Conventional Physiotherapy Treatment Research Articles

A Study to Investigate the Efficacy of Application Based Activities on Hand Dexterity among Individual with Sub Acute Stroke : A Pilot Study

Stroke is the sudden loss of neurological functions caused by an interruption of blood flow to the brain. Stroke is more clinically prevalent and it is the second leading cause of disability The aim of the study was to investigate the efficacy of application – based activities on hand dexterity among individuals with sub-acute stroke. A total of 20 patients, aged 42 to 60 years with subacute stroke were undertaken and were divided into two groups. The total duration of the study was one and a half year. Patients meeting inclusion and exclusion criteria were selected in the study and were assessed for hand dexterity, arm and hand function. A pilot study was conducted in which treatment was given using tablet including the game intervention along with conventional physiotherapy for Group A. The conventional physiotherapy treatment for upper limb and hand was given to Group B that is the control group. The treatment was carried out for 5 days per week for 9 weeks. in which first week was for training session for Group A and for Group B the treatment time was 45 minutes per session for 9 weeks; 5 days per week. It is thereby, concluded from the results that the virtuous use of application-based activities aids as a fun based measure along with conventional rehab protocol. Stroke rehab is multi- centered approach and it is of utmost importance to consider all the aspects affecting the patient’s capabilities. Using game- based measure for rehabilitation provides clinical insights towards symptoms improvement and consistency.

Effect of Physiotherapy on Pain Intensity and Disability in Patients with Chronic Low Back Pain: A Call for Patients’ Awareness to Focus on Physiotherapy Treatment in Cameroon

Background: This study aimed at evaluating the effects of conventional physiotherapy (CPT) treatment on pain and disability among patients with Chronic low back pain (CLBP) Methods: we conducted a quasi-experimental study in some major physiotherapy units in Cameroon from December 2022 to April 2023, patients following physiotherapy treatment for CLBP were enrolled. A structured questionnaire was used to collect general characteristics of participants; the level of pain was assessed with the VAS (Visual Analog Scale) and the impairment of physical function with the EIFEL scale (Echelle d’Incapacité Fonctionelle du Patient Lombalgique). The data collected were analyzed using SPSS. The paired Student test was used to compare the initial and final VAS and EIFEL scores. The Leverne test was used to compare treatment outcomes between patients who received CPT alone and those who received non-conventional traditional medicine (TM). Statistical significance was calculated at P˂ 0.05. Results: Were included in this study 158 patients with CLBP with a mean age of 46.3 ±14.3. Female were more represented (106/157, 67%). The patients underwent CPT for a mean duration of 8.9 ±15.8 months at a weekly mean session frequency of 3.8±1. Of the 158 participants, 35 (22.2%) underwent additional TM. Conventional physiotherapy significantly reduced pain (Initial VAS:7.4± 1.3; Final VAS: 3.9± 1; P=0.000) and physical impairment of participants (Initial EIFEL: 15.7± 4.5; Finale EIFEL: 6.8 ± 3.2; P=0.000). The study found no significative difference in pain (P= 0.317) and physical impairment (P=0.302) in patients following exclusively CPT and those following physiotherapy additionally to non-conventional TM. Conclusion: Physiotherapy treatment reduces pain and improve physical function of patients with chronic low back pain and additional non-conventional TM did not have improve further pain and disability in these patients.

Effect of Combined Neck, Shoulder and Hand Exercises with Conventional Physiotherapy Treatment on Hand Grip Strength and Hand Function in Patients with Unilateral Cervical Radiculopathy: a Comparative Study

Effect of Combined Neck, Shoulder and Hand Exercises with Conventional Physiotherapy Treatment on Hand Grip Strength and Hand Function in Patients with Unilateral Cervical Radiculopathy: a Comparative Study

Possibilities of backward walking application in the rehabilitation of patients with gonarthrosis: review

