International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
Bootstrap Slider

Indexed and Abstracted in: Crossref, CAS Abstracts, Publons, CiteFactor, Open J-Gate, ROAD, Indian Citation Index (ICI), Indian Journals Index (IJINDEX), Internet Archive, IP Indexing, Google Scholar, Scientific Indexing Services, Index Copernicus, ResearchBib, Science Central, Revistas Medicas Portuguesas, EBSCO, BOAI, SOROS, NEWJOUR, ResearchGATE, Ulrich's Periodicals Directory, DocStoc, PdfCast, getCITED, SkyDrive, Citebase, e-Print, WorldCat (World's largest network of library content and services), Electronic Journals Library by University Library of Regensburg, SciPeople.

Search Articles

Track manuscript

Advertisement

Full Html

IJCRR - Vol 12 Issue 08, April, 2020

Pages: 05-10

Date of Publication: 23-Apr-2020


Print Article   Download XML  Download PDF

Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial

Author: Ilona Gracie De Souza, Pavan Kumar G.

Category: Healthcare

Abstract:Background: Patellofemoral pain syndrome (PFPS) is characterized by diffuse anterior knee pain. Musculoskeletal dysfunction arises from alterations in the deep fascia that pull or crowd the osseous structures out of alignment resulting in pain and dysfunction. Purpose of the study was to evaluate the effect of releasing myofascial chain in patients with patellofemoral pain syndrome.
Methods: 40 patients were randomly allocated into 2 groups. Experimental group (n=20) mean age 36.60\?7.36 was treated with Myofascial chain release and exercise therapy. Control group (n=20) mean age 32.25\?9.11 was treated with exercise therapy, three sessions in a week for a period of 4 weeks. Kujala, Visual analogue scale (VAS) and Patient specific functional scale (PSFS) were used as outcome measures. Paired & unpaired t test was used for statistical analysis
Results: Both groups showed statistically significant change in all the three outcome measures. The experimental group showed (p< 0.001) for Kujala questionnaire, (p=0.004) for Patient specific functional scale and (p< 0.001) for visual analogue scale.
Conclusion: Results suggest that Myofascial chain release showed superior improvement. This is due to the release of interconnected fascia that corrects lower extremity kinematics thereby reducing pain and improving functional activities and reducing the stress on patellofemoral joint.

Keywords: Exercise therapy, Fascia, Myofascial release, Patellofemoral pain syndrome (PFPS), Physical therapy

Full Text:

INTRODUCTION

Patellofemoral pain syndrome (PFPS) is the most prevalent musculoskeletal condition seen in general practice and sports medicine clinics which is characterized as anterior knee pain.[1] The patellofemoral joint is the most heavily loaded in the human frame and its articular cartilage is the thickest.[2] Incidence ranges from 21 to 40% in clinical setting and females are affected more than males in the ratio 2:1. [3] The symptoms include diffuse pain over anterior aspect of knee that is aggravated by activities such as ascending or descending stairs, prolonged sitting and squatting.[4] Physical impairments include destruction of articular cartilage, pain, diminished muscular control, patella mal-alignment, inflexibility of the hamstrings, gastrocnemius, iliotibial band, tensor fasciae latae, and biomechanical alterations in the lower extremity, thus indicating multifactorial causes. The causes and mechanisms involved in patellofemoral pain are extrinsic and intrinsic.[5]

Clinical experience and emerging data proved that weakness of hip musculature and limited lower extremity flexibility are the key factors for the conservative management of patellofemoral pain syndrome.[6] Tight lateral retinaculum causes lateral patellar compression that puts excessive stress on lateral patellofemoral joint. Tight quadriceps becomes less efficient to absorb energy eccentrically which transmits the load to adjacent structures that is patella and quadriceps tendon subjecting them to stress. A tight iliotibial band (ITB) causes increase tension on lateral retinaculum and lateral patellofemoral joint stress. In addition with a tight quadriceps, hamstrings has to overcome this resistance during knee flexion thus generating an increase in patellofemoral joint reaction force.[7]

