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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Effect of Matrix Rhythm Therapy on Subjects with Asymptomatic Hamstring Tightness: A Quasi-experimental Study
Correspondence Address :
Dr. Varun Chandrakant Naik,
Assistant Professor, Department of Cardiovascular and Thoracic Surgery Physiotherapy, Kaher institute of Physiotherapy, 2nd Floor, Nehru Nagar Belagavi-590010, Karnataka, India.
E-mail: varunnaik@klekipt.edu.in
Introduction: Hamstring tightness is a decreased range of motion at the knee with an associated feeling of restriction in the posterior thigh. The hamstrings are a group of muscles that control hip and knee joint mobility as well as pelvis and spine alignment. Because hamstring tightness impacts body posture and causes musculoskeletal pain, finding a new effective approach to restore hamstring flexibility is critical. Matrix rhythm therapy is a class IIA medical device that enhances an increase in microcirculation and tissue flexibility and elasticity.
Aim: To determine the immediate effect of Matrix Rhythm Therapy (MaRhyThe©) on an individual with asymptomatic hamstring tightness between the age group of 18-25 years on an active knee extension test and ultrasonography.
Materials and Methods: This quasi-experimental single session study was conducted in KAHER Institute of Physiotherapy (tertiary care hospital), Belagavi, Karnataka, India, from November 2020 to January 2021. A total of 63 people were screened for the study out of which 30 were included (17 Female and 13 Male) and were recruited using the Active Knee Extension (AKE) test and ultrasonographic assessment. The age criterion was 18-25 years. MaRhyThe© was given for only one session of 60 minutes on both legs (30 minutes on each leg). After the session, the immediate effect of the treatment was noted by comparing the active knee extension test of both legs and conducting the ultrasonographic assessment. The pretest and post-test scores were analysed using the Kolmogorov Smirnov test.
Results: The results showed that there was a 41.39% reduction in the AKE of the right leg and a 42.40% reduction in the AKE on the left leg of the participants which was statistically significant. Post-intervention statistically significant differences were found in an increase in the length, blood flow, and decrease in thickness of the hamstring muscle (p-value ≤0.001) after a 60 minute session of MaRhyThe©.
Conclusion: MaRhyThe© for 60 minutes duration (30 minutes each leg) produces beneficial effects such as improved tissue extensibility, increased blood microcirculation, and decreased tissue thickness in subjects with asymptomatic hamstring tightness.
Active knee extension, Microcirculation, Musculoskeletal pain, Ultrasonography
The hamstring is a muscle situated in the posterior aspect of the thigh which consists of three muscles which include semitendinosus, semimembranosus, biceps femoris long head, and short head. A part of the adductor magnus is also considered a hamstring muscle (1). The main function of a hamstring muscle is flexion of the knee joint and extension of the hip joint. The hamstring plays an important role in performing activities of daily living such as walking, running, and jumping and some of the gluteal movements (2). The inability to fully extend the knee when the hip is flexed, as well as discomfort or pain along the posterior thigh and/or knee, are usually attributed to hamstring muscle tightness. The flexibility of this two-joint muscle group is crucial for everyday postures and activities (3). The main reason for it is the reduced ability of the muscle to deform hence forcing the movements at the joint to restrict themselves (4).
Hamstring tightness is a decreased range of motion with an associated feeling of restriction in the posterior thigh. The most frequent cause of hamstring tightness is an intense form of activity; strenuous exercise leads to tightness. Because hamstring tightness impacts body posture and causes musculoskeletal pain, finding a new effective approach to restore hamstring flexibility is critical. According to a previous study prevalence of hamstring tightness is very high amongst people between the age group of 18-25 years (5). Several physical therapists have an opinion that when "apparent hamstring inflexibility/tightness" is identified during clinical examination, quick and instantaneous changes in various clinical signs and symptoms may emerge over time due to tissue extensibility malfunction.