INTRODUCTION. Osteoarthritis of the knee joint or gonarthrosis (GA) is one of the most common joint pathologies. The medical and social significance of GA is associated with its high prevalence and a significant percentage of premature disability and a significant deterioration in the quality of life due to persistent pain syndrome. Modern treatment of patients with GA includes a combination of pharmacological and non-pharmacological methods; physical therapy is the leading method of non-drug therapy. By now, a number of studies have been conducted to research the effectiveness of backward walking (BW) in people with GA. AIM. Analysis of scientific data on the possibilities of using BW in the rehabilitation of patients with GA. MATERIALS AND METHODS. A systematic search of literary sources by keywords was carried out: “backward walking”, “gonarthrosis”, “knee osteoarthritis”, “knee joint”, “rehabilitation”, “physical therapy”. DISCUSSION. Recently, backward locomotion is increasingly used in medicine. Kinetic and kinematic analysis during BW showed a number of advantages over the usual method of movement, which can be successfully used for rehabilitation of patients with GA. BW is associated with less overload on knee joints. It is also one of the few natural ways of strengthening the quadriceps. It prevents excessive stretching of the anterior cruciate ligament and improves the stability of the knee joint. BW leads to a more cardiovascular and respiratory load and a more significant aerobic and anaerobic capacity of the organism compared with forward walking at similar parameters of physical activity. CONCLUSION. There is evidence that adding BW to conventional physiotherapy treatment may further reduce pain, functional disability and improve the strength of the quadriceps muscles.

Ab. No. 149 Therapeutic Effects of Yoga On Gait Variables, Walking Capacity, Balance, Lower Extremity Strength, and Flexibility in Ambulatory Children With Cerebral Palsy

Introduction: The purpose is to explore the effects of Yoga on gait variables, walking capacity, balance, and lower extremity strength and flexibility in ambulatory children with cerebral palsy. Children with cerebral palsy have limited access to skill-based movement programs that combine therapeutic principles of movement rehabilitation with community involvement, the need for activity-grounded therapeutics in cerebral palsy is the need of the hour. Rehabilitation typically focuses on range of motion exercises to prevent and delay contractures, flexibility exercises to increase range of motion, progressive resistance exercises to enhance strength, and varied interventions to improve posture, balance, and the acquisition of functional skills. Thus, the therapeutic movement that improves motor control and imitates social interaction. Methods: Twenty-one children with the potential to participate and corresponding to the inclusion criteria were recruited in the study. The mean average age group of the participants was 8.97 years with 5 girls and 16 boys. Children with cerebral palsy with Gross Motor Function Classification I–III were divided into a control group and an experimental group. Throughout 12 weeks, the control group received conventional physiotherapy treatment while the experimental group an additional one-hour yoga sessions three times each week. The Walking capacity (6 Minute Walk Test), Balance (Pediatric Balance Scale), Muscle strength (Manual Muscle Test Score), and Flexibility (rotational profile using goniometric measurements) were administered before, and after the interventions in each group. Wilcoxon signed-rank test was used to evaluate thedata. Results: Statistically significant differences were found in the walking capacity (p < 0.004), dynamic balance (p 0.002), Strength (p 0.007), and flexibility (p 0.007). Conclusion: Yoga can be used as an adjunct to conventional physiotherapy interventions. Implications: An improvement in walking capacity, and balance leads to increased mobility and improved functional activities of the children with cerebral palsy. As yoga was an additional therapy, this showed better engagement in therapy as it improved the zeal to attend the therapy. These further improved the quality of life as children could engage amongsttheir typically developing peers.