In accordance with Fascial Manipulation theory, uncoordinated quadriceps contraction produces anomalous fascial tension in the thigh causing pain in the patella. Therefore the focus of treatment was on the muscular fascia of the thigh.[8] Musculoskeletal dysfunction arise from alterations in the deep fascia.[9] Fascia is tough connective tissue from head to toe spreading throughout the body in a three-dimensional web pattern.[10]

     As a response to injury, disease, inactivity or inflammation fascial tissue loses its elasticity and become dehydrated. Fascia binds around traumatized areas causing fibrous adhesions that prevents normal muscle mechanics and decreases soft tissue extensibility. Fascial restrictions crowd or pull the osseous structures out of proper alignment creating abnormal strain patterns, resulting in joint compression producing pain and/or dysfunction.[10]

‘Myofascial chain’ is the bundled together inseparable nature of muscle tissue (myo) and its accompanying web of connective tissue (fascia).[11] 'Myofascial continuity' describes the connection between two longitudinally adjacent and aligned structures within the structural webbing. Quadriceps runs from ASIS, shaft of femur, then as subpatellar tendon, patella and then continues as Tibialis Anterior towards the inside of the ankle. This Quadriceps, Tibialis anterior chain affects knee tracking. The tensor fascia latae blends with the iliotibial band on the outer aspect of the knee on the lateral condyle of tibia and then onto the tibialis anterior crossing the lower shin bone.[12] Thus Quadriceps, Tibialis Anterior and Iliotibial band chains influence the patellofemoral joint the most.

The current rehabilitation studies for patellofemoral pain syndrome are Kinesio taping, custom-fitted foot orthosis, lumbopelvic manipulation and exercise therapy.[13-16] Exercise therapy has proved effective in  management of patellofemoral pain syndrome but has limitations as it doesn’t correct the fascial restrictions and a recent systematic review has stated its poor adherence in patients suffering with knee pain due to lack of time, lack of knowledge about the exercise, apathetic condition, poor behavior to exercise and impaired general health status.[17] Despite the success of conservative treatment, patients continue to experience pain and dysfunction making patellofemoral pain syndrome a challenging condition to treat.[18]

Myofascial therapy is defined as “the facilitation of mechanical, neural and psycho physiological adaptive potential as interfaced by the myofascial system”. Myofascial release (MFR) is a hands on technique which stretches the fascia and releases, bonds between muscles, integuments and fascia in order to eliminate pain, improve motion and to maintain myofascial balance within the body. [19]

Fascia is manipulated by direct technique that involves the use of knuckles, elbows, ulnar border of the hands and fist, indirect or self-myofascial technique, indirect myofascial release uses hands and the self myofascial release uses a soft roll or ball (tennis ball).  The purpose of myofascial release is to focus on the deeper layers of fascia by elongating the muscular elastic component, cross-links and altering the viscosity of ground tissue.[19]

Studies have shown the effectiveness of myofascial release in reducing chronic pain, neck pain, shoulder pain, muscular spasm and muscle tightness.[19] Studies proved the effectiveness of myofascial release on Iliotibial band flexibility and patellar alignment in patients with knee osteoarthritis.[20] Recent study has shown effectiveness of static stretching versus myofascial release in Iliotibial band tightness in long distance runners.[21] Also a recent study have shown the effectiveness of chiropractic mechanical assisted adjusted techniques (MAT), soft tissue therapy involving deep effleurage and myofascial release and specific strengthening and stretching rehabilitation program in a professional basketball player with chronic patellar tendinopathy complicated with patellofemoral pain syndrome.[22]

As inflexibility of soft tissues have been an important factor in causing patellofemoral pain syndrome due to the interconnected fascia, many treatment techniques have been successful in treating patients with patellofemoral pain syndrome but no study has focused on the treatment of muscular fascia involvement. Exercise therapy has been the most effective treatment in patellofemoral pain syndrome. However, myofascial therapy can be an added benefit in order to overcome the poor adherence to exercise therapy. Research on myofascial release has shown promising results in the area of soft tissue inflexibility and could potentially be a form of treatment. As per the existing evidence of soft tissue inflexibility causing patellofemoral pain syndrome. Though the efficacy of myofascial release has been effective in releasing inflexibility of soft tissues, no studies have been retrieved of its effectiveness in patellofemoral pain syndrome patients. Thus the purpose of this study is to know the effect of myofascial chain release compared to exercise therapy on patellofemoral pain syndrome patients.

