The Rehabilitation Journal 2022-07-12T16:17:32+00:00 Huraim Ahmed Awan Open Journal Systems <p>The Rehabilitation Journal (TRJ) is an international multidisciplinary peer-review journal published biannually <strong>(Quarterly after December 2021)</strong> 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> MOTIVATIONAL FACTORS ASSOCIATED WITH SPORTS PARTICIPATION AMONG ATHLETES 2022-02-21T17:25:15+00:00 Anum Aftab Nazish Rafique Sadia Basharat Bushra Sultana Farwa Abid Anum Rafique <p><strong>Background: </strong>Successful athletes are motivated for future-oriented for more achievements. Apprehensive athletes are not as successful as highly motivated athletes. The sport participation is influenced by many factors those contribute in success of athletes. <strong>Objective: </strong>To explore the motivational factors for sports participation among Pakistani athletes. <strong>Methodology:</strong> The cross-sectional survey was conducted on both male and female athletes (n=400) between the age of 14 to 40 years, played at the national and international levels at least from one year. The study was conducted at the Pakistan sports board (PSB) from July-December 2018. The non-probability convenience sampling was used in this study. The sports participation scale-6 was used to explore the motivational factors. The data was presented as n(%). <strong>Results:</strong> the mean age of the participants were 24±5.45 years The results showed that the mean scores of six categories of Sports Motivational Scale (SMS) was 134.69±13.431, which showed that majority of athletes were highly motivated. The result of the study also showed that all subdomain of sports motivation scale positively correlated to total score (p&lt;0.001), while a motivation was negatively associated r=-0.701, p&lt;0.001) with total score of sports motivation scale. Although most of the athletes were normal in term of depression, anxiety, and stress. But depression is negatively correlated (r=-0.09, p=0.04) with sports motivation. <strong>Conclusion:</strong> This study concluded that most athletes are motivated because hard training improves their performance and other motivational factors are also associated like pleasure, internal satisfaction, and excitement. The least motivational factor was achieving social or material benefits of being an athlete.</p> <p><strong>Keywords</strong>: Athlete, motivation, participation, stress.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Anum Aftab, Nazish Rafique, Sadia Basharat, Bushra Sultana, Farwa Abid, Anum Rafique FREQUENCY OF KINESIOPHOBIA IN PREGNANCY RELATED LOW BACK PAIN 2022-04-27T17:54:00+00:00 Maleeha Fuad Zainab Hassan Hafiz Muhammad Asim hafizasim@gmail.con Muzna Munir <p><strong>Background:</strong> For a small but significant group, pregnancy-related lumbopelvic pain may become persistent. While multiple factors may lead to post-partum disabilities’ such as kinesiphobia sleep disturbance, body perception or mindfulness. <strong>Objective: </strong>To explore the frequency of kinesiophobia in pregnancy related low back pain.<strong> Methodology: </strong>The Cross sectional study was conducted on n=97 pregnant women in 3<sup>rd</sup> trimester presenting to gynaecology outpatient department of Ghurki Trust and Teaching hospital from August 2016 to January 2017 were included in the study through non probability convenient sampling technique. All women were experiencing low back pain in their third trimester of pregnancy. Numeric Pain Rating Scale (NPRS) was used to determine pain whereas; the kinesiophobia was assessed by using Tampa scale of kinesiophobia (TSK). The mean ± standard deviation, frequency and percentages were used for description of result. SPSS Ver. 20 was used for data analysis.<strong> Results: </strong>The mean age of n=97 pregnant women having low back pain was 29.45±5.87 years Results showed that, n=18(18.6%) patients represented high level of kinesiophobia while n=52 (53.6%) and n=27 (27.8%) had moderate and low levels of kinesiophobia respectively. The result also showed strong positive correlation between pain and level of kinesiophobia (<em>r<sub>s</sub>=0.708, p&lt;0.001</em>).<strong> Conclusion</strong>: The study concluded that all women those having low back pain in 3<sup>rd</sup> trimester also has kinesiophobia. The level of LBP highly contributes in kinesiophobia.</p> <p><strong>Keywords</strong>: Kinesiophobia, lumbo pelvic pain, pregnant women, postpartum depression.