Efficacy of scapular and upper limb proprioceptive neuromuscular facilitation techniques on scapular alignment, upper limb function, and gait in subacute stroke: a randomized controlled trial protocol

Background: Stroke is a neurological disability produced by vascular-related acute focal injury to the central nervous system and is one of the leading causes of disability in adults, and it is frequently accompanied by motor skill loss. Patients suffering from hemiplegia after a stroke are more prone to have fall and are more likely to experience further injury due to irregular gait, diminished muscular strength, and functional impairment. In the affected upper limb of the hemiplegic stroke, spasticity in the shoulder girdle causes scapular malalignment, which reduces the functional mobility and stability of the upper limb. This is reflected as the reduced reciprocal arm swing during walking, which is further reinforced by an abnormal synergy pattern on the affected side. Proprioceptive neuromuscular facilitation (PNF) is a treatment strategy that stimulates motor activity and enhances control and function of the neuromuscular system. This research protocol is intended to assess and evaluate the effects of applying scapular and upper limb PNF along with conventional physiotherapy treatment to subacute-stroke patients on their scapular alignment, upper limb function, and gait. Methods: A total of 40 individuals in total will be allocated equally into two groups, group-A (experimental) and group-B (control). Both groups will be receiving treatment for six weeks with five sessions per week. Each patient will be examined both before and after therapy using the Palpation Meter (PALM), the Fugl-Meyer Assessment of Upper Extremity (FMA-UE), 10-Meter Walk Test, Handheld dynamometer (10MWT), and Dynamic gait index (DGI). After six weeks of therapy, the results will be assessed and the data will be analyzed before and after the intervention using a paired t-test to discover within-group differences in measurements. Conclusions: This physiotherapy method may be used in the management of stroke patients if our study's hypothesis is found to be valid. Registration: CTRI (CTRI/2023/05/052930, 19/05/2023).

Early application of extracorporeal shock wave therapy improves pain control and functional scores in patients undergoing total knee arthroplasty: a randomized controlled trial.

The use of biophysical stimuli produced by extracorporeal shock wave therapy (ESWT) can improve the rehabilitation treatment of patients undergoing total knee arthroplasty (TKA). The aim of our study is to evaluate the short-term efficacy of early postoperative ESWT in combination with physiotherapy in terms of pain reduction and motor function recovery of patients undergoing TKA and compare it with conventional physiotherapy treatment. Fifty-six patients undergoing TKA were enrolled in the study from January 2019 to February 2020. Patients received two sessions of physiotherapy daily, with (experimental group) or without (control group) four sessions of ESWT within sevendays after surgery. Patients were prospectively evaluated at baseline and at post-operative day two and seven. Assessment included active knee range of motion (aROM), timed up and go (TUG)test, visual analogue scale (VAS) for pain, and Borg scale. Fifty patients completed the study. Both treatments proved to be effective in reducing pain and improving the knee range of motion and functional scores at sevendays after surgery: the aROM in the ESWT group was 36.8 ± 11.0 grades (p < 0.001), while in control group was 19.8 ± 7.8 grades (p < 0.001). TUG, VAS, and BORG scores showed a similar trend. Comparative analysis revealed superior clinical results for the experimental group in all the outcomes, in particular aROM (96.0 ± 5.40 vs. 81.20 ± 11.01, p < 0.001) and TUG test (17.4 ± 5.61 vs. 21.24 ± 5.88, p < 0.001), at day seven after surgery. Early application of ESWT in addition to physiotherapy can positively influence the rehabilitation process after TKA. The treatment proved to be well tolerated and safe. Preliminary results demonstrated better pain control and functional scores compared to physiotherapy alone.

Combined effect of Brunnstrom's hand rehabilitation and functional electrical stimulation for improving hand function in patients with chronic stroke: A randomized controlled trial