METHOD

Forty subjects were recruited from Srinivas college of physiotherapy and research center OPD and Srinivas Hospital, Mangalore from April 2016 to March 2017. Inclusion criteria 1) Age between 18-50 years 2) both gender 3) visual analogue scale (VAS) rating of atleast 30mm on a 100mm scale over the previous week. 4) anterior knee or retropatellar pain during atleast three of the following activities like stair ascent or descent, squatting, kneeling, hopping, jumping and prolonged sitting. 5) Gradual onset of symptoms 6) Subject experiences pain during palpation of patellar facets or while performing a 25-cm step down test or double legged squat.[3,6] Exclusion criteria included meniscal or intra-articular pathological conditions, cruciate or collateral ligaments involvement, tenderness over the patellar tendon, iliotibial band or pes anserinus tendons, sign of patellar apprehension, patellar tendinopathy, hip or lumbar referred pain, history of patellar dislocation, evidence of knee joint effusion, history of previous surgery, pre-patellar tendinitis, fat pad bursitis, quadriceps tendinopathy, over sensitive patients, systemic or local infections, healing fractures, anti-coagulant therapy and under corticosteroids and or anti-inflammatory drugs.

PROCEDURE

The approval was obtained from the scientific committee and college ethical committee. Subjects with patellofemoral pain syndrome were screened for inclusion and exclusion criterion. A total of 53 subjects were screened. 40 subjects met the inclusion criteria. The purpose of the study was explained to all the subjects and was asked to sign the written consent form stating the voluntary acceptance to participate in this study. Demographic information was collected. Purposive sampling was done. 40 subjects were assigned randomly into experimental or control groups by block randomization. Pre -treatment score was evaluated by using Kujala Questionnaire [23], Patient specific functional scale [24] and visual analogue scale[25]. Experimental group (n=20) was treated with myofascial chain release for the Quadriceps, Iliotibial band and Tibialis anterior muscle along with exercise therapy. Control group (n=20) was treated with exercise therapy that included stretching and strengthening of hip and knee musculature. Treatment was given for 3 days in a week for a period of 4 weeks. Post treatment score were evaluated after the last treatment session

DESCRIPTION OF TREATMENT

Brief assessment was conducted.

Evaluation of fascial restriction was assessed using the therapists elbow. Any restrictions felt were assessed and given treatment.

Experimental group: Myofascial chain release and exercise therapy

Myofascial chain release- [26]                                         

Position of the patient- Supine lying, prone lying and side lying

Position of the therapist- Side of the patient limb to be treated

Technique-

Using the therapist elbow a vertical release proximal to the attachment of the muscle belly or fascia was applied.

Once an end-feel was reached a slow stroke down the length of the target tissue was performed along with monitoring the indirect feedback and tissue tension to identify any additional restrictions.

The long stroke was repeated in a line parallel to the first stroke. It was continued until an end-feel is reached throughout the entire muscle belly or fascia on the most restricted/painful points.

Myofascial chain release was given to Quadriceps, Iliotibial band and Tibialis anterior for three days in a week for a period of four weeks of 5 to 10 min duration.[16]

Figures 1: Myofascial chain release for Quadriceps.

Maximum resistance were given that enables 10 repetitions

Load was 70% of the 1-repetition maximum.

Treatment was given for 3 days in a week for a period of 4 weeks, total 12 sessions.

STATISTICAL ANALYSIS[27, 28]

Descriptive analysis was done by finding mean and standard deviation. The data was then subjected to test of normality. Data was analysed using Paired t-test to compare the outcomes within the group and Unpaired t- test for between the groups. The confidence interval was kept at 95%.