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Maleeha Fuad, Zainab Hassan, Hafiz Muhammad Asim, Muzna Munir PERCEIVED STRESS AND PSYCHOLOGICAL ADJUSTMENT AMONG FATHERS AND MOTHERS OF PHYSICALLY HANDICAPPED GIRLS 2021-12-11T11:07:33+00:00 Maryam Khurshid Neelam Ehsan Mamoona Ismail Loona Saima Waqar Amna Ahsan <p><strong>Background:</strong> Physical disability of a female child by birth or by some injury in a family is very challenging for the parents and siblings. Present study is an attempt to explore the role of Perceived Stress and Psychological adjustment among parents of Physically Handicap girls. <strong>Objective:</strong> to explore the relationship between stress and psychological adjustment among parents of physically handicapped girls. <strong>Methodology: </strong>The sample consisted of n=40 parents of physically handicapped female children from the Nishtar hospital Multan. Snowball sampling technique was used for data collection. The parents of female physically disable children were included in the study. Perceived Stress Scale (PSS) (Cohen et al. 1988)) and Psychological Adjustment Scale were used to measure study variables. <strong>Results: </strong>There was a negative association between perceived stress and psychological adjustment (r=-0.77, p=0.01) among parents of handicapped girls. Results further suggested through t-test scores that fathers of handicapped girls were high on psychological adjustment as compared to mothers (p=0.01) and mothers were more under stress as compared to fathers (p=0.02). <strong>Conclusion: </strong>The Fathers and mothers of physically disabled female children are different in term of coping the level of stress as well as the fathers show more psychological adjustment as compare to mothers.</p> <p><strong>Keywords</strong>: Disability, psychological Adjustment, Stress.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Maryam Khurshid, Neelam Ehsan, Mamoona Ismail Loona, Saima Waqar, Amna Ahsan EFFECTS OF ULTRASOUND THERAPY VERSUS TRANSVERSE FRICTION MASSAGE ALONG WITH ECCENTRIC EXERCISE PROGRAM ON CHRONIC ACHILLES TENDINOPATHY 2022-04-29T20:14:48+00:00 Raheela Kousar Muhammad Sanaullah Mehwish Ikram Asma Aleem Aamir Gul Memon Syed Shakil ur Rehman <p><strong>Background: </strong>Achilles tendinopathy is highly prevalent and caused by intrinsic or extrinsic factors. The multiple minor traumas can lead to achilles tendinopathy. Physical therapy treatment includes soft tissue mobilization and exercises. <strong>Objective:</strong> To compare ultrasound and transverse friction massage in chronic Achilles tendinopathy. <strong>Methodology:</strong> The study was a randomized control trial from 1<sup>st</sup> March 2019 to 15<sup>th</sup> August 2019. The non-probability convenient sampling technique was used to include n=76 patients having pain and activity limitation of Achilles tendon and randomly allocated into groups A and B by lottery method. The outcome measuring tools were numeric pain rating scale (NPRS) for pain, the Victorian Institute of Sports Assessment- Achilles questionnaire (VISA-A) for severity and goniometry for ROM. The Group A was treated with transverse friction massage and the group B was treated with ultrasound therapy. Both groups also performed eccentric exercises. The assessment was done at the baseline on the 1<sup>st</sup> session, at end of the 9<sup>th</sup> and 18<sup>th</sup> session. The data was analysed by SPSS 23 using independent t-test and repeated measures ANOVA.<strong> Results:</strong> The results of RM-ANOVA with pairwise comparison showed that both groups improve significantly (p&lt;0.05) throughout the treatment duration with large effect size for all variables. While comparing the groups with independent t-test, TFM group showed more improvement in all variables as compared to UST group (p&lt;0.05) after 3<sup>rd</sup> week as well as after 6<sup>th</sup> week of intervention.<strong> Conclusion:</strong> The Transverse friction massage (TFM) was more effective than ultrasound therapy (UST) when combined with eccentric exercises in improving pain severity of tendinopathy and ROM of ankle.</p> <p><strong>Keywords</strong>: Achilles tendon, eccentric exercises, pain stretching, myofascial release, ultrasonic therapy, tendinopathy.