BackgroundMotor recovery of the upper extremity is one of the most common challenging outcomes after stroke. ObjectiveTo find out the combined effects of Brunnstrom hand rehabilitation (BHR) and functional electrical stimulation for improving hand functions in patients with chronic stroke. Study designRandomized controlled trial. Method25 participants, both male (n = 11) and female (n = 14), age group between 40 and 70 years were randomly divided into control group (n = 12) and experimental group (n = 13). The treatment protocol was continued 5 days per week, for 4 weeks. The experimental group received Brunnstrom hand training and functional electrical stimulation (FES) along with conventional physiotherapy. The control group received only conventional physiotherapy. Participants were evaluated at baseline and after 4 weeks of intervention. Outcome measures: Fugl Meyer Assessment scale-upper extremity, Modified Ashworth scale, Handheld Dynamometer, and Jabsen Taylor Hand Function Test. Paired t-test was used to compare within-group variables and an independent t-test was used for between-group comparisons. P-value was set as 0.05 to minimize type-1 error. ResultsStatistically significant difference was obtained in favor of the experimental group undergoing FMA (p < .001), MAS (p = .004), JTHF (p = .018), and HHD (p < .001) in between-group analysis. However, both groups showed significant improvement [experimental group; FMA-UE (p < .001), MAS (p < .001); JTHF (p < .001), and HHD (p < .001), and control group; FMA-UE (p < .001), MAS (p < .001), JTHF (p < .001) and HHD (p < .001)] in within-group analysis at post-intervention. ConclusionBrunnstrom hand rehabilitation and FES in combination were found to be more effective in improving hand function than conventional physiotherapy treatment. Clinical trial registrationURL: http://www.ctri.nic.in. No: CTRI/2019/06/019,905.

Comparing muscle energy technique (MET) versus conventional physiotherapy in cases of adhesive capsulitis of shoulder- A randomized controlled trial

This study was a randomized controlled trial conducted at Noor Hospital Rawalpindi, Pakistan to compare muscle energy technique (MET) and conventional physiotherapy techniques in patients with confirmed diagnosis of adhesive capsulitis. This study was, conducted between March 2021 to August 2021. A total of 30 participants regardless of gender, aged between 30 to 60 years, with confirmed diagnosis of idiopathic adhesive capsulitis were included. Participants with unstable shoulder fractures and dislocation, thoracic outlet syndrome, rotator cuff injuries, reflex sympathetic syndrome, rheumatoid arthritis, extreme shoulder pain not relieved by any medication or rest were excluded from study. The patients were assigned in experimental (n=15) and control group (n=15) using sealed envelope method. Participants in both groups were assessed at baseline and after 4 weeks. The outcome of the treatment was measured in terms of numeric pain rating scale (NPRS), Shoulder Pain &amp; Disability Index (SPADI) and goniometer for measuring shoulder ROM. The overall mean age of participants was 51.64±5.31 years. The study included 12 (40%) males and 18 (60%) females. After 4 weeks of treatment a significant difference (p-value &lt;0.05) was seen between groups in terms of pain, disability and shoulder ROM. The study concluded that MET is a non-invasive treatment for reducing pain. The MET was also shown to improve functional ability and ROM in patients with adhesive capsulitis in comparison to conventional physical therapy treatment.

EFFECT OF STATIC STRETCHING OF HAMSTRING ON NON-SPECIFIC LOW BACK PAIN

Objective: To determine the effect of static stretching of hamstring muscle on the non-specific low back pain. Methodology: A Quasi-Experimental study was conducted in Rabia Moon Institute of Neurology which total 30 participants were included through non-probability purposive sampling. Thirty participants were selected who fulfilled our inclusion criteria, they were divided into two groups; group A or treatment group received conventional physiotherapy treatment as well a static stretching exercise protocol for 5 days. Group B or control group received conventional physiotherapy treatment only. VAS (Visual analog scale) and Oswestry Disability questionnaire, SFGD (Standing Finger to ground Distance,) PSLR (passive straight leg raise) for both legs were measured pre- and post-treatment. Result: A total of 30 patients aged 20-55 were included in the study. Mean age of the participants was found to be 37.88 years. The difference in means of all the assessment parameters pre and post-treatment for both groups were analyzed through paired t-test. There was a significant improvement in VAS, SFGD, Passive Straight leg Raise PSLR (right leg), PSLR (left leg) and level of disability pre- and post-treatment in the treatment group. Conclusion: This present study concluded that static stretching of hamstrings is effective in decreasing non-specific low back pain.

