The Rehabilitation Journal

Anxiety and perceived stress among students due to covid-19 pandemic in Lahore

Afshan Ahmad — 2023-06-30

Background: The COVID-19 pandemic has had the impact that may contribute to a rise in mental health problems. The novel coronavirus disease (COVID-19) is spreading rapidly, increasing the stress and challenges for healthcare professionals around the world.

Objective: To explore the levels of anxiety and perceived stress among students due to the COVID-19 pandemic in Lahore, Pakistan.

Methodology: An online cross-sectional survey was conducted in Lahore in the duration of 6 months on n=249 participants sampled through a non-probability convenient sampling technique. Participants with an age group between 15-30 years residing in Lahore were included in the study. The survey was done on all the medical students in this range so it could not affect the generalizability of results. Students with Ongoing physical or previous mental illness were excluded. Perceived Stress Scale (PSS) and generalized anxiety disorder were questionnaires converted into Google Forms and were distributed to students of medical discipline through WhatsApp, Instagram, and Facebook.

Results: The mean age of the study participant was 22.0±1.94 years. The mean score of the perceived stress scale (PSS) was found to be 16.90±4.21 which showed that out of n=249 students n= 181(72.69%) reported moderate stress. While n=30(12.04%) students had low stress. While remaining high-stress levels were found among n=38(15.2%) students. The mean score of General Anxiety Disorder was found to be 18.45 ±3.16 which showed that out of 249 students, 35.74% (n= 71) students showed Mild Anxiety Level and 12.05% (n=30) showed Severe Anxiety Level.

Conclusion: It was concluded that most of the medical students from Lahore reported stress and anxiety. However, higher stress and anxiety were reported among younger age groups and greater stress was found in females as compared to males.

Keywords: anxiety; COVID-19; GAD- 7; mental health; perceived stress

Effects of percussive massage treatment with theragun on pain and muscle length on post exercise delayed onset muscle soreness of calf muscles in healthy population

Mahnoor Rao — 2023-06-30

Background: People who engage in unusually intense or prolonged physical activity frequently experience delayed onset muscle soreness (DOMS). DOMS may be treated using percussion massage therapy, which employs a portable tool to administer quick, repeated strikes to the muscle tissue. While there hasn't been much research done on the effects of Theragun specifically.

Objective: to determine the effects of percussive massage treatment with theragun on pain and muscle length on post-exercise delayed onset muscle soreness of calf muscles in the healthy population.

Methodology: This randomized control trial (NCT05026944) was conducted at Kasrat Health and Fitness Club, Lahore, Pakistan. The study was approved by the research ethical committee of Riphah International University Islamabad (REC/RCR &AHS/21/0410) A total of n=24, healthy females, age ranging from 20-30 years with post-exercise DOMS of calf muscles were included. All the study participants were randomly divided into group A received Percussive Massage Treatment with Theragun in addition to stretching exercises, while group B only received stretching exercises. The outcome variables were pain on NPRS and short-form McGill pain (SF-McGill) and calf muscle length with Goniometer, measured on the baseline, after 24 hours, after 48 hours and after 72 hours.

Results: The mean age was 25.8±3.00 years, and BMI was 24.7±4.72 kg/m2 respectively. Both groups showed significant improvement (p<0.05) from the baseline to the end of treatment at each level of assessment. The group comparison showed that both the groups are not significantly different (p≥0.05) in all variables except left calf muscle length, which showed significant improvement (p<0.05) in group A, at the end of treatment, as compared to group B.

Conclusion: It was concluded that individuals with post-exercise DOMS treated with theragun percussive massage increased the calf muscle length, however, no significant difference was seen in pain when compared with the static stretching group.

Keywords: muscle flexibility; muscle soreness; percussion therapy; stretching exercises.

Parenting stress and marital satisfaction among parents of children with neurodevelopmental disorders: Moderating role of resilience

Bushra Irshad — 2023-06-30

Background: Parenting stress is an important factor that affects the marital satisfaction of parents of children with neurodevelopmental disorders. When parents are faced with a challenging situation, such as having a child with a neuro-developmental disability, resilience facilitates a more positive coping style and improves marital satisfaction.

Objective: to investigate the relationship between parenting children with neurodevelopment disorders, stress and marital satisfaction among parents while moderating the role of resilience.