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Raheela Kousar, Muhammad Sanaullah, Mehwish Ikram, Asma Aleem, Aamir Gul Memon, Syed Shakil ur Rehman THE COMPARISON OF EASY ONSET AND PANTOMIMING TREATMENT ON BLOCKING IN STAMMERING 2022-06-03T17:11:51+00:00 Saba Imtiaz Maryam Nadir Kiyani Tehreem Ijaz <p><strong>Background:</strong> Stammering is a speech fluency disorder categorized by repetitions, prolongations and blocks that interrupt the normal flow and forward movement of speech. The Fluency shaping techniques including Easy Onset and Pantomiming treatment are commonly used techniques for the management of stuttering. <strong>Objective:</strong> To compare the effectiveness of Pantomiming and easy onset method for the treatment of blocks in stammering in school aged children. <strong>Material &amp; Method</strong>: A randomized control trial (NCT04813588) was conducted in hospitals of Rawalpindi and Islamabad. The Convenient sampling technique was used for data collection from National Institute of Rehabilitation Medicine (NIRM). The sample size was n=16, randomly divided in Easy onset (n=8) and Pantomiming (n=8) through lottery method. The schools going children and adolescent between 6-18 years of both genders with mild to moderate stammering with blocking symptoms were included. The severity of stuttering was assessed with real time analysis of speech fluency. The data was analysed at the baseline and after three months of intervention. The non-parametric tests were applied for within and between group analyses. <strong>Results</strong>: The mean age of the participants was 10.38±5.290 years. A total n=11 were males and n=5 were females. When compared both groups, there was no significant difference between Easy onset and Pantomiming technique {MR=9 vs MR=8, U=28, p=0.535} in the management of stuttering after three months of intervention. <strong>Conclusion:</strong> The easy onset and pantomiming techniques are equally effective in improving the blocking in stuttering.</p> <p><strong>Keywords:</strong> Blocks, easy onset, fluency shaping, pantomiming, speech therapy, stammering, stuttering</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Saba Imtiaz, Maryam Nadir Kiyani, Tehreem Ijaz GENDER BASED DIFFERENCES OF BURNOUT AMONG CLINICAL AND ACADEMIC PHYSICAL THERAPISTS 2022-04-15T18:22:27+00:00 Laraib Altaf Sania Zafar Shajia Khan Hadia Nadeem Nabeela Kanwal Marrium Batool <p><strong>Background: </strong>Burnout can develop due to various risk factors including socio-economic, conventional and personal, for both men and women. Some studies suggest increased prevalence of burnout in female individuals, which may be due to actual aspects like how the assessment tools are used or the way burnout manifests in both genders, including levels of emotional exhaustion, feelings of decrease in personal effectiveness in the work environment.<strong> Objective: </strong>To determine the gender based differences of burnout among clinical and academic physical therapist.<strong> Methodology: </strong>This cross-sectional comparative study was conducted at major various educational institutes, hospitals and private clinical setups of twin cities Rawalpindi and Islamabad from January to June 2021 (6 months) The total sample was n= 324 participants enlisted using non-probability purposive sampling. The adults aged 25-40 years, with at least 1 year of working experience, both male and female were included. The data was collected using Copenhagen Burnout Inventory (CBI) tool. The data analysis was done by SPSS 21 version.<strong> Results: </strong>The mean age of participant was 29.69±4.34 years. The level of burnout among the physical therapist on the basis of gender (p&lt;0.001) and occupational differences (p=0.001), both showed statistically significant association.<strong> Conclusion: </strong>Level of burnout in physical therapists was found to be low. Female physical therapists exhibited greater level of burnout as compared to their male counterparts and also academicians tended to have greater burnout as compared to those working in clinical settings</p> <p><strong>Keywords</strong>: Academic training, burnout, gender, health care delivery, physical therapist</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Laraib Altaf, Sania Zafar, Shajia Khan, Hadia Nadeem, Nabeela Kanwal, Marrium Batool EFFECT OF MODIFIED EPLEY’S & SEMONT’S MANEUVERS WITH OR WITHOUT BETA-HISTINE ON BENIGN PAROXYSMAL POSITIONAL VERTIGO: A RANDOMIZED CONTROL TRAIL 2022-06-04T19:39:27+00:00 Muhammad Salman Muhammad Umar Mazhar Badshah Aamer Naeem <p><strong>Background: </strong>Benign Paroxysmal Positional Vertigo (BPPV) is