Effects of core muscle strengthening on pain and dynamic balance among professional basketball players with ankle sprain

Basketball is a contact sports that requires offense and defense. Ankle sprain in basketball is the most common injuries due to quick changes in direction with constant jumping and turns. The highest incidence of ankle sprain is 41.1% in basketball followed by other sports.Objectives: To study the effectiveness of 6 weeks core muscle strengthening program in reducing the pain and improving dynamic balance among professional basketball players with ankle sprain.Methodology: An experimental study was conducted among 20 professional basketball players with ankle sprain using Star Excursion Balance Test.20 participants were divided into 2 groups: experimental group (A) and control group (B). During 6-week time, the experimental group performed a core stability program with conventional physiotherapy, whereas the control group was dealt with only the conventional physiotherapy treatment. Result: The result showed that there was significant difference in terms of pain and dynamic balance among the two groups.Conclusion: The study concluded that core muscle strengthening can improve the dynamic balance and reduce the pain in basketball players with ankle sprain.

Perfectionism of coaches and their effects on Burnout of their Athletes

Basketball is a contact sports that requires offense and defense. Ankle sprain in basketball is the most common injuries due to quick changes in direction with constant jumping and turns. The highest incidence of ankle sprain is 41.1% in basketball followed by other sports.Objectives: To study the effectiveness of 6 weeks core muscle strengthening program in reducing the pain and improving dynamic balance among professional basketball players with ankle sprain.Methodology: An experimental study was conducted among 20 professional basketball players with ankle sprain using Star Excursion Balance Test.20 participants were divided into 2 groups: experimental group (A) and control group (B). During 6-week time, the experimental group performed a core stability program with conventional physiotherapy, whereas the control group was dealt with only the conventional physiotherapy treatment. Result: The result showed that there was significant difference in terms of pain and dynamic balance among the two groups.Conclusion: The study concluded that core muscle strengthening can improve the dynamic balance and reduce the pain in basketball players with ankle sprain.

Cardiopulmonary and hematological effects of infrared LED photobiomodulation in the treatment of SARS-COV2.

COVID-19 disease is caused by SARS-CoV-2 which can trigger acute respiratory syndrome, which presents with dense alveolar and interstitial infiltrates and pulmonary edema, causing severe hypoxemia and significant alteration to pulmonary mechanics with reduced pulmonary compliance. The photobiomodulation technique alters cellular and molecular metabolism, showing promising results regarding the reduction of acute pulmonary inflammation. To compare the photomodulation technique using near-infrared LED to conventional respiratory physiotherapy treatment in patients with COVID-19 in reversing acute conditions, reducing hospitalization time, and decreasing the need for oxygen therapy. The cohort was comprised of 30 patients undergoing COVID-19 treatment who were divided and allocated into two equal groups randomly: the LED group (LED), treated with infrared LED at 940nm and conventional therapy, and the control group (CON), who received conventional treatment (antibiotic therapy for preventing superimposed bacterial infections, and physiotherapy) with LED irradiation off. Phototherapy used a vest with an array of 300 LEDs (940nm) mounted on a 36cm×58cm area and positioned in the patient's anterior thoracic and abdominal regions. The total power was 6W, with 15min irradiation time. Cardiopulmonary functions and blood count were monitored before and after treatment. The patients were treated daily for 7days. Statistical analysis was conducted using a two-tailed unpaired Student's t-test at a significance level of α=0.05. Post-treatment, the LED group showed a reduction in hospital discharge time and a statistically significant improvement for the following cardiopulmonary functions: Partial Oxygen Saturation, Tidal Volume, Maximum Inspiratory, and Expiratory Pressures, Respiratory Frequency, Heart Rate, and Systolic Blood Pressure (p<0.05). Regarding blood count, it was observed that post-treatment, the LED group presented with significant differences in the count of leukocytes, neutrophils, and lymphocytes. Photobiomodulation therapy can be used as a complement to conventional treatment of COVID-19, promoting the improvement of cardiopulmonary functions, and minimization of respiratory symptoms.

