Rajiv Gandhi University of Health Sciences, Karnataka



Rajiv Gandhi University of Health Sciences, Karnataka

Bangalore

ANNEXURE II

|1. |Name of the Candidate and Address (in block letters |BHATIKAR KETAN KIRTIKUMAR |

|2. |Name of the Institution |CITY COLLEGE OF PHYSIOTHERAPY |

|3. |Course of Study and Subject |MASTER OF PHYSIOTHERAPY (MPT) MUSCULO SKELETAL AND SPORTS|

| | |PHYSIOTHERAPY |

|4. |Date of Admission to Course |15-10-2009 |

|5. |Title of the Topic |EFFECTIVENESS OF KINESIO TAPING IN COMBINATION WITH ICE |

| | |AND SPRAY TO REDUCE PAIN IN THE CALF MUSCLE CRAMPS FOR |

| | |CRICKET PLAYERS. |

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| | | |

|6. |Brief Resume of the Intended Work |

| |6.1) Introduction and Need of the Study: |

| |Muscle cramps are experienced by most athletes at one time or another. Such cramps are an involuntary and usually painful contraction |

| |of a skeletal muscle, most often in a structure that is actively providing muscle power at the moment of the onset of the cramp. The |

| |surface of the affected area will present as hard and contracted, with the skin appearing as if drawn tight over the muscle. A muscle |

| |cramp will invariably occur without warning. A cricket player falls due to a leg muscle cramp .Muscle cramps are distinct from muscle |

| |twitches, another involuntary muscle action. . The most common causes of muscle cramps, a number of which will occur in combination, |

| |include: fatigue, strenuous exercise and overuse of particular muscle groups ,a failure to stretch or properly warm up prior to |

| |activity ,dehydration, and the related problem of sodium deficiency ,low blood sugar (glucose) levels ,magnesium deficiency ,calcium |

| |deficiency ,the presence of the hydrogen ion that is a byproduct of lactic acid formation in working muscles ,thyroid gland |

| |irregularity ,kidney dysfunction ,side effects of certain medications . . In sports, muscle cramps most frequently occur in the |

| |gastronomies (calf), the hamstrings, and the quadriceps (thigh) muscles. In cricket, the calf muscles are a frequent cramp location. |

| |The onset of a muscle cramp is a disabling event. The first action to relieve the condition is the gentle stretching of the affected |

| |muscle. A stretch of the tissues that is slow and that does not itself create a further stress on the muscle will provide relief from |

| |the muscle contraction. At the point when the athlete can sense some reduction in the tightness of the cramp, the principles of the |

| |RICE (rest/ice/compression/elevation) treatment can be applied to the injured area. In some circumstances, the athlete can continue to |

| |gently stretch the muscle with the ice applied. As many cramps are related to the dehydration of the body, the athlete should consume |

| |fluids immediately. |

| |Kinesio taping attempts to prevent cramping and over-contraction by applying tape from the muscle insertion to the origin. As the |

| |muscle contracts, the tape pulls and attempts to relax the muscle and prevent over-contraction. The key benefit to Kinesio taping is to|

| |reduce and prevent contraction of the affected muscle. |

| |Ice therapy is a treatment involving the application of ice and Cooling the deep tissue also reduces severe spasm by reducing the |

| |muscle’s ability to maintain contraction.Vapocoolant spray to severe spasmodic calf muscles often produce rapid spasm reduction of |

| |affected areas. |

| |This combination therapy will helpful to reduce severe cramps and alleviate pain in short period of time. so many studies had done on |

| |muscle cramps and suggested there was great relief with the combination treatment. so this study is intend to evaluate the |

| |effectiveness of taping and ice with spray to reduce the pain on the calf muscle cramp for cricket players. |