RESULT:

Both groups showed a statistically highly significant change (P <0.001) which means that both the groups significantly reported improved functional activity. However when analyzed between the post intervention value of experimental group and control group, it showed a statistically significant change (P<0.001) showing that experimental group had superior improvements in functional activity than control group.

Both groups showed a statistically significant change (P=0.002) which implied that both the groups had favourable outcome in functional activity levels. Patient specific functional scale was analyzed between post intervention value of experimental group and control group, it showed a statistically significant change (P=0.004) showing that experimental group had superior improvements in functional activity than control group.

Both groups showed a statistically highly significant change (P <0.001) for reduction in pain. Visual analogue scale when analyzed between the groups, it showed that there was statistically significant change (P <0.001) showing that experimental group had superior improvements in reducing pain than control group.

DISCUSSION

Study was conducted to evaluate the effect of releasing the myofascial chain in patients with patellofemoral pain syndrome. Conservative management has focused on hip muscle weakness and inflexibility of lower extremity muscles as it has been the common factors causing patellofemoral pain syndrome.[6] Travell and Simons have stated that chronic overload of the lower extremity muscles is the prime problem without gross abnormality of the articular cartilage for the development of patellofemoral pain syndrome. As inflexibility of soft tissues have been an important factor in causing patellofemoral pain syndrome due to the interconnected fascia and due to the multifactorial causes many treatment techniques have been successful in treating patients with patellofemoral pain syndrome but had limitations as it did not focus on the treatment on muscular fascia involvement. To the best of the author’s knowledge there were no clinical trial done on the treatment of releasing the myofascial chain in patients with patellofemoral pain syndrome.

Fascia is a complex structure that connects throughout the body. Fascia allows for effective load transfer between the spine, pelvis, legs and arms. Fascia is continuous, has pain fibers and is capable of transmitting tension. The hip muscles form a vital link in the lower extremity kinetic chain transferring ground-reaction forces from the legs to the trunk during gait.[29]

This study had myofascial release therapy along with exercise therapy in the experimental group and exercise therapy alone in the control group. A pure control group with no treatment or a pure experimental group with no conventional treatment could not be taken based on ethical grounds. Exercise therapy included stretching and strengthening exercises for the lower extremity as it has been proved as the most effective conventional treatment for the management of patellofemoral pain syndrome in reducing pain as well as improving functional dynamic activities. It was stated that since it focused on pelvis and hip muscle recruitment the patients had better hip motor control during the exercises and weight bearing functional activities.[16] The lower extremity kinematics improved during functional activities because movement patterns were executed more correctly and thus reducing stress on patellofemoral joint and consequently decreasing pain. Relaxing and stretching tight and shortened postural muscles along with strengthening the weaker, inhibited phasic muscles helped in balancing postural and phasic muscle activity as well as joint mobility of the lower extremity and pelvis bony articulations thereby improving the patellofemoral function.

The results in the study showed that both the groups showed similar improvements. However experimental group showed superior improvement than control group, stating that the experimental group had an added effect for reducing pain and improving functional activity. Hence the hypothesis is been rejected.

The better improvement in experimental group was due to the direct focused treatment to the muscles that showed inflexibilty. Release of interconnected fascia corrected lower extremity kinematics and movement patterns thus reducing stress on the patellofemoral joint. Likewise Gate control theory interferes with the transmission of painful stimuli thus closing the gate to the brain’s perception of pain. Interpersonal attention refers to the hands on, individualized attention. This personal attention and human touch has a calming effect that decreases the perception of pain which relates to the parasympathetic response of the nervous system. Stimulaton of parasympathetic response decreases the release of stress, anxiety, depression and pain. Release of serotonin blocks the transmission of noxious stimuli to the brain.[30] Thus it has been demonstrated that myofascial release techniques are beneficial for individuals recovering from myofascial injuries and thereby reducing musculoskeletal pain.

Conclusion Both experimental group and control group reported significant improvement in all the three outcome variables. However experimental group showed superior improvement demonstrating that it had an added effect in reducing pain and improving functional activity in patients with patellofemoral pain syndrome.