Comparison of Two Thoracic Kinesio-Taping Techniques on Pulmonary Function, Oxygen Saturation, and Exercise Capacity in COPD Patients: A Randomized Clinical Trial

Context: Chronic obstructive pulmonary disease (COPD), though a disease of the lung, the extrapulmonary manifestations contribute significantly to morbidity and mortality. Aim: This study aims to evaluate and compare the effects of two different thoracic kinesio taping techniques on pulmonary function, oxygen saturation, and exercise capacity in patients with COPD. Settings and Design: A randomized clinical trial was conducted across tertiary health-care hospitals in Belagavi, Karnataka. Subjects and Methods: A total of 42 participants aged 30–65 years (51.58 ± 10.21 years) participated in the study. All participants underwent baseline evaluations for pulmonary function, oxygen saturation, and exercise capacity, following which they were randomly allocated to one of the two intervention groups. Both groups, Group A (diaphragmatic taping) and Group B (intercostal muscle taping), were given intervention for 15 days, with the applied tape changed on every 3rd day. Postintervention evaluation was performed on the 15th day. Statistical Analysis: Mann–Whitney test was used for between-group comparison, and the Wilcoxon test was used for within-group comparison. Results: A significant improvement was noted in all parameters in Group A except forced expiratory volume in 6 s (FEV6) (P = 0.47) and FEV1/FEV6 (P = 0.301) ratio when compared with preintervention values. In Group B, all the parameters showed a significant improvement compared to preintervention values. The between-group comparison showed that only FEV1/FEV6 (P = 0.018) ratio showed a significant improvement. Conclusion: There is no significant difference between diaphragmatic taping and intercostal muscle taping technique. It was noted that both the techniques were equally effective in improving pulmonary function, oxygen saturation, and exercise capacity in COPD patients. Hence, thoracic kinesio taping, in addition to conventional physiotherapy treatment, can help in achieving better patient outcomes.

Efekat robotski potpomognutog hoda i tradicionalnog treninga na motorička oštećenja kod dece sa cerebralnom paralizom

Aims. The aim of the study was to assess the effectiveness of robotic-assisted gait treadmill training (Lokomat) as an adjunct to traditional physiotherapy in improving the range of motion, muscle strength and decreasing spasticity in lower extremities in children with cerebral palsy. Materials and Methods. Twenty-six participants, with mean 7.69 ± 2.90 years, levels I-IV on Gross Motor Classification System (38.5% level I-II and 61.5% level III-IV) with a bilateral and unilateral form of cerebral palsy underwent intensive 20 Lokomat and 20 traditional physiotherapy sessions, each training session lasting 40 minutes. Preand post-testing was done using goniometer measure, manual muscle testing and modified Ashworth scale. Results. Positive effects were seen in participant who underwent a combination of Lokomat training and traditional therapy. An increase in the range of motion was minimal (2 - 4 degrees) in hip flexion, extension, and abduction. A significant improvement was achieved in ankle dorsiflexion on the right (p = 0.003) and left side (p = 0.006), while the values of knee extension for the left and right extremity were p = 0.062 left and p = 0.075, respectively. An increase in muscle strength of the lower limb was seen in 30.8% - 80% of participants. Reduction of spasticity in adductors, hamstrings and gastrocnemius were seen in 26.9% of participants. Conclusion. Lokomat training is an adjunct to conventional physiotherapy treatment. It has a negligible effect on the increase in the range of motion and muscle strength of the lower limb and reduction of spasticity in children with cerebral palsy.