Matrix Rhythm Therapy (MaRhyThe©) was developed by Dr. Ulrich Randoll in Germany in the 1990s. It is widely used in Germany. MaRhyThe© is applied by the Matrixmobil®, which is a Class IIA medical device. Like a crank handle, it is mechano-magnetically synchronizing the body's intrinsic vibrations via the neuromuscular system in the alpha rhythm (8-12 Hz). The treatment approach is a systemic one, using physiological rhythms and focusing on Extracellular Matrix (ECM) to normalise the metabolism by optimisation of cellular logistics (6),(7),(8).
The purpose of this study was to determine the immediate therapeutic effectiveness of MaRhyThe© in individuals with asymptomatic hamstring tightness.
This quasi-experimental single session study was conducted in KAHER Institute of Physiotherapy, Belagavi, Karnataka, India, from November 2020 to January 2021. Ethical clearance (Sl. No: 779) was obtained from the Institutional Ethical Committee. The study was with Clinical Trial Registry - India with reference no: CTRI/2021/03/031728. The purpose and procedure of the study were explained and written informed consent was obtained.
Sample size was calculated based on previous prevalence study and sample size determined was 30 (5). A total of 63 people were screened for the study out of which 30 were included which fit into the exclusion criteria.
Inclusion and Exclusion criteria: Subjects willing to participate in the study, asymptomatic subjects with hamstring tightness and knee flexion angle greater than 20º, subjects with an age group of 18-25 years, subjects with a body mass index of 18.5 to 24.9 kg/m2 were considered in inclusion criteria. Subjects showing associated symptoms due to hamstring tightness like lower back pain, on any kind of medications for musculoskeletal problems, or who underwent musculoskeletal surgeries in the past six months were excluded from the study.
A brief demographic data of age, weight, height, and Body Mass Index (BMI) was taken from the participants before the assessment. The dependent variable used to assess hamstring flexibility was the Active Knee Extension (AKE) test and the Ultrasonographic assessment provided information on microscopic values i.e. length of muscle fiber, size of muscle fiber, and blood circulation of the hamstring muscle.
Procedure
Ultrasonography procedure: The entire ultrasonography assessment was performed in a dark, cold, and safe environment by the same person for all the subjects. The same linear probe was used for pre and post-evaluation of the length, thickness, and blood flow. The subject was made to lie in a prone position with the posterior thigh exposed and their foot outside the couch so as to attain a stretch in the muscles. The water-based gel was applied to the thigh and the linear probe was used to locate the origin and insertion of the hamstring muscle. After locating the origin and insertion of the muscle, segmental length of the muscle was calculated and sum of all the measurements were taken in order to determine the length of the muscle. Along with the length, muscle thickness at the muscle bulk was measured and blood flow of the minor arteries were noted. Measurements of the thickness of the hamstring muscle (Table/Fig 1), hamstring length (Table/Fig 2), and blood flow (Table/Fig 3) were recorded preintervention and postintervention.
Active knee extension test: The patient was made to lie down on the examination table. The testing limb was lifted to a position perpendicular to the ground, with the hip at 90o of flexion and the knees extended. A lag of 20o from the full extension was regarded normal; anything less than 20o degrees was termed hamstring tightness. A goniometer was used to determine this range. The fulcrum was at the knee, with the fixed arm pointing to the greater trochanter and the moving arm pointing to the lateral malleoli (9).
Interventional Procedure: During the session, the participant was asked to lie comfortably in a prone position. To avoid the friction created by the Matrix Mobil®, the hamstring muscle was exposed and talcum powder was administered to the treatment region. The Matrix Mobil® is a rod-shaped with a spiral-shaped vibration head that vibrates at 8 to 12 Hz. Matrix Mobil® was used in a longitudinal stroking manner, with the probe of the device being pushed into the muscles of the hamstring. The session was delivered for 60 minutes, with 30 minutes on each of the hamstring muscles side.
Statistical Analysis
Data were tabulated using Microsoft Excel version 16 and analysed using Statistical Package for Social Sciences (SPSS) software version 20.0 and the statistical level of significance was set at p-value <0.05. Normality of pretest and post-test scores of all parameters was done by the Kolmogorov Smirnov test. A dependent t-test was applied for pre-comparison and post-comparison.