References:

1. Richard B, Christopher M. Differences in hip kinematics, muscle strength and muscle activation between subjects with and withour patellofemoral pain. J Orthop Sports Phys Ther 2009;39:12-9.

2. S.T.Green. Patellofemoral syndrome. J Bodyword Move Ther 2005;9:16-26.

3. Nakagawa TH, Muniz TB, Baldon RM, Maciel CD, Reiff RBM, Serrao FV. The effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study. Clin Rehabil 2008;22:1051-60.

4. Wilson T, Carter N, Thomas G. A multicenter, single-masked study of medial, neutral and lateral patellar taping in individuals with patellofemoral pain syndrome. J Orthop Sports Phys Ther 2003;33(8):437-48.

5. Fairbank JCT, Pynsent PB, Poortvliet JAV, Phillips H. Mechanical factors in the incidence of knee pain in adolescents and young adults. J Bone Joint Surg 1984;66(5):685-93.

6. Piva SR, Goodnite EA, Childs JD. Strength around the hip and flexibility of soft tissues in individuals with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 2005;35(12):793-801.

7. LaBella C. Patellofemoral pain syndrome: evaluation and treatment. Prim Care Clin Office Practl 2004;31:977-1003.

8. Pedrelli A, Stecco C, Day JA. Treating patellar tendinopathy with fascial manipulation. J Bodyw Mov Ther 2009;13:73-80.

9. John W. the effectiveness of myofascial release techniques in the treatment of myofascial pain: a literature review. Prim Care Clin Office Practl 2004; 2:12-9

10. Barnes, MF. The basic science of myofascial release: morphologic changes in connective tissue. J Bodyword Move Ther 1997;1:231-8.

11. Vlacilova I. Cervical-thoracic spine and change of its shape due to posterior muscle chain and tilt of the pelvis. Ceska kinantropologie 2015;19(1):39-45.

12. Myers TW. Myofascial meridians for manual and movement therapist. 2nd ed. Sydney Toronto: Churchill Livingstone Elsevier; 2009. p. 136-144, 98-101.

13. Chen PL, Hong WH, Lin CH, Chen WC. Biomechanics effects of Kinesio taping for persons with patellofemoral pain syndrome during stair climbing. Biomed 2008;21:395-7.

14. Johnston LB, Michael T. Gross. Effects of foot orthoses on quality of life for individuals with patellofemoral pain syndrome. J Orthop Sports Phys Ther 2004;34(8):440-8.

15. Iverson CA, Sutlive TG, Crowell MS, Morrell RL, Perkins MW, Garber MB et al. Lumbopelvic Manipulation for the treatment of patients with patellofemoral pain syndrome: development of a clinical prediction rule. J Orthop Sports Phys Ther 2008;6:297-312.

16. Fukuda TY, Rossetto FM, Magalhaes E, Bryk FF, Lucareli PRG, Carvalho NAA. Short-term effects of hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: a randomized controlled clinical trial. J Orthop Sports Phys Ther 2010;40(11):736-42.

17. Marks R. Knee osteoarthritis and exercise adherence: a review. Curr Aging Sci 2012;5(1):72-83.

18. Peters JS, Tyson NL. Proximal exercises are effective in treating patellofemoral pain syndrome: A systematic review. Int J sports Phys Ther 2013;8(5):689-700.

19. Shah S, Bhalara A. Myofascial release. Int J Health Sci Res 2012;2(2):69-77.

20. Gomaa EF, Zaky LA. Effect of iliotibial band myofascial release on flexibility and patellar alignment in patients with knee osteoarthritis. Int J Adv Res 2015;3(4):399-410.

21. Muragod A, Patil VR, Nitsure P. Immediate effects of static stretching versus myofascial release in iliotibial band tightness in long distance runners- a randomised clinical trial. Eur J Sport Med 2014;2(1):31-8.

22. Jarosz, Brett S. Tretatment of chronic patellar tendinopathy in a professional basketball player: a case report. Chiropr J Aust 2010;40(1):3-8.

