The Rehabilitation Journal <p>The Rehabilitation Journal (TRJ) is an international multidisciplinary peer-review journal published biannually in English. TRJ is the official publication of the Health Education Research Foundation (HERF), which is non profit organizaton registered with government of Pakistan under society registration act 1860.</p> <p>The aim of TRJ is to publish articles about all aspects Rehabilitation Sciences and to promote excellence in education, scientific research, clinical practice, health policy, and administration.TRJ publishes two issues in a year and welcomes manuscripts from all over the world in the field of Medical Rehabilitation but not limited to;</p> <ul> <li>Musculoskeletal Rehabilitation</li> <li>Neurological Rehabilitation</li> <li>Cardiopulmonary Rehabilitation</li> <li>Sports Rehabilitation</li> <li>PsychosocialRehabilitation</li> <li>Speech and Language Rehabilitation</li> <li>Community Based Rehabilitation</li> </ul> <p>The overall goal of TRJ <em>is</em> to enhance the interrelationship of practice, research, and education to advance the field of Rehabilitation Sciences for the ultimate benefit of the patient and the field.</p> en-US (Huraim Ahmed Awan) (Dr Danish Rauf) Thu, 31 Dec 2020 00:00:00 +0000 OJS 60 QUALITY OF LIFE IN PATIENTS WITH NEUROGENIC COMMUNICATION DISORDER <p style="text-align: justify;"><strong>Background</strong>: neurogenic communication disorders e.g. Dysarthria, aphasia and Voice disorders impacts the quality of life of individuals. A comprehensive picture for an intense understanding of different dimensions, that affecting QOL in neurogenic communication disorder is needed. <strong>Objectives: </strong>to determine the Quality of life in patients with neurogenic communication disorders <strong>Method: </strong>The Study design was comparative Cross-sectional survey. A total of n=100 participants were included through Conventional sampling technique. The data was collected from speech therapy department of Pakistan Railway Hospital (PRH) and NESCOM hospital Islamabad. The male and females both were included in the study. The older adults with age range 50-75 years with neurogenic conditions like dysarthria, aphasia and voice disorders related to stroke, Bell’s palsy Parkinson’s disease and triatic brain injury were included in the study The quality of life was assessed through Stroke Aphasia Quality of Life questionnaire. One Way ANOVA was used for comparison between the different conditions regarding quality of life (QOL). <strong>Results</strong>: the Mean±SD of age was 61.4 <u>+</u> 7.9 years. A total of n=63 participant were male and remaining n-37 were female. The result of One Way ANOVA can be seen in Table 1, which shows that there no significant difference (<em>p≥0.05</em>) in neurogenic communication disorders regarding QOL. <strong>Conclusion:</strong> It was concluded that quality of life was compromised equally in +neurogenic communication disorders like dysarthria, aphasia and voice disorders.</p> Humaira Shamim Kiani, Adeela Riaz Copyright (c) 2021 Humaira Shamim Kiani, Adeela Riaz Thu, 31 Dec 2020 00:00:00 +0000 LEVEL OF MOBILITY AND ITS ASSOCIATION WITH QUALITY OF LIFE IN LOWER LIMB AMPUTEES <p style="text-align: justify;"><strong>Objectives:</strong> The objective of the study was to explore the levels of mobility and its association with quality of life in lower limb amputees. <strong>Methodology:</strong> A cross-sectional correlational study was conducted at Chal foundation, Fauji Foundation Hospital and PIPOS on the sample of 230 patients for time duration of six months from January–July 2019. The lower limb amputees aged between 18-57 years, and using prosthesis from more than four months were included in the study. The level of mobility was measured through Self-reporting Prosthetic Limb User Survey of Mobility (SF-PLUS-M) questionnaire, while Prosthetic Evaluation Questionnaire (PEQ) was used to determine the Quality of Life (QOL) among prosthesis users. This data was analyzed by SPSS version 21. <strong>Results:</strong> The mean age of study participants was 43±14.89 years. The mean PLUS-M score was 39.48±14.33. The results showed a positive significant association between level of mobility and quality of life in lower limb amputees (p&lt;0.001). <strong>Conclusion:</strong> The study concluded that in Pakistan lower limb amputees has high level of mobility that contributes in improved quality of life.