Comparison between specific lumber mobilization and core-stability exercises with core-stability exercises alone in mechanical low back pain

To Compare the Specific Lumber Mobilization [SLM] techniques and Core-Stability [CS] Exercises with Core-Stability Exercises Alone in Mechanical low back pain [MLP] A 6 month pretest-posttest design, quasi experimental study was conducted at department of physiotherapy Khyber Teaching Hospital [KTH] Peshawar, Pakistan. We conveniently selected a sample 40 patients and placed into two groups. The SLM techniques with CS exercises was applied in group A and CS exercises alone in group B for 6 weeks. The Oswestry Disability Index [ODI] and Visual analog scale [VAS] for mechanical low back pain were assessment tools assessed for all patients before and after 6 weeks of physical therapy intervention. Data was analyzed by SPSS and statistical test were applied at 95% level of significance determine the efficacy of both the treatments regimes and compared with each other. After comparison between two groups, the group A treated with specific lumber mobilization techniques shows better results in improving pain [p=0.008] and reducing physical disability [p=0.004] as compared to the group B treated with specific lumber mobilization techniques alone [pain intensity: p= 0.172 and physical disability: p=0.201]. It is concluded that patients with mechanical low back pain will show more improvement in pain and function while treated by specific lumber mobilization and core stability exercises as compared to those patients who will be treated by specific joint mobilization techniques

efficacy of sustained natural apophyseal glides with and without isometric exercise training in non-specific neck pain

To determine the efficacy of Sustained Natural Apophyseal Glides [SNAGs] with and without Isometric Exercise Training Program [IETP] in Non-specific Neck Pain [NSNP]. This randomized control trial of one year duration was conducted at out-patient department of Physiotherapy and Rehabilitation, Khyber Teaching Hospital [KTH] Peshawar, Pakistan from July 2012 to June 2013. The sample of 102 patients of NSNP were randomly selected through simple random sampling technique, and placed into two groups. The SNAGs manual physical therapy technique with IETP was applied on 51 patients in group A and SNAGs manual physical therapy techniques was applied alone on 51 patients in group B. The duration of intervention was 6 weeks, at 4 times per week. The Neck Disability Index [NDI] and Visual Analog Scale [VAS] for neck pain were assessment tools used for all patients before and after 6 weeks of physical therapy intervention. All the patients were assessed through NDI and VAS before intervention and at the completion of 6 weeks program. The data of all 102 was analyzed by SPSS-20 and statistical test was applied at 95% level of significance determine the efficacy of both the treatments interventions and compare with each other. The patients in group A, treated with SNAGs and followed by IETP for 6 weeks, demonstrated more improvement in pain and physical activity as assessed by VAS [p=0.013] and NDI [p=0.003], as compared to the patients treated with SNAGS alone, as pain and function assessed by VAS [p=0.047] and NDI [p=0.164]. In group A the NDI score improved from 40 to 15 and VAS from 7 to 4, while in group B the NDI score improved from 42 to 30 and VAS from 7 to 4. Patients with non-specific neck pain treated with SNAGs manual physical therapy techniques and followed by IETP was more effective in reduction of pain and enhancement of function, as compared to those patients treated with SNAGs manual physical therapy techniques alone

Effects of Active Self Propelled Wheel Chairs versus Regular Standard Wheel Chairs on Quality of Life in Paraplegic Population

To observe the effects of Active Self Propelled Wheel Chairs versus Regular [Standard] Wheel Chairs on Quality of Life in Paraplegic Population. This observational study was conducted in three union councils of district Swat from the period of January to December 2012. The total of 50 paraplegic patients were selected and placed into two groups. After taking a written consent Active Wheel Chair Self Propelled was provided to the patients in group A, and Regular Wheel Chair Standard to the patients in group B. Initially all the patients were trained for the proper use of wheel chair. The baseline characteristics were same in all patients. The individual prioritize problem assessment instrument [IPPA] was used an assessment toll, and it measures the effects of assistive technology. IPPA score was calculated for all patients at baseline and after 3 months use of wheel chairs. The quality of life was significantly more enhanced in group A with Active Self Propelled Wheel Chairs [P=O.OOl], as compared to group B with Regular Standard Wheel Chairs [P=0.541], in paraplegic population, as assessed by the individual prioritize problem assessment instrument [IPPA]. The Active Self Propelled Wheel Chairs are more effective for the enhancement in quality of life, as Compare to Regular Standard Wheel Chairs in Paraplegic Population

Efficacy of Paraffin Wax Bath with and without joint mobilization techniques in rehabilitation of post-traumatic stiff hand