a condition related to vestibular system accompanied by dizziness, tinnitus and balance problems leading to increased fall risk and potential disability. Various treatment options are available including pharmacotherapy and vestibular rehabilitation with varied results. <strong>Objective:</strong> To compare the efficacy of Modified Epley and Semont’s manoeuvre with and without Beta-histine for BPPV. <strong>Methodology: </strong>A single blinded Randomized control trail, registered at under clinical trial registry NCT05309538, was conducted on n=90 patient having Benign Paroxysmal Positional Vertigo; at the Neurocouncil Hospital &amp; the physiotherapy clinic. from June 2021- August 2021. The participants between 18 to 60 years with positive modified Dix Hil pike test were included in the study. The n=90 participants were equally divided via lottery method into Group A and B, Both group received mEpley’s and Semont’s Manoeuvres, Group B additionally received beta-histine. The dizziness handicapped inventory and EQ-5D-5L questionnaire were used for dizziness and quality of life respectively. The data were collected at the baseline and at the end of 4<sup>th</sup> week. The data was analyzed with SPSS version 21. <strong>Results</strong>: The wilcoxon rank test showed that there was significant improvement (p&lt;0.001) in dizziness handicapped inventory, all domains and the total score of EQ-5D quality of life questionnaire. While comparing both groups no significant (p≥0.05) additional effects of Betahistine with modified Epley’s and Semont’s manoeuvres on dizziness handicapped inventory and quality of life. <strong>Conclusion</strong>: The study concluded that the Betahistine has no additional effects in the management dizziness of BPPV</p> <p><strong>Keywords</strong>: Disability, psychological Adjustment, Stress BPPV, Modified Epley’s manoeuvre, Semont’s manoeuvre, vertigo, dizziness, quality of life.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Muhammad Salman, Muhammad Umar, Mazhar Badshah, Aamer Naeem EFFECT OF MIRROR THERAPY VERSUS REPETITIVE FACILITATION EXERCISE ON UPPER LIMB FUNCTION IN POST STROKE PATIENT 2022-02-10T16:43:10+00:00 Saba Karamat Aruba Saeed Fizah Mahnoor Khan Aroosa Tariq <p><strong>Background: </strong>After stroke one of the most devastating consequences is the hemiparetic arm. Difficulty in using this UL in daily tasks has been related to lower quality of life, improving use of the affected UL is important. <strong>Objective: </strong>To compare the effects of task-based mirror therapy and Repetitive Facilitation Exercise on upper limb function in post stroke patient<strong>. Methodology:</strong> A randomized controlled trial was conducted in Pakistan Railway general hospital, Rawalpindi. The duration of this study was from 10th July to 31st December 2019. Non-probability purposive sampling technique was used with n=50 male and female subacute and chronic post-stroke patients between 40-50 years. The patients with Modified Ashworth Scale &lt;3 and the first-ever stroke was included. The participants were randomly divided by the sealed envelope method into mirror therapy group (n=25) and Repetitive Facilitation Exercise group (n=25). The Upper extremity functional index (UEFI) was used to assess the functional impairment in individuals with upper limb dysfunction, Fugl Meyer (FMA-UE) for assessment of activity in post stroke patients, “Wolf Motor Function Test (WMFT) for upper extremity performance and functional capability” and Brunnstrom recovery scale (BRS) for motor function of the upper limb was used in a post stroke patient. All the patients were assessed at baseline than after 3 weeks and again after 6week for interventional session of 30 min,3 days of the week. Data were analyzed through SPSS version 23.<strong> Results</strong>: The mean age of Group A (MT) was 50.97±6.741 and 49.76±12.66 of Group B (RFE). After 6 weeks of intervention between groups analysis of Task-based mirror therapy showed significant improvement in mirror therapy group as compare to Repetitive Facilitation Exercise group, for upper extremity functional index scores(p&lt;0.001) but for motor assessment (FMA-UE), Wolf Motor Function Test (WMFT) and for stroke recovery (Brunnstrom) no statistically significant difference (p≥0.05) was found. Within-group analysis of both groups showed statistically significant results in all variables (p&lt;0.001).