</p> Amenah Mughal, Ausaf Chaudhary Copyright (c) 2021 Amenah Mughal, Ausaf Chaudhary Thu, 31 Dec 2020 00:00:00 +0000 EFFECTIVENESS OF STABILITY BALL EXERCISES AND ERGONOMICS TRAINING IN PREGNANCY RELATED LOW BACK PAIN <p style="text-align: justify;"><strong>Objective: </strong>to determine the effectiveness of stability ball exercises and ergonomics training to reduce pregnancy related low back pain.<strong> Methodology: </strong>A pretest-posttest, randomized clinical trial was conducted at Dr. Nousheen Nazir, gynaecology clinic in I-10/4 Islamabad, for a time period of 1 year. The participants with age criteria of 18-35 years and pregnant females up to 32 weeks were included in the study. Low back pain was assessed through Oswestry Disability Index (ODI). The level of significance was set at 95% CI (<em>p≤0.05</em>).<strong>Results: </strong>The mean age of the study participants was 26.48±4.54 years. Ergonomic training (ET) showed significant improvement in overall low back disability {X<sup>2</sup>(2) =24.58, W=0.53, <em>p&lt;0.001</em>} but no significant improvement (<em>p&gt;0.05</em>) observed from 0 to 2<sup>nd</sup> week and from 2<sup>nd</sup> to 4<sup>th</sup> week, large significant improvement was observed (<em>p=0.005, r=0.59</em>). Stability ball exercise showed large significant improvement {X<sup>2</sup>(2) =36.86, W=0.84, <em>p&lt;0.001</em>} from 0 to 2<sup>nd</sup> week (<em>p=0.000, r=0.84</em>) and from 2<sup>nd</sup> to 4<sup>th</sup> week (<em>p=0.000, r=0.77</em>). There was moderate significant difference in overall ODI score between SBE and ET group after 2nd {19(9.5) vs 24(13), p<em>=0.012, r=-0.37</em>) and 4th week {9(10) vs 18(10), <em>p=0.002, r=0.472</em>}. <strong>Conclusion: </strong>Both protocols such as ergonomics training and balancing ball exercises were effective for pregnancy related low back pain. But stability ball exercises were more effective in reducing the disability.</p> Faiqa Izhar, Qudsia Naqvi, Anam Aftab Copyright (c) 2020 Faiqa Izhar, Qudsia Naqvi Thu, 31 Dec 2020 00:00:00 +0000 RELATIONSHIP BETWEEN DIETARY FAT AND PHYSICAL FITNESS AMONG ATHLETES <p style="text-align: justify;"><strong>Objective: </strong>to evaluate the relationship between dietary fats and physical fitness in young athlete of Pakistan. <strong>Methodology: </strong>An correlational study conducted in Pakistan Sports Board (PSB) in 2018, after the approval of Director Admin of Pakistan Sports Board (PSB), a total sample size of n=130 elite athletes (both male and females) were recruited from the camp for National games held in PSB through convenience sampling technique. The data was collected about the age, gender, BMI and physical fitness. Physical fitness was measured through following tests; back ward throw with 3kg medicine ball, 30 meter Speed Test, Single-leg hope three step test, Agility T test and 800 meter Endurance test. The pre camp dietary fat intake was calculated through online software Self Nutrition Data by entering the meal recipe and Nutrition Facts label was generated according to the nutrition labelling standard maintained by the FDA. The results were presented in terms of n (%), mean±SD and to determine association Pearson product-moment correlation coefficient was used. <strong>Results: </strong>The mean age of participants was 23.63±5.30 years. The results showed positive correlation of agility T test (sec) with saturated fat (r=0.180, <em>p=0.040</em>), mono unsaturated fat (r=0.199, <em>p=0.023</em>), poly unsaturated fat (r=0.187, <em>p=0.033</em>), Omega 3 fatty acids (r=0.187, <em>p=0.033</em>) and total fat intake(r=0.202, <em>p=0.021)</em>. The 800 M endurance test was positively correlated with polyunsaturated fat (r=0.187, <em>p=0.033</em>), omega 6 fatty acids (r=0.182, <em>p=0.038</em>) and total fat intake (r=0.181, <em>p=0.039</em>). While leg strength test was found to be negatively correlated with monounsaturated fats (r=-0.174, <em>p=0.048</em>) and polyunsaturated (r=-0.175, <em>p=0.047</em>). <strong>Conclusion: </strong>Nutrition rich in dietary fats results in decreases performance and ability of athletes involved in agility and endurance training, while for those involved in strength training dietary fats may enhance their performance</p> Asadullah, Syed Alamadar Hussein, Musa Haseeb, Ausaf Chaudhary, Muhammad Ashraf Copyright (c) 2020 Asadullah, Syed Alamadar Hussein, Musa Haseeb, Ausaf Chaudhary, Muhammad Ashraf Thu, 31 Dec 2020 00:00:00 +0000 EFFECTIVENESS OF KEGEL’S EXERCISES IN ELDERLY MALE AND FEMALE WITH URINARY INCONTINENCE <p style="text-align: justify;"><strong>Objective: </strong>to determine the effectiveness of Kegel exercises in elderly male and female patients with stress urinary incontinence.