Methodology: The cross-sectional analytical study was conducted on n=300 parents of children with ADHD, an intellectual disability, and autism. Purposive sampling was employed to get a sample from RHS Rehabilitation Centre Islamabad. The mothers (n=150) and fathers (n=150) were selected with the age range of 25 to 50 years. Parenting stress was measured using the Parental Stress Scale after translating it into Urdu. To determine the Resilience, the Urdu version of the Connor-Davidson Resilience scale was used. Whereas marital satisfaction was determined using an Urdu-translated version of the Dyadic Adjustment Scale.

Results: A negative correlation was revealed in the findings between parenting stress and marital satisfaction (p < 0.05). Moderation analysis demonstrated a significant effect of resilience on the relationship between parenting stress and marital satisfaction (R2 = 0.70, B = 0.002, β = -0.71, p < 0.05).

Conclusion: In conclusion, it was found that high stress experienced by parents of children with neurodevelopmental disorders has a negative impact on their marital satisfaction. Both their marriage and parental lives were affected equally. For both fathers and mothers, resilience can be a useful tool in resolving marital problems.

Keywords: marital satisfaction, neurodevelopmental disorders, parenting stress, resilience

Pattern and perception about vocal use and misuse among young adult in Pakistan

Jamshaid Haider Malik — 2023-06-30

Background: The human voice is a prominent feature and the most susceptible to environmental changes, lifestyle, and age. Voice problems tend to be significantly under-reported and consequently less likely to be clinically treated. It is yet to be established if the cause lies in the lack of awareness or the impermanent nature of most voice disorders.

Objective: To evaluate the patterns and perceptions about vocal use and misuse among young adults in Pakistan.

Method: The study used a cross-sectional survey design. A convenient sampling technique was employed to collect the data from n=242 healthy young adults aged 18-25 years studying in colleges and universities of Rawalpindi and Islamabad. A 32-item survey questionnaire titled “patterns and Perceptions about voice use and Misuse” was employed, with a portion for demographic data and five sections dedicated to general awareness, self-perception about voice, and habits of vocal use and misuse.

Results: The results regarding the perception and patterns of vocal use and misuse reflects that 88.3% of the participants agreed that precautionary measure would help them to avoid voice disorder. In contrast, 83.3% of the participants reported screaming and yelling as part of their vocal pattern. Participants showed a strong association with the positive attributes related to their voice such as beautiful as 82.2% of the participants reported their voice as pleasant.

Conclusion: The study concluded that the outcome of participants’ perceptions and their patterns of vocal behavior were significantly atypical. Screaming and smoking were the most frequently reported response by adults but on the other hand, they did not seek professional help and did not perceive their voice as unpleasant voice.

Keywords: speech therapy; voice disorder; vocal misuse; young adults.

Assessment of satisfaction level among university teachers of Doctor of physical therapy program on online teaching during COVID-19 pandemic: A cross-sectional survey

Rabia Afzal — 2023-06-30

Background: The recent covid-19 pandemic has also displayed a worldwide increase in online education as a method of learning, at an exponential rate. In the wake of the COVID-19 pandemic, the education program of physical therapy abruptly moved from on-campus to remote online medium.

Objective: to find out the satisfaction level of the faculty of Doctor of Physical Therapy (DPT) in twin cities of Pakistan.

Methodology: A cross-sectional survey was conducted on faculty members of various universities having the Doctor of Physical Therapy program students in Islamabad and Rawalpindi, Pakistan. A total of n=120 participants between 24 to 60 years were recruited through a nonprobability purposive sampling technique. The research team used the Online Faculty Satisfaction Survey (OFSS) which has a total of 34 questions and was designed to quantify and authenticate the satisfaction of faculty regarding the students, teaching mode as well as the institutions. Questionnaires were distributed through emails and other social media applications i.e. Facebook and WhatsApp.

Results: The mean age of participants was 29.4± 6.5 years with 63.3 % females & 36.7% males. The Satisfaction levels were different among the participants. A total of n=66(55%) of participants were less satisfied with the online method of teaching whereas n=42 (35%) shows a higher level of satisfaction. The remaining 10% showed various responses regarding satisfaction level i.e. average n=4 (3.3%), moderately satisfied n=4 (3.3%), neutral n=2 (1.7%), satisfied n=2 (1.7%).