<strong> Conclusion</strong>: Mirror therapy and Repetitive facilitation Exercise both were found to be effective in improving upper limb motor functions of acute stroke patients. However, Mirror therapy has shown significant effects in upper extremity functional index.</p> <p><strong>Keywords</strong>: Mirror therapy, Physical therapy, Repetitive Facilitation Exercise, Stroke, Upper extremity.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Saba Karamat , Aruba Saeed, Fizah Mahnoor Khan, Aroosa Tariq EFFECTS OF NEUROMUSCULAR TRAINING ON SINGLE LIMB STABILITY IN YOUNG FEMALE ATHLETES 2022-05-26T18:33:21+00:00 Shah Bano Mujtaba Syed Shakil ur Rehman Mehwish Ikram Momina Jalil Komal Tariq <p><strong>Background</strong>: Lower limb injuries in sports affect postural stability and balance. Muscular imbalance, postural malalignments, and altered biomechanics occurred in athletes due to injuries. <strong>Objective: </strong>To determine the effects of the 6-week neuromuscular training program on single-limb stability in young female athletes. <strong>Methodology: </strong>A single-subject study design was used in which n=20 female athletes aged between 18 to 25 years with previous lower limb injuries that lead to impaired balance and postural instability participated in this study included by the convenience sampling from the Faisalabad sports complex.. Athletes completed 6-week neuromuscular training program, with every session of 90 min and 3 times a week. Assessment of athletes was performed before and after the completion of the neuromuscular training program at 6 weeks, with a single-limb stance test, Stork balance stand test, and star excursion balance test. <strong>Results:</strong> The mean age of participants was 20.6±1.82 years. Single limb stance test score with eyes open pre 27.70±13.85 and post-test treatment 40.75±16.45 showed significant results with (p &lt;0.01). Stork balance test scores pre 28.40±17.25 and post-treatment 38.85±14.543 also showed significant results with (p &lt;0.01). Star excursion balance test right and left anterior, left medial, right and left lateral also showed significant results with (p &lt;0.01). Star excursion balance test right medial pre and post-treatment showed insignificant results with (p-value =0.234). <strong>Conclusion:</strong> Although 6-week neuromuscular training program showed a significant improvement on single-limb stability in young female athletes. But without control or comparative group we cannot establish its gender specific effectiveness.</p> <p><strong>Keywords</strong>: Neuromuscular training, static and dynamic balance, single limb stance test, stork balance stand test, star excursion test.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Shah Bano Mujtaba, Syed Shakil ur Rehman, Mehwish Ikram, Momina Jalil, Komal Tariq EFFECTIVENESS OF LATERAL WEDGE INSOLE ON KNEE OSTEOARTHRITIS OUTCOMES IN PAKISTANI POPULATION 2022-06-15T18:02:39+00:00 Rabbiya Riaz Omar W Althomali Bushra Sultana Imran Amjad Sammar Abbas Nasir Khan <p><strong>Background</strong>: Osteoarthritis (OA) is a persistent joint disorder, which normally affects the weight bearing joints especially knee joint. Lateral wedge insole is one such approach suggested by professionals to manage the knee osteoarthritis. <strong>Objective</strong>: To determine the effectiveness of lateral wedge insoles on knee osteoarthritis outcomes in Pakistani population <strong>Design: </strong>A single-blinded, pretest-posttest comparison. <strong>Setting</strong>: District Headquarter (DHQ) Hospital, Bahawalnagar and National Institute of Rehabilitation Medicine (NIRM), for a time period of one month. <strong>Population</strong>: Patients with the age criteria of 40-70 years, and who had knee OA were included in the study. <strong>Methods</strong>: Participants were randomly divided in two groups; lateral wedge insoles (LWI) group (n=20), and conventional physical therapy (CPT) group (n=20). Pain, stiffness, activities of daily living, sports and recreational activities, and quality of life was assessed on Urdu version of Knee Injury and Osteoarthritis Outcome Score scale (KOOS) on every week till 4<sup>th</sup> week of intervention. Mixed ANOVA was used for interaction effect of between-subject factor (group) and within-subject factor (time) with-in group analysis and one way ANOVA for between group comparisons with their effect size (ɳp<sup>2</sup>). <strong>Results: S</strong>ignificant improvement with large effect size was observed in Symptoms and stiffness (p&lt;0.001, ɳp<sup>2</sup>=.329} , pain (p&lt;0.001, ɳp<sup>2</sup>=.559), functional activities (p&lt;0.001, ɳp<sup>2</sup>=.394), recreational activities (p&lt;0.001, ɳp<sup>2</sup>=.369) and quality of life (p&lt;0.001, ɳp<sup>2</sup>=.280). The CPT group showed more significant improvement (p&lt;0.001) in all domains of KOOS as compared to LWI group. <strong>Conclusion: </strong>Lateral wedge insoles (LWI) and conventional physical therapy (CPT) both have positive impact on knee osteoarthritis outcomes. But conventional physical therapy was more effective in improving functional independence. <strong>Clinical rehabilitation impact: </strong>This study provides the evidence on the use of LWI and CPT as alternative strategies to improving Knee OA outcome measures.</p> <p><strong>Keywords</strong>: Knee osteoarthritis, functional independence, geriatric population, musculoskeletal physiotherapy, orthotics, quality of life, rehabilitation.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Rabbiya Riaz, Omar W Althomali, Bushra Sultana, Imran Amjad, Sammar Abbas, Nasir Khan EFFECTS OF MODERATE PHYSICAL ACTIVITY ON GLYCEMIC CONTROL IN TYPE-2 DIABETES MELLITUS 2022-06-18T07:48:05+00:00 Anam Aftab Zainab Qadri Sumaiyah Obaid Farwa Abid Mirza Obaid Baig Sarah Kafeel <p><strong>Background: </strong>Sedentary lifestyle cause obesity that can disturb body composition, metabolic profiles and insulin resistance which may then lead to ectopic fat in organs and thus leads to diabetes. Physical activity and life style modification was found to be very effective in reducing diabetes and its risk in adults<strong>. Objective:</strong> The objective of this study was to determine the effectiveness of moderate physical activity on glycemic control in Type-2 Diabetes Mellitus. <strong>Methodology:</strong> The participants with the age criteria of 35 years and above and non-insulin dependent type II diabetic mellitus were included in a study. A total of n=45 diabetic patient were assigned to three groups i.e. group 1 (brisk walk, n=16), Group 2 (aerobic training, n=16) and group 3 (resistance training, n=13). Each group performed these exercises for three months for five days a week, a total of 150 minutes per week. HbA1c test was used to determine the glucose level in blood. The data was presented in terms of frequency, percentage, mean, standard deviation, median, and mode. Depending on normality of the data, MANCOVA test was used for within group changes while paired sample T test was used for between group comparisons. Paired sample T test was used to determine correlation. <strong>Results:</strong> The mean age of n=45 study participants were 49.75 ±7.86 years. Between groups analysis showed that all groups significantly improved (p&lt;0.001) regarding HBA1c level after 12 weeks intervention. However, no significant difference {F(2,39), p=0.117} was observed among the groups regarding HBA1c level after 12 week intervention. <strong>Conclusion:</strong> Moderate physical activity showed significant improvement on HbA1c levels.</p> <p><strong>Keywords</strong>: Type 2 diabetes mellitus, moderate physical activity, HbA1c</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Anam Aftab, Zainab Qadri, Sumaiyah Obaid, Farwa Abid, Mirza Obaid Baig, Sarah Kafeel EFFECTS OF ELECTROMYOGRAPHIC BIOFEEDBACK ON THE PERFORMANCE OF VASTUS MEDIALIS OBLIQUE MUSCLE IN KNEE OSTEOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL 2022-06-19T20:38:50+00:00 Huma Khan Huma Riaz Ahsen Farooq Fazeela Farid <p><strong>Background</strong>: Knee osteoarthritis is a common musculoskeletal disorder, enhancing performance of Vastus Medialis Oblique (VMO) can reduce the symptoms<strong>. Objective:</strong> The study objective was to determine the effects of Electromyographic Biofeedback (EMG BF) on the performance of VMO in patients with knee osteoarthritis (OA). <strong>Methods:</strong> A Randomized Controlled Trial (RCT) was conducted at Pakistan Railway General Hospital, Rawalpindi from July to December 2019. In this study, n=30 patients with a diagnosis of knee OA were recruited with the age ranging from 50 to 65 years. The participants were randomly allocated to two groups. Group A has received isometric exercises with Electromyographic Biofeedback (EMG BF) training and Group B has received only isometric exercises for 6 weeks. The Assessments were taken at the baseline and after 6<sup>th</sup> week of intervention. The outcome measure of vastus medialis