Effect of Trunk Stabilization Exercises on Static and Dynamic Sitting Balance among Children with Cerebral Palsy: A Randomized Control Trial

Aim: To evaluate the effectiveness of trunk stabilization exercises on Static and Dynamic Sitting Balance among Children with Cerebral Palsy Method: This randomized controlled trail was conducted at physiotherapy department, Mayo hospital, Lahore. 38 children were with cerebral palsy were enrolled in this study via non-probability purposive sampling technique which later on randomized and allocated to two equal groups. Group A received specific core stability training while group B received conventional physical therapy treatment. Written informed consent was procured from every participant or their guardian through signed consent forms. Questionnaire used for data collection was Gross Motor Function Measure (GMFM-88) also used for assessment of sitting balance. Results: Descriptive statistics showed participants were having mean age of6.00 ±2.00 for group A and 5.52±.1.80 for Group B. Participants who received trunk stabilization exercises showed marked improvement as compared to group B. There was a statistically significant improvement in all measured variables following the intervention (P&lt;0.05). Pre-treatment sitting GMFM mean score in group A was 27.54 ± 3.61, while in group B was 26.48 ± 4.64. After 3 week treatment mean score in group A was 30.04 ± 3.81 and in group B was 27.43 ± 4.36 and post treatment mean score in group A was 32.80 ± 3.54 and in group B was 29.46 ±4.36. Practical Implication: This research would lay another evidence highlighting the effectiveness of trunk stability exercises to not only improve sitting balance among cerebral palsy patients but also the quality of life among them. Conclusion: It was concluded from the study that trunk stabilization exercises showed significant improvement in static and dynamic sitting balance scale among cerebral palsy children. The children when treated with trunk stabilization exercises showed a significant treatment outcome when analyzed on Gross Motor Function Measure GMFM-88. Keywords: Cerebral Palsy, Trunk control, Static sitting Balance, Dynamic sitting balance, GMFM-88.

Effect of Proprioceptive Neuromuscular Facilitation on Basic Motor Skills in Children with Down Syndrome

Objective: Trisomy 21 is a genetic disorder occurs in 92% individuals. Majority of the skeletal abnormalities are associated with it. Therefore the study had been planned with an aim to determine the effect of PNF on basic motor skills in child Down syndrome children. Methods: The study design was quasi-experimental. 22 children were included on inclusion &amp;exclusion criteria. The data was collected from Rising Sun Institute for Special Children Lahore Group A was treated with conventional physical therapy whereas Group B were treated with PNF technique and conventional physical therapy. Pre-assessment was done by using GMFM. Each subject received 36 treatment sessions with 03 sessions per week. The session continued for 30 minutes for both groups. Post treatment reading for Gross Motor Function Measure was recorded after the end of 12 weeks. The collected data analyzed by using Statistical Package for Social Software (SPSS). Results: It showed that across the group comparison shows both treatments which are applied to both groups shows good results as their mean difference values show it and their P value are not significant. Results also showed that within the group comparison PNF has better results on group B patients as per their mean difference values show it and their p values are significant. Conclusion: The study concluded that the PNF technique has better effect in Down syndrome children as compared to conventional physical therapy treatment in children on gross motor skills like standing, walking, running jumping Keywords: Down syndrome (DS), Proprioceptive Neuromuscular Facilitation (PNF), Gross Motor Function Measure (GMFM).

Comparison Between Proprioceptive Neuromuscular Facilitation and Neuromuscular Re-Education in Patients with Bell’S Palsy

The condition known as Bell's palsy results in the weakness of fascial muscles causing it to sag and stiffen on that side. It results from damage to the 7 cranial nerve. objective: To identify the comparative effects between the PNF and neuromuscular re-education. Methods: It was randomized clinical trial with non-probability purposive sampling. Data were collected from Aziz Fatima, DHQ, Allied and MTH hospital of Faisalabad. The study consisted of 30 patients (males and females), 15 participants were randomly divided in each group by lottery method. Group A treated by proprioceptive neuromuscular facilitation with conventional physical therapy that include EMS and home plan exercises. Group B treated by neuromuscular re-education facilitation techniques with conventional physical therapy treatment. Total treatment was of 4 days per week for 4 weeks. Data were analyzed by SPSS version 21.0. Results: The findings indicated that Group A had a considerably greater value on the Facial Disability Index (FDI). Group A differed significantly from Group B in each single element (physical and social functioning), while Group B showed very moderate recovery on FDI. Conclusions: After completing four weeks of treatment, PNF demonstrated considerable reduction in facial dysfunction in conjunction with conventional PT treatment. In the case of facial paralysis, proprioceptive neuromuscular facilitation combined with conventional treatment is more efficient than neuromuscular re-education combined with conventional PT.