Conclusion: This study concluded that the faculty of Doctor of Physical Therapy (DPT) was less satisfied with online teaching methods due to the lack of face-to-face interaction and practical components of studies.

Keywords: COVID-19; education; faculty satisfaction; pandemic; university teacher.

Educational environment perception and cognitive load among physical therapy students during e-learning

Zahid Mehmood — 2023-06-30

Background: Understanding students' perception of the educational environment and their cognitive load in this context is crucial for optimizing the effectiveness of e-learning platforms.

Objective: To compare educational environment perception and cognitive load in under-graduates Doctor of Physical Therapy (DPT) and post-graduate Master in Science of Physical Therapy (MSPT) students having online learning experiences.

Methodology: In this comparative cross-sectional study, data was collected through non-probability convenient sampling from n=274 under-graduates DPT (n=225) and post-graduates MSPT(n=49) students of either gender having one-semester experience of online learning, Dundee Ready Education Environment Measure (DREEM) for measuring educational environmental perception and Rating Scale of Mental Effort (RSME) for measurement of cognitive load. Online self-structured was developed questionnaire and shared through communication media platform and data analysis was made through SPSS version 28.

Results: There were n=225 under-graduates (DPT) and n=49 post-graduates (MSPT) students in which, there were n=208 females and n=66 males. The overall DREEM score showed that MSPT students are more significantly positive (p<0.001, Cohen’s d=1.01) than DPT students regarding the perception of the educational environment with a large effect size. While there was no significant difference (p=0.114) between MSP and DPT students regarding cognitive load.

Conclusion: Post-graduates (MSPT) students have better educational environmental perception than undergraduate (DPT) students but there was no significant difference in cognitive load in undergraduate (DPT) and post-graduates (MSPT) students.

Keywords: cognition; cognitive load; mental effort; e-learning; physiotherapist.

Correlation between cervical proprioception with the neck length and neck pain in patients of cervical spondylosis

Rutaba Hussain — 2023-06-30

Background: Cervical proprioception has been a major source of attention among the population of cervical spondylosis as it is associated with neck pain, whereas it can lead to alteration in physiological manifestations which enhance neck pain as a consequence of disturbed proprioception.

Objective: To determine the correlation between cervical proprioception with neck length and neck pain in patients with cervical spondylosis.

Methodology: It is a cross-sectional correlational study conducted at Innovative Health Concepts (IHC) and Pakistan Society for Rehabilitation for Differently-abled Lahore, in the duration of six months from November 2021 to March 2022. The sample size of n=130 participants was recruited and data was collected through non-probability purposive sampling. Patients diagnosed with cervical spondylosis aged 25 to 50 years with neck pain, decreased neck range of motion, and osteophytes formation were included. Whereas, vestibule basilar artery insufficiency or any systemic illness was excluded. Joint Position Error Test (JPET) for cervical proprioception assessment, Numeric Pain Rating Scale (NPRS) was used for neck pain, and lateral view X-rays were taken for neck length measurement. Data was analyzed using Statistical Package for Social Sciences (IBM-SPSS) version 22.

Results: There was no significant association between proprioception except for left rotation (r=0.21, p=0.016) which showed a weak positive correlation. On the other hand, neck pain showed a significant strong positive correlation with flexion (r=0.88, p=0.002), moderate with extension (r=0.39, p=0.004), strong with right rotation (r=0.81, p=0.001) and left rotation (r=0.61,p=0.001) respectively.

Conclusion: It was concluded that the population of cervical spondylosis has no correlation between cervical proprioception and cervical length. Whereas, a positive strong correlation was found between cervical proprioception and neck pain.

Keywords: Joint position error test, Neck pain, Proprioception.

Effect of cardiac rehabilitation program on kinesiophobia and functional capacity in open heart surgery

Muhammad Bilal — 2023-06-30

Background: Open heart surgery is the major surgical procedure that is the most frequently conducted in general hospitals. Kinesiophobia and functional capacity are greatly compromised after open heart surgery. Cardiac rehabilitation helps in secondary prevention and minimizes different risk factors of cardiovascular disease.

Objective: To determine the effect of a cardiac rehabilitation program on kinesiophobia and functional capacity after open heart surgery.