Mean age, weight, height and BMI is presented in (Table/Fig 4). All parameters pretest and post-test scores were following a normal distribution (Table/Fig 5).
There was a significant decrease in AKE angle with percentage of change on the right leg was 41.395 and on the left leg was 42.405 (Table/Fig 6). There was a significant increase in the length of the hamstring muscle with a mean difference of -2.23 on the right-side and -2.00 on the left-side (Table/Fig 7).
There was a significant difference in the thickness of the hamstring muscle (mm) the in right leg and left leg post-intervention (Table/Fig 8). There was a significant increase in the blood flow of the hamstring muscle (cm/sec) the in right leg and left leg post-intervention (Table/Fig 9).
As a newly developed therapeutic tool, MaRhyThe© has been used in comparatively limited research investigations. It has been demonstrated to be useful in improving joint range of motion, muscular flexibility, pain reduction, and daily life capabilities (6).
According to the results of case report, MaRhyThe© improves blood circulation. The compressive effect induced by the application of MaRhyThe© may produce additional soft tissue mobilization and afferent impulses due to the action of vibration (10). According to Callaghan (11), the major function of mechanical vibration massage is to enhance blood circulation, and the tonic vibration reflex produces active muscle contraction in mechanical vibration. As a result of the muscle contraction, blood flow may have increased leading to the flexibility of the hamstring muscle. Previous studies have shown that the use of mechanical vibratory devices increased blood flow by 20%, 26%, and 46% (12),(13),(14).
According to Button, applying a mechanical vibration level to the bloodstream generates a 22 minute spike in blood flow. Increased blood flow to the hamstring muscle must have contributed to an increase in muscular temperature, allowing muscles to relax and release tension (13). Muscle tension and tightness are alleviated, allowing a muscle to stretch to its full length without restriction and increasing range of motion. The effect of vibration on muscle perfusion has recently gotten a lot of research due to the supposed health benefits of being able to enhance blood flow. Vibration-induced increases in muscle perfusion appeared to be proportional to the vibratory stress applied. As a result, modulating the vibratory load may be able to produce desirable improvements in muscle perfusion to minimise inflammation, discomfort, and accelerate muscle tissue repair after an acute injury or in chronic circulation disorders like peripheral vascular disease (15). Reflexive muscular contractions (16),(17) are widely used to describe the process that causes vibration-induced increases in muscle perfusion. Enhanced blood viscosity and artery diameter contribute to improved microcirculation, which results in increased blood flow, oxygen, and metabolite exchange at the tissue site (10). This promotes fibroblastic activity, which improves soft tissue function and leads to increased range of motion, which assists tissue healing. Similar tissue healing effects were seen in a previous study using Instrument Assisted Soft Tissue Mobilization (IASTM) on Plantar Fasciitis (18). The acute effects of MaRhyThe© versus passive stretching on female hamstring flexibility were examined by Ratwani N et al that concluded that MaRhyThe© is better in improving hamstring muscle flexibility than passive stretching (19). Further studies are needed to study comparing other clinical tools to improve the length of the hamstring muscles.
Limitation(s)
The study’s sample size is small hence generalization of the results is limited. Absence of control or placebo group. The long-term effect was not evaluated in this study.
MaRhyThe© for 60 minutes (30 minutes each leg) produces beneficial effects on subjects with asymptomatic hamstring tightness between the ages of 18 and 25 years. The ultrasonographic assessment revealed a significant increase in hamstring muscle length and blood flow, as well as a decrease in hamstring muscle thickness As a result, the researchers propose using MaRhyThe© as part of physiotherapeutic therapy in clinical settings for persons with the tightness of hamstring muscles.
DOI: 10.7860/JCDR/2022/56228.16917
Date of Submission: Mar 09, 2022
Date of Peer Review: Apr 06, 2022
Date of Acceptance: Jun 21, 2022
Date of Publishing: Sep 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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