Objective: Post-traumatic stiff hand is common a condition which causes pain and disability, the paraffin wax bath and joint mobilizations have the key role in its rehabilitation. We conducted the present study to determine the efficacy of paraffin wax bath with mobilization techniques compared with joint mobilization alone

Methodology: This single blind randomized control trial was conducted on 71 patients in department of physical therapy and rehabilitation, Riphah International University Islamabad, and patients with posttraumatic stiff hand after distal upper extremity fractures, were included. The patients were randomized into two groups: the joint mobilization techniques with paraffin wax bath were included in group A, and joint mobilization techniques without paraffin wax bath in group B. The study variables were pain score on visual analogue scale [VAS] 0/10, thumb function score [TFS] and passive range of motion [PROM] of wrist flexion, extension, radial and ulnar deviation, and were compared at baseline and at completion on planof-care after six weeks

Results: Seventy one patients with post-traumatic stiff hand were enrolled and placed randomly into two groups. The baseline characteristics were similar in both groups. Six week after intervention, patients in group A had more improvement in pain score [p=0.001], TFS [p=0.003], and PROM of wrist flexion [p=0.002], extension [p=0.003], radial deviation [p=0.013], and ulnar deviation [p=0.004], as compared to group B. However, in group B the improvement was less in pain score [p=0.104], TFS [p=0.520], and PROM of wrist flexion [p=0.193], extension [p=0.1081], radial deviation [p=0.051], and ulnar deviation [p=0.168], as compared to group A

Conclusion: Paraffin wax bath with joint mobilization techniques are more effective than mobilization techniques without paraffin wax bath in the rehabilitation of post traumatic stiff hand

Role of Early Range of Motion Exercises in Reduction of Scar Formation and Prevention of Contracture in Sub-acute Stage of Burn Patients

To determine the role of early passive range of motion exercises in the reduction in scar formation and prevention of Contracture in sub-acute Burn Patients. Study Design: Randomized Control Trail [RCT]. Burn Centre Pakistan Institute of Medical Sciences Islamabad, from January to December, 2010. Thirty patients were selected from the burn center at Pakistan Institute of Medical sciences [PIMS] Islamabad, age ranging from 12-60 years, and were randomly placed into two groups, 15 patients in each group. The anti-contracture positioning program was applied on group A with early passive range of motion [PROM] exercises of the involved areas and in group B only anticontracture positioning program was applied. The Vancouver Scar Scale [VSS] was used as an assessment tool and 4 variables were assessed including vascularity, height/thickness, pliability, and pigmentation. Data was analyzed on SPSS version-20 and independent t-test was applied at 90% level of significance to calculate the p-value for group A and B. The results show that the anti-contracture positioning with early passive range of motion [PROM] exercises reduced scar formation and prevent contractures more significantly in group A [P-value =0.002] with average VSS score 6, as compare to the anticontracture positioning alone in group B [P-value=0.435] with VSS score 10, as assessed at the completion of physical therapy management program in all the 30 patients of subacute stage of burn. It was concluded that the early passive range of motion exercises with anti-contractures positing can reduce the amount of scar formation, prevent contractures and increase the quality of physical therapy management in sub-acute stage of burn patients

efficacy of Rib Cage Mobilization on lung function in COPD patients

To determine the efficacy of rib cage mobilization on lung function in COPD patients. This randomized control trial was carried out at Department of Physical Therapy and Rehabilitation, Fauji Foundation Hospital, Rawalpindi and Railway General Hospital Rawalpindi, Pakistan from sep. 2010 to sep. 2011. Sixty two patients were randomly placed into two groups, 35 in group A and 27 in group B. The inclusion criteria was at least one year history of COPD, altered Dyspnea index, and decrease FEV1/FVC ratio and the exclusion criteria was less than one year history of COPD, normal Dyspnea index and no change in FEV1/FVC ratio. All the patients were treated for three weeks and rib cage mobilization was applied in group A and deep breathing exercise in group B. The rib cage mobilization was applied in sitting and side lying position for 10[th] to 2[nd] ribs and in supine position for 1[st] rib. The Dyspnea index and FEV1/FVC ratio were used as assessment tools, and were calculated before and after the therapy intervention. The data was analyzed by SPSS v 20 and paired t- test was applied to calculate the probability at 95% level of significance. The rib cage mobilization increased FEV1/FVC ratio and Dyspnea index significantly [P=0.004, P=0.006] in group A, as compared to the deep breathing exercise in group B [P= 0.073, and P=0.083]. We conclude that rib cage mobilization had very effective role in increasing rib cage mobility and improve lung function in COPD patients