23. Urho M.K, Seppo K.K, Simo T et al. Scoring of patellofemoral disorders. Arthroscopy. 1993;9(2):2-6.

24. Chatman AB, Hyam CP, Neel JM, Binklq JM, Stratfwd PW, Schornberg A. The patient-specific functional scale: measurement properties in patients with knee dysfunction. Phys Ther 1997;77(8):820-9.

25. Bijur PE, Silver W, Gallagher JE. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001;8(12):1153-6.

26. Manheim CJ. The myofascial release manual. 3rd ed. Thorofare New Jersey: Slack; 2000. p. 194.

27. Portney LG, Watkins MP. Foundation for clinical research. 2nd ed. New Jersey: Prentice Hall Health; 2005. p. 475-8.

28. Daniel WW. Biostatistics a foundation for analysis in the health sciences. 8th ed. New York: Wiley; 2005. p. 680-762.

29. Hruska R. Pelvic stability: influences of lower extremity kinematics. Biomechs1998;5:23-9.

30. Paloni, John. Review of myofascial release as an effective massage therapy technique. Athletic Ther Today. 2009;14:30-4.

Announcements

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

COPE guidelines for Reviewers

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 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 situs slot and 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 et al. situs slot "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 situs slot 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 situs slot et al 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
Late to bed everyday? You may die early, get depression situs slot
Egg a day tied to lower risk of heart disease situs slot
88 Percent Of Delhi Population Has Vitamin D situs slot  Deficiency: ASSOCHAM Report

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


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before Toto Macau forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: We at IJCRR voluntarily adopt policies on Code of Conduct, and Code of Ethics given by OASPA and COPE. To know about IJCRRs Code of Conduct, Code of Ethics, Artical Retraction policy, Digital Preservation Policy, and Journals Licence policy click here

Disclaimer: 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.



Company name

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

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2022 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions

  1. Situs Slot KayaMendadak88
  2. Situs Slot Online Terbaik Dan Terpercaya No 1
  3. Slot Pragmatic Play
  4. Situs Slot Online Terpercaya
  5. Kumpulan Situs Judi Slot Terpercaya
  6. Game Slot Online
  7. Judi Slot Online Jackpot Terbesar
  8. Situs Judi Slot Online Terpercaya 2021
  9. Slot Joker123
  10. Agen Slot Online Resmi
  11. Slot Deposit Pulsa
  12. Daftar Situs Judi Slot Terbaik Dan Terpercaya No 1
  13. AloJudi Slot
  14. KayaMendadak88 Slot
  15. Situs Slot Gacor 2022
  16. Judi Slot Online Jackpot Terbesar Gampang Menang
  17. Joker123 Slot
  18. Daftar Situs Judi Slot Online Deposit Pulsa Terbaik
  19. Mesin slot gacor 88
  20. Mesin slot
  21. Link Slot Online
  22. Slot Via Dana
  23. situs judi slot terbaik dan terpercaya no 1
  24. Daftar Situs Bo Slot Online Gacor Terbaik 2022
  1. Slot Online
  2. Judi Slot Online Jackpot Terbesar
  3. Daftar Situs Judi Slot Online Terpercaya
  4. Judi Slot Terpercaya
  5. Kumpulan Situs Judi QQ Online Terpercaya
  6. Slot Online Terbaru
  7. Situs Game Slot Online Terbaik
  8. Daftar Situs Judi Slot Online Gacor Gampang Menang 2022
  9. Situs Slot Deposit Pulsa dan Slot Online Terbaik
  10. Slot Hacker
  11. Situs Slot Online Terbaik
  12. Slot Gacor Gampang Menang
  13. Situs Judi Slot Online Gacor Terbaik 2022
  14. Situs Judi Slot Online Jackpot Terbesar
  15. Slot Online Terpercaya
  16. Game Slot Penghasil Uang
  17. Situs Slot Online Terbaik 2021
  18. Situs Slot Online Terbaik dan Terpercaya
  19. Situs Slot Terbaik
  20. Situs Judi Slot Terbaik Dan Terpercaya No 1