Methodology: A quasi-experimental study was conducted at Rehman medical institute, Peshawar. The sample size was calculated as 45 by using G power, both male and female patients of aged 50 to 70 years who underwent open heart surgery were selected through a nonprobability purposive sampling technique from July 2021 to February 2022. Patients having any neurodegenerative disease, disorder of stance and gait, or drug intoxication were excluded. Pre and post-assessment after a week after was done using scale Tampa scale of kinesiophobia-11 for kinesiophobia and 6 minutes walk test for functional capacity. Phase 1 cardiac rehabilitation program was used as an intervention after open heart surgery. Paired t-test was applied to determine the mean difference in a group pre and post-interventional. SPSS version 23 was used to analyze the data.

Results: The Mean age of the patients was 59.71±5.01 years. The results showed a significant improvement in kinesiophobia (28.96±4.67 versus 21.76±3.51, p<0.001) and functional capacity on 6 MWT (227.11±74.40 versus 326.02±80.05, p<0.001) after cardiac rehabilitation program was observed in study participants enrolled.

Conclusion: The study concluded that cardiac rehabilitation programs have a significant effect on kinesiophobia and functional capacity after open heart surgery.

Keywords: cardiac rehabilitation, functional capacity, kinesiophobia, open heart surgery.

Translation, adaptation, and validation of caregiver difficulties scale in Urdu

Saima Waqar — 2023-06-30

Background: Even though there are extensive, studies carried out to assess the caregiver burden among caregivers of Cerebral Palsy children through different scales. Caregiver Difficulties scale (CDS) is designed for the specific population of CP’s Caregivers. So this scale is translated in Urdu to use on the parents of CP children in Pakistan.

Objective: To translate, adapt and validate the Caregiver Difficulties Scale into Urdu.

Method: There Descriptive Study was conducted on n=40 caregivers of Cerebral Palsy children. Males & Females (Specifically fathers & mothers) age ranged 30 to 60 from Rehabilitation Institute took part in the study. Caregiver difficulties scale (CDS) was used along with a demographic Performa for data collection.

Results: The caregiver difficulties scale is a reliable measure to assess the caregiver burden among caregivers of CP Children (Cronbach α=0.91). The significant correlation value ranges from r=0.88 (Urdu to Urdu) to r=0.83 (English to English) which shows that Urdu version has conceptual equivalence and cross-language validity.

Conclusion: The translation and adaptation of the Caregiver Difficulties Scale (CDS) in Urdu is reliable and valid for the assessment of caregiver giver difficulties in caregivers of cerebral palsy children

Keywords: cerebral palsy; caregivers; care giver burden

Effectiveness of group therapy versus individual therapy in acquisition of pre-linguistic skills in children with expressive language disorders

Ruqaiya Faiz Akbar — 2023-06-30

Background: Children with expressive language difficulties may find it difficult to communicate effectively. To encourage the development of prelinguistic skills and improve overall language development, early intervention is essential.

Objective: To determine the effectiveness of group therapy as compared to individual therapy in the acquisition of pre-linguistic skills in children with expressive language disorders.

Methods: A experimental study was conducted at special education centers of Rawalpindi & Islamabad, from August 2015 to January 2016. A total of n=17 children with expressive language disorders of either gender with ages between 4-7 years were recruited through a nonprobability convenient sampling technique, with Group A (Individual Therapy) including n=7 kids and Group B (Group therapy) n=10 kids. The outcome measures were Eye contact, attention span, turn-taking, and imitation skills, noted before therapy and after completing 20 sessions post-therapy (after 7 weeks). Statistical analysis was done using SPSS 20. An Independent t-test was utilized to see any difference between groups.

Results: The study included 10(58.82%) males and 7(41.18%) females with most 9(52.94%) being 6 to 7 years of age. Post therapy results revealed significantly better results for group therapy versus individual therapy (11.0±1.24 vs 8.28±1.11) for eye-contact (p=0.000); (11.0±0.94 vs 7.8±1.34) attention span (p=0.000); (11.4±0.69 vs 8.0±0.81) turn taking (p=0.000); and (10.6±1.34 vs 8.4±0.97) for imitation skills (p=002).

Conclusion: The study concludes that group therapy is significantly more effective than individual therapy for improving pre-linguistic skills including eye contact, attention span, turn-taking, and imitation skills in 4 to 7 years old kids with expressive language disorders.

Keywords: Language, Expressive language disorder, Pre-linguistic skills, Group therapy, Individual therapy