&nbsp;<strong>Methodology: </strong>A quasi experimental study was conducted at In Department of urology of Shaheed Mohtarma Benazir Bhutto medical university, Chandka medical college Larkana Sindh from January 2017 to June 2019. The non-probability convenient sampling technique was used for sample selection. The n=43 patient with the age above 55 years was included in the study. Patient with neurological, cognitive and male with prostate problem were excluded from the study. Both male and female were received intervention of Kegel exercise (KE) for three months and 3-4 time/day. The urinary distress inventory (UDI) and Incontinence impact questionnaire was used for urinary distress and quality of life. The data was obtained at baseline, at 6th week and after 12th week. The mean±SD, n(%), Mean difference (MD),&nbsp; p-value (p&lt;0.05) and effect size (Cohen’s d &amp; partial eta square was use to describe the data. For within group analysis Repeated Measure ANOVA was used and for between the groups analysis independent t-test was used. SPSS ver 21 was used for data analysis.&nbsp;<strong>Results: </strong>The mean age of the study participants was 64.97±9.36 year. Within group analysis showed large significant improvement in both, males and females (<em>p&lt;0.05</em>). However, between group differences showed significant improvement with larger effect size in males as compared to females (<em>p&lt;0.05</em>). &nbsp;<strong>Conclusion: </strong>Kegel exercises are effective therapy for urinary incontinence in both genders. But Kegel exercises are more effective in males for urinary incontinence in improving urinary distress and quality of life.</p> <p style="text-align: justify;"><strong>Keywords: </strong>Geriatric population, Kegel exercises, Urinary incontinence</p> Ali Sikandar Bhutto, Suhail Karim, Muhammad Junaid Akram, Hania Farheen, Saleh Shah, Zona Mehreen Copyright (c) 2021 Ali Sikandar Bhutto, Suhail Karim Thu, 31 Dec 2020 00:00:00 +0000 STRUGGLING FIELD OF SPEECH-LANGUAGE PATHOLOGY IN PAKISTAN <p style="text-align: justify;">The need of speech and language pathology (SLP) as a specialized field in Pakistan emerged with the education of deaf. Development in education of deaf began in Pakistan by Mr. Siddique Akbar Makhdum in 1949. Later in 1951 College for the Teachers of the Deaf in Lahore was established with the collaboration of USAID and faculty from US to teach speech-language pathology. The basic courses introduced were speech, language and audiology. In the tenure of 6<sup>th</sup> president of Pakistan General Zia-ul-Haq, many organizations were formed to serve special needs children. In his time special education centers were developed in Islamabad, Lahore and Karachi. One of its kind was Speech and Hearing Centre, Karachi, which was established in 1983 and aimed to advocate Auditory Verbal Therapy (AVT).<sup>1</sup> In 1991, Post graduate diploma in speech-language therapy (PGD-SLT) was launched with collaboration of NIRM (formerly called National Institute of Handicapped NIHd), UNDP and National Institute of Psychology (NIP), Quaid-e-Azam University, Islamabad. Ministry of Women Development, Social Welfare and Special education took this initiative. Diane Schaffer from USA and Linda from England were two expert speech therapists who came to Pakistan to teach and train PGD-SLT students in NIRM.&nbsp;</p> <p style="text-align: justify;">Speech and Hearing Association of Pakistan (SHAP) was formed in January 2000.<sup>2</sup> On 13<sup>th</sup> June 2002 SHAP got registered under Sindh Government with registrar of societies Act 21 of 1860. Currently Ms. Amina Siddiqui is President and Dr. Nadeem Mukhtar is Vice President of SHAP. In 2006-2007 Special Education Department of Karachi University launched masters in speech Therapy program. In 2007 Zia-u-Din Hospital started clinical services and collaborated with SHAP to develop the College of Speech Language &amp; Hearing Sciences (CSLHS) where nation’s first 4-year Bachelor’s program in Speech Language Therapy was launched in 2007.