oblique (VMO) performance was maximum voluntary isometric contraction (MVIC), measured by an EMG BF device, and one-repetition maximum (1RM)). The VMO muscle thickness was measured by musculoskeletal ultrasound. SPSS version 21 was used for data analysis. <strong>Results: </strong>The mean age of the group A was 58.94±3.1 years and of group B was 59.44±2.9 years. There was found significant between-group improvement (p&lt;0.001) in VMO thickness and 1RM. But for MVIC between-group difference was not significant (p&gt;0.05). Within-group analysis for all variables was statistically significant (p 0&lt;.001) in both experimental and control groups. <strong>Conclusion: </strong>It is concluded that VMO training with an EMG BF device is more effective to enhance VMO thickness and strength in terms of 1RM in patients with knee osteoarthritis.</p> <p><strong>Keywords:</strong> Osteoarthritis, Electromyography Biofeedback, One repetition maximum</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Huma Khan, Huma Riaz, Ahsen Farooq, Fazeela Farid LEVEL OF PATIENTS’ SATISFACTION FROM PHYSICAL THERAPY SERVICES IN OUTPATIENT DEPARTMENT OF TERTIARY CARE HOSPITALS IN PESHAWAR: A CROSS-SECTIONAL SURVEY 2022-06-28T14:57:44+00:00 Asad Khan Sakeena Masoud Muhammad Yasir Syed Alamdar Hussain Usman Farooq Huma Balqias Syeda Kaniz Fatima Haider <p><strong>Background: </strong>Patient satisfaction is a reference point of that degree to which a client is satisfied with the attention and treatment or health care services they get from their health care professional. It provides an idea about the intervention that is effective or not and removes the different malpractice claims. <strong>Objective:</strong> To determine the level of patients’ satisfaction in outpatient departments of physiotherapy in tertiary care hospitals of Peshawar. <strong>Methodology:</strong> This study was a cross sectional survey in which purposive sampling was used and data was collected through MED-RISK patient satisfaction questionnaire. Both male and female aged between 18 to 75 and had received at least 3 or more sessions of physiotherapy were recruited in the study The sample size was n=375, participants were selected from physiotherapy (OPD) of Tertiary Care Hospitals of Peshawar. The 13 items, slightly modified form of Med Risk Patient Satisfaction instrument (MRPS) was used for data collection. The data was analyzed and presented in the form of frequencies and percentages. <strong>Results:</strong> The respondent characteristics of 375 patient showed that more than half were male 245 (65.3%) and the remaining were female 130 (34.7%). The overall patient satisfaction from physical therapy services was 4.38±0.70 which showed that majority of the participants were satisfied with physical therapy services. When comparing the public and private setups, it was observed that participant received PT services in private setup are significantly satisfied (p&lt;0.05) with services as compared to public setups. <strong>Conclusion:</strong> The level of patient’s satisfaction receiving physiotherapy health services in tertiary care hospitals of Peshawar can be considered high. Lower back pain was the most presenting symptom for the selected population receiving physiotherapy treatment. The patient education showed the highest mean as compared to other factors. The private sector showed statistically high level of satisfaction as compared to the public sector while practically the services being delivered by private and public sector were on same level.</p> <p><strong>Keywords</strong>: Med- Risk, outpatient department, patient satisfaction, physical therapy</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Asad Khan, Sakeena Masoud, Muhammad Yasir, Syed Alamdar Hussain, Usman Farooq, Huma Balqias, Syeda Kaniz Fatima Haider PROFESSIONAL PREFERENCES OF SPEECH PATHOLOGIST FOR THE ASSESSMENT AND MANAGEMENT OF DYSPHAGIA AFTER STROKE 2022-06-30T09:00:41+00:00 Jannat Haider Rabia Zubair <p><strong>Background: </strong>Dysphagia is common after stroke, leading to adverse outcome. The clinical decisions are often based on usual practice, however no formal or similar methods exists to determine the efficacy for assessment and treatment of dysphagia after stroke. <strong>Objective: </strong>To determine professional preferences among SLPs in terms of opted techniques and approaches for the assessment and management of dysphagia in major cities of Pakistan. <strong>Methods:</strong> Study