Effect of virtual reality and conventional physiotherapy on rehabilitation of distal radius fracture

Rehabilitation sometimes may be an uncomfortable and tiring method that incorporates multiple activities and sets of exercises which patients require to perform to achieve good prognosis, for a significant period of time. Unfortunately, most of times the patients frequently become not willing, aggravated, and need inspiration and feel exhausted which makes recovery from the condition will less proficient. Use of the Virtual Reality have been broadly executing into rehabilitation program intends to make the process of recovery more energizing, invigorating and engaging for patients. Within this protocol, we propose to utilization of head wearing gadget name Oculus Quest for patient's wrist recovery after Colle’s fracture. After receiving Institutional Ethical committee approval, we will include 40 Colle’s fracture patients, and randomly divide them in two groups. Further group A will receive conventional physiotherapy treatment and group B will receive treatment from Virtual reality as well as conventional treatment for 4 weeks. Pre and post treatment assessment for Pain, Range of motion and functional parameters will be evaluated. The primary aim study is to check the impact of virtual reality and conventional physiotherapy after Colle’s Fracture. This exploration will help in distinguishing quick and longterm impacts of Virtual reality in DRF patients. The investigation results would assist in forming the newly planned strategies with better prognosis in rehabilitation of patients with Colle’s fracture.

Effects of Sensorimotor Stimulation Program with and Without Routine Physical Therapy on Balance and Cognitive Performance in Patients with Mild Traumatic Brain Injury: A randomized Controlled Trial

The term "Traumatic brain injury (TBI)" has replaced the phrase "head injury." A disturbance in neuronal activity caused by the application of a quick, abrupt, and unbearable mechanical force is classified as traumatic brain injury. Every year, around 1.7 billion new cases of TBI are recorded worldwide. Objectives: To compare the effects of Routine physical therapy and Routine physical therapy along with Sensorimotor stimulation program on balance and cognitive performance in patients with mild traumatic brain injury. Methods: A total of 64 patients were divided into two groups, each including 32 people. Those in Group A got routine physiotherapy, whereas patients in Group B also received sensorimotor stimulation. Patients were randomized to groups at random using a lottery system. The study was intended as a single RCT with blinding. The duration of the intervention was sixteen weeks. Data was gathered on the first day prior to the implementation of treatments, then again after eight weeks, and finally after sixteen weeks. The obtained data was evaluated using the Berg balance scale and the Rancho loss amigos scale. Results: In group A, balance before treatment was 21.90±5.43 and after treatment of 8th and 16th weeks it was 25.93 ± 4.977 and 39.62 ± 5.68. Mean of cognition before treatment was 5.15 ± 0.94 and after treatment of 8th and 16th weeks it was 5.468 ± 0.802 and 5.90 ± 0.85 with p-value &lt; 0.05. In group B balance before treatment was 21.43 ± 5.17 and after treatment of 8th and 16th weeks it was 27.12 ± 6.59 or 52.78 ± 2.70, mean of cognition before treatment was 5.12 ± 1.00 and after treatment of 8th and 16th weeks it was 6.250 ± 0.87 and 7.70 ± 0.4 with p-value &lt; 0.05. Conclusions: The study concluded that both treatment plans were effective for balance and cognitive performance but sensorimotor along with physical therapy significantly better outcomes as compared to conventional physical therapy treatment.