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| |Need of the Study: |

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| |Muscle cramps are experienced by most crickets. It affects the players performance and giving discomfort to them. Most cramps caused by|

| |exercise induced or heat or metabolic disorers.cricket players those who involved in strenuous activity during playing, most |

| |prominently involves calf cramps. There are many treatment available on immediatiate situation and it relieves temporarily. but |

| |recurrent muscle cramps leads discomfort. There are lot of treatment programmes available for reducing cramps. According to research, |

| |Many treatment programmes did not support the permanent solution to relive muscle cramps. But there is some studies supported the |

| |taping technique along with cryotherapy proves the better solution to alleviate muscle cramps in shorter period of time so this study |

| |aimed to the effect of these techniques are reduce calf muscle cramps for cricket players. |

| | |

| |Research Question: |

| |Does the kinesio taping in combination with ice and spray to reduce calf muscle cramps for cricket players?. |

| |Hypothesis: |

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| |Experimental Hypothesis |

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| |kinesio taping in combination with ice and spray may reduce calf muscle cramps for cricket players |

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| |Null Hypothesis |

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| |kinesio taping in combination with ice and spray may not reduce calf muscle cramps for cricket players |

| |. |

| |. |

| |6.2) REVIEW OF LITERATURE |

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| |.1. HART CE et al (2008) |

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| |They studied the effect of 5 days kinesio taping with 10 min cryotherapy on severe calf cramps in young athletes 6 sessions in a week |

| |and suggested that a short term treatment of this type can reduce the pain and improve circulation and prevent recurrent muscle cramps |

| |in young athletes. |

| | |

| |2.verginia s.et.al (2005) |

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| |They studied that the effect of one week of cryotherapy and vapocollant spray for 26 cricketers and found that it reduces severe |

| |painful calf cramps in the short period of time. |

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| |3.Erica D. Carlyn Stuart |

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| |KT may provide benefits to patients who present with calf cramps and assist and prevent over contraction of muscles. |

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| |4.Colleen Morrissey Wheatley |

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| |KT Tape also reduces inflammation and increases circulation which prevents muscle cramping and lactic acid buildup. |

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| |5.Lorena Newkirk |

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| |She suggested that the kinesiotaping is advantage, from muscle spasms to muscle cramps and reduce moderate pain. |

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| |6. Dr. Donald Liebell |

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| |He stated that the Vapocollant Spray reduces muscle fatigue and prevents excessive exertion, contraction and cramping, while |

| |simultaneously increasing range of motion. |

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| |7. Janet G. Travell, David G. Simons – 1992: |

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| |They suggested that application of vapocoolant spray combined with ice produce remarkable effect to reduce pain and repeated cramps. |

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| |8.Joanne Stapensea |

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| |She suggested that 5 days of kinesio taping relieve pain in Calf spasms, cramps and provides therapeutic benefits with immediate |

| |effect. |

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| |9. Lorraine Loretz s |

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| |He confirmed the verbal descriptor scale has a good reliability and validity for testing pain especially for adults. |

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| |10. K. Roeleveld1,2, B. G. M. van Engelen3, and D. F. Stegeman1,4 |

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| |They have studied the EMG analysis of intiation and development of muscle cramps. The results show that cramp presents itself as a |

| |contraction of a slowly moving fraction of muscle fibers, indicating that either the spatial arrangement of the motoneurons and muscle |

| |fibers is highly related or that cramp spreads at a level close to the muscle. Spectral analyses of the EMG and peak-triggered average |

| |potentials show the presence of extremely short potentials during cramp. |

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| |6.3) OBJECTIVE OF THE STUDY; |

| | |

| |To reduce pain in the calf muscle cramps by the application of kinesio taping in combination with ice and spray for the cricket |

| |players. |

|7. |MATERIALS AND METHODS; |

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| |7.1) STUDY DESIGN; |

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| |Pre and Post two group experimental design. |

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| |7.2) SOURCE OF DATA; |

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| |Data is collected using random sampling at City Hospital, Kadri, and Mangalore and Mangalore cricket team. |

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| |7.2(I) Definition of Study Subjects; |