design was cross sectional survey and data was collected from practicing speech language pathologists of Rawalpindi, Islamabad, Lahore and Karachi from July 2020 till January 2021through online medium on Google forms. The non-probability convenient sampling technique was used for data collection from speech language pathologists. Sample size was n=31 out of which n=20 were females and n=11 were males. Responses of all participants were presented in the form of n(%) through SPSS version 20. <strong>Results: </strong>There was variation between all the responses of participants from different cities of Pakistan. The Speech and language pathologists (SLPs)had access to instrumental assessment video fluoroscopy n=5 (16.1%), FEES n= 4 (12.9%) and more than one instrumental assessment tools n= 8 (25.7%) but before recommendation of exercise is rarely n=20 (64.3%) practiced. The two principal outcome measures for direct dysphagia exercises indicated by SLPs were Oral control n=12 (35.2%) and reduced aspiration n=8 (12.9%). To measure direct exercises outcomes SLPs rarely n=25 (80.7%) uses instrumental assessment tools but use rating scales n=29 (93%). SLPs also prefer to see patient for management of dysphagia 1-2 times a day, 1-4 days a week, for 45 minutes. The most frequently preferred direct exercises are lip range movement n=15 (48.4%), lip strength n=16 (51.6%) and effortful swallow n= 16 (51.6%) whereas electrical stimulation method is least practiced n=5 (16.2%). <strong>Conclusion: </strong>The Speech language pathologists showed variability in preferences for assessments and management practices and format.</p> <p><strong>Keywords</strong>: Dysphagia, clinical decision making, speech-language pathology, stroke</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Jannat Haider, Rabia Zubair EFFICACY OF DIGITAL MANIPULATION OF THYROID CARTILAGE, FLUENCY SHAPING THERAPY AND COMBINATION OF BOTH IN TREATMENT OF STUTTERING SEVERITY: A RANDOMIZED CLINICAL TRIAL 2022-07-12T16:17:32+00:00 Nasir Khan Raheela Khatoon Hina Saleem Humaira Shamim Kiani Rizwana Butt <p><strong>Background: </strong>The stuttering is manifested by disruption in normal speech flow and fluency that also disturbs social and emotional wellbeing. There is immediate need of rehabilitation for the improvement of fluency and reduce the severity of stuttering. <strong>Objective:</strong> To compare the digital manipulation of thyroid cartilage (DMTC), fluency shaping therapy (FST) and combination of DMTC and FST for improving severity in stuttering patients. <strong>Material and Method</strong>: A randomized clinical trial was conducted at National Institute of Rehabilitation Medicine. The patients were enrolled through non-probability, convenient sampling technique. The participants were randomly allocated into three equal groups (n=10): DMTC group, FST group and combination of both. The Scale of Rating Severity of Stuttering (SRSS) was used to assess the severity level at baseline, 2<sup>nd</sup> week, 4<sup>th</sup> week, 8<sup>th</sup> week and 12<sup>th</sup> week of intervention. <strong>RESULTS: </strong>The mean age of DMTC, FST and combination group was, 22.25 ±3.33 years, 21.65±3.36 and 21.35±3.76 years respectively. Friedman with post hoc test revealed significant improvement (p&lt;0.05) in all groups but combination group had showed better outcome than single DMTC and FST intervention. A Kruskal-Wallis H test showed that there was no significant difference (p≥0.05) among DMTC, FST and Combination group from baseline to 8<sup>th</sup> weeks of training, but significant difference {X<sup>2</sup>(2) =5.897, p&lt;0.014} was observed after 12<sup>th</sup> week of training among the groups. The post hoc test showed that the combination group was more significantly improved as compared to DMTC group {MR=9.10 ver. MR=17.71, p=0.012} but not significant difference between difference between combination and FST group (p=0.317) as well as DMTC and FST group (p=0.619) regarding severity of stuttering.&nbsp; <strong>Conclusion</strong>: It is concluded that combination of digital manipulation of thyroid cartilage and fluency shaping therapy were more beneficial for improving fluency in stuttering patients</p> <p><strong>Keywords</strong>: digital manipulation of thyroid cartilage, fluency shaping therapy, stuttering.</p> 2022-06-30T00:00:00+00:00 Copyright (c) 2022 Nasir Khan, Raheela Khatoon, Hina Saleem, Humaira Shamim Kiani, Rizwana Butt