<sup>2</sup> In 2010 Riphah University Islamabad started MS program in speech-language pathology under supervision of Dr. Ayesha Kamal Butt. In 2013 Isra University Islamabad campus started M.Phil SLP degree program and PhD in Rehabilitation Sciences which opened way to doctoral degree for SLPs as well. In 2019 Riphah International University also launched PhD in Rehabilitation Sciences program. &nbsp;King Edward Medical University also launched BS program in 2008. Currently there are 16 institutes offering BS, 5 institutes offering MS/MPhil and 6 institutes offering diploma in SLP. On 9<sup>th</sup> October 2019 Pakistan Speech and language pathologist association (PSLPA) was formed by pioneers of field in Pakistan. It is federally registered under the society’s registration act 21 of 1860. Launch day of PSLPA i.e. 9<sup>th</sup> October was also declared as National Speech Pathology Day. President and Vice President of PSLPA are Dr. Nazia Mumtaz and Ms. Saima Tariq respectively. &nbsp;</p> <p style="text-align: justify;">Although the field of speech-language pathology in Pakistan headed up in 1990 but research in the field began with the commencement of degree programs. The lag between practice and research resulted in the lack of culturally appropriate standardized practices which has yet not been eradicated fully. Despite efforts of existing associations to eliminate malpractice and quackery from the field, it is still going on a huge scale. In fact many practicing SLPs are yet not registered with any association because on legal grounds there is not yet any such compulsion for them on national level. In many states, like other medical professions, it is mandatory for SLPs to be licensed through a state authority in order to practice their speciality.<sup>3 </sup>The licensing process includes such steps that helps to maintain and establish stringent standards for licensure candidacy and practice. In Pakistan there is a dire need of state’s recognized licensing system that could assure provision of genuine SLPs to public through a standardized vetting process that internationally involves qualifying degree education, supervised clinical experience and examination.</p> <p style="text-align: justify;">Graduate programs are producing culturally consistent researches, even though application of these researches is slow and rare to an extent that out dated traditional practices still dominates. Consequently patients and their families suffer with no or slow pace of progress. There are also centers where patients treated by SLP students are not supervised and guided by senior therapists hence their trial and error learning only benefits them in making stronger clinical record books but at the cost of patient’s wastage of time and student’s malpractice. One reason behind lack of desired clinical supervision is recruitment of less number of SLP clinical supervisors in teaching hospitals as compared to number of students and case load. In many institutes SLP departments are provided with too low budget to equip their clinics with latest assessment and treatment tools due to which students could not get know how of latest practices happening in the field at international level. A huge proportion of clients that take speech therapy sessions are children and adolescents. Regarding pediatric speech therapy, many families raise issues that they are not allowed to observe or stay in sessions. Furthermore, non-provision of appropriate parent training which is contrary to roles and responsibilities of SLPs,<sup>4</sup> is also a critical issue that puts parents or guardians in psychological stress when they try to work with their affected family member. Like other countries, in Pakistan the solution of all aforesaid problems can only be found with integration of evidence based practices (EBP). Only with evidence based practices Pakistani SLPs can make informed, evidence based decisions in their practices along with provision of high quality services reflecting the needs, choices, interests and values of target population.</p> Faseeha Shafqat Copyright (c) 2021 Faseeha Shafqat Thu, 31 Dec 2020 00:00:00 +0000