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| |20 adult patients diagnosed calf cramps will be taken in this study. |

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| |7.2(II)Inclusion and Exclusion Criteria; |

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| |INCLUSION CRITERIA; |

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| |Calf cramps diagnosed by neuro physician through EMG. |

| |Adult clients. |

| |Only cricketers. |

| |Both sexes. |

| |. |

| |EXCLUSION CRITERIA; |

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| |Drug dependent clients |

| |Young and geriatrics. |

| |Leg myalgia |

| |Sprain. |

| |Strain. |

| |Vascular disorders. |

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| |7.2(III) Study Sampling Design, Method and Size: |

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| |SAMPLE DESIGN |

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| |Random sampling design. |

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| |METHOD OF COLLECTION DATA |

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| |Patients fulfilling the inclusive and exclusive criteria would only be recruited. Patients will be screened using a screening tool. |

| |Patients will be scored using Verbal Descriptor Scale. |

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| |SAMPLE-SIZE; |

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| |Approximately 30 patients fulfilling the inclusion and exclusion criteria will be the sample size. |

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| |7.2(IV) Follow Up |

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| |For the purpose of the present study, the patients will be studied initially Verbal Descriptor Scale and combination therapy for one |

| |week and reassessed by Verbal Descriptor Scale |

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| |7.2(V) Parameters and Stastical tests: |

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| |variables: |

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| |Verbal Descriptor Scale scoring |

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| |The Most Intense Pain Imaginable - 6 |

| |Extreme Pain - 5 |

| |Severe Pain - 4 |

| |Moderate Pain - 3 |

| |Mild Pain - 2 |

| |Slight Pain - 1 |

| |No Pain - 0 |

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| |Stastical tests: |

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| |Collected data will be analyzed by t-test with the help of standard deviation. |

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| |7.2(VI) Duration of study: |

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| |Total duration of study is 12 months. |

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| |7.2(VII) Methodology: |

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| |The purpose and procedures of our study were explained, and verbal consent to participate was obtained Subjects will be taken into the |

| |study after obtaining their informed consent , thorough medical history will be taken for all the participants to screen for the |

| |inclusive criteria . Proper instruction about the evaluation criteria will be explained to the subjects. All participating subjects |

| |will be assessed as per the Verbal Descriptor Scale. Verbal Descriptor Scale (VDS) will be taken prior treatment combination therapy |

| |(ice,spray,taping) will be implemented for 7 days a week. Total duration per day 20 minutes. After end of 1 st week score will be taken|

| |and analyzed and compared. Pre scores are compared with post treatment scores using stastical tool. |

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| |Treatment protocols |

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| |Spray |

| |Type : vapocollant |

| |Cryotherapy |

| |Type : proximal to distal stroking |

| |Duration : 10 min |

| |Taping |

| |Type : kinesio taping |

| |Technique : Simple support taping |

| |Duration : 7 days |

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| |7.3) Does the study require any investigations to be conducted on patients or other human or animal? If so, please describe briefly. |

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| |Yes. |

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| |7.4) Has ethical clearance been obtained from your institution in case of 7.3. |

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| |Yes. |

|8 |List of Refeences: |

| |Hall AJ. Cramp and salt balance in ordinary life. Lancet 1947;ii:231-3. |

| |Daniel HW. Simple cure for nocturnal leg cramps. N Engl J Med 1979; 301: 216. |

| |Peer G, Blum M, Aviram A. Relief of hemodialysis-induced muscular cramps by nifedipine. Dialysis and Transplantation 1983;12:180-1. |

| |Ayres S, Mihan R. Nocturnal leg cramps (systremma) and 'restless legs' syndrome: response to vitamin E. South Med J 1974;67:1308-12. |

| |McGee SR. Muscle cramps. Arch Intern Med 1990;159:511-8. |

| |Moss HK, Herrmann LG. The use of quinine for relief of night cramps in the extremities. JAMA 1940;115:1358-9 |

