Li Z, Tan J, Chen T, Lin W. Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized control trials. Complement Ther Clin Pract. (2017); 28:75-48.

  26. Ji S, Kim M. The effects of mirror therapy on the gait of subacute stroke patients: a randomized controlled trial. Clin Rehabil. 2014;29(4):348-54.

  27. Oostra K, Oomen A, Vanderstraeten G, Vingerhoets G. Influence of motor imagery training on gait rehabilitation in sub-acute stroke: A randomized controlled trial. J Rehabil Med. 2015;47(3):204-09.

  28. Lee H, Kim Y, Lee D. The effects of action observation training and mirror therapy on gait and balance in stroke patients. J Phys Ther Sci. 2017;29(3):523-26.

  29. García D, Aboiti J. Effectiveness of motor imagery or mental practice in functional recovery after stroke: a systematic review. Neurología. 2016;31(1):43-52.

  30. Lacourse M, Orr E, Cramer S, Cohen M. Brain activation during execution and motor imagery of novel and skilled sequential hand movements. NeuroImage. 2005;27(3):505-19.

  31. Guerra Z, Lucchetti A, Lucchetti G. Motor Imagery Training After Stroke. J Neurol Phys Ther. 2017;41(4):205-14.

  32. Li Y, Wei, Q, Gou W, He C. Effects of mirror therapy on walking ability, balance and lower limb motor recovery after stroke: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2018;32(8):1007-21

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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.

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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.

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‘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.


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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
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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
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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
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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
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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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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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