| |Maguire RB, Stroncek DF, Campbell AC. Recurrent pancytopenia, coagulopathy, and renal failure associated with multiple |

| |quinine-dependent antibodies. Ann Intern Med 1993;119:215 |

| |Bateman DN, Blain PG, Woodhouse KW, Rawlins MD, Dyson H, Heyworth R, et al. Pharmacokinetics and clinical toxicity of quinine |

| |overdosage: lack of efficacy of techniques intended to enhance elimination. Q J Med 1985;214:125-31. |

| |Bacon P, Spalton DJ, Smith SE. Blindness from quinine toxicity. Br J Ophthalmol 1988;72:219- |

| |Baltodono N, Gallo BV, Weidler DJ. Verapamil vs quinine in recumbent nocturnal leg cramps in the elderly. Arch Intern Med |

| |1988;148:1969-7 |

| |Lim SH. Randomized double-blind trial of quinine sulphate for nocturnal leg cramps. Br J Clin Pract 1986;40:462. |

| |Gorlich HD, von Gablenz E, Steinberg HW. Treatment of nocturnal leg cramps. A multi-center, double blind, placebo controlled comparison|

| |between the combination of quinine and theophylline ethylene diamine with quinine. Arzneimittelforschung 1991;41:167-75. |

| |Roca AO, Jarjoura D, Blend D, Cugino A, Rutecki GW, Nuchikat PS, et al. Dialysis leg cramps. Efficacy of quinine versus vitamin E. |

| |ASAIO J 1992;38:481-5. |

| |Kaji DM, Ackad A, Nottage WG, Stein RM. Prevention of muscle cramps in haemodialysis patients by quinine sulphate. Lancet 1976;ii:66-7.|

| | |

| |Jones K, Castleden CM. A double blind comparison of quinine sulphate and placebo in muscle cramps. Age Ageing 1983;12:155-8. |

| |Warburton A, Royston JP, O'Neill CJA, Nicholson PW, Jee RD, Denham MJ, et al. A quinine a day keeps the leg cramps away? Br J Clin |

| |Pharmacol 1987;23:459-65. |

| |Fung MC, Holbrook JH. Placebo-controlled trial of quinine therapy for nocturnal leg cramps. West J Med 1989;151:42-4. |

| |Connolly PS, Shirley EA, Wassen JH, Nierenberg DW. Treatment of nocturnal leg cramps. A crossover trial of quinine vs vitamin E. Arch |

| |Intern Med 1992;152:1877-80. |

| |Dunn NR. Effectiveness of quinine for night cramps [letter]. Br J Gen Pract 1993;43:127-8. |

| |Siderov J. Quinine sulfate for leg cramps: does it work? J Am Geriatr Soc 1993;41:498-500. |

| |Moerl H, Dieterich HA. Nocturnal leg cramps: their causes and treatment. Med Klin 1980;75:40-5. |

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|9. |SIGNATURE OF THE CANDIDATE |Ketan |

|10. |REMARKS OF GUIDE |Appropriate And Feasible Study Recommended |

|11. |NAME AND DESIGNATION (in block letters) | |

| |11.1 GUIDE |BHARATH K H |

| | |ASSISTANT PROFESSOR |

| |11.2 SIGNATURE |Bharath |

| |11.3 CO-GUIDE |Mr. J. JOHN AROCKIA VIJAY PRINCIPAL |

| |(if any) | |

| |11.4 SIGNATURE |John |

| |11.5 HEAD OF DEPARTMENT |Mr. J. JOHN AROCKIA VIJAY PRINCIPAL |

| |11.6 SIGNATURE |John |

|12. |12.1 REMARKS OF THE CHAIRMAN AND PRINCIPAL |TOPIC IS APPROPRIATE AND HAS CLINICAL IMPLICATIONS. |

| | |RECOMMENDED |

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| |12.2 SIGNATURE | |

| | |John |

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