Relationship between gross motor function of cerebral palsy children and quality of life of their primary caregivers.

OBJECTIVE: To determine the relationship between gross motor function of children with cerebral palsy and quality of life of their primary caregivers. METHODS: The cross-sectional analytical study was conducted from December 2020 to August 2021 at the Sindh Institute of Physical Medicine and Rehabilitation and the Rabia Moon Trust, Karachi, and comprised children with cerebral palsy and their caregivers. The children were assessed on the basis of Gross Motor Function Measure-66 and Gross Motor Functional Classification System, while the caregivers were asked to complete the self-administered World Health Organisation Quality of Life-BREF questionnaire. All the categorical variables were presented through frequencies and percentages. Spearman's Correlation was applied to evaluate the correlation. Data was analysed using SPSS 16. RESULTS: Of the 43 children, 26(60.5%) were male and 17(39.5%) were females. The overall mean age was 5.70±1.820 years. Among the caregivers, 40(93%) were females and 3(7%) were males. The mean age of the caregivers was 27.70±4.77 years. None of domains of quality of life showed significant correlation with total score of Gross Motor Function Measure-66 (p>0.05). CONCLUSIONS: The disease severity among children with cerebral palsy was not a factor associated with quality of life of the caregivers. The physical health was relatively lower among the caregivers, but it was not associated with motor disabilities.

Effect of hip joint mobilisations and strength training on pain, physical function and dynamic balance in patients with Knee Osteoarthritis: A randomized controlled trial.

OBJECTIVE: To determine the effects of hip joint mobilisations and strengthening exercises on pain, physical function and dynamic balance in patients with knee osteoarthritis. Methods: The single-blind three-arm parallel randomised controlled trial was conducted at Sindh Institute of Physical Medicine and Rehabilitation, the outpatient department of Dow University of Health Sciences' Ojha Campus, Rabia Moon Memorial Welfare Trust and the Civil Hospital, Karachi, from January to July 2021. The sample comprised patients aged at least 50 years having knee osteoarthritis grade 1-3. The patients were randomised into 3 equal groups, with group A receiving hip mobilisations along with strengthening exercises of hip and conventional knee exercises, group B receiving strengthening exercises of hip along with conventional knee interventional exercises, and group C receiving conventional knee exercises only. Pain, physical function and dynamic balance were assessed using visual analogue scale, knee injury osteoarthritis outcome score and four-step square test, respectively, at baseline and after 18th session. Data was analysed using SPSS 21. RESULTS: Of the 74 subjects assessed, 66(89.2%) were included; 22(33.3%) in each of the three groups. The sample had 19(28.8%) male subjects and 47(71.2%) female. The mean age in groups A, B and C were 55.64±3.56 years, 53.64±4.65 years and 54.91±4.30 years, respectively. There was significant difference among groups post-treatment (p<0.001). Significant improvement was also found in inter-group analyses of all outcomes (p<0.001). CONCLUSIONS: Addition of hip joint mobilisations provided better results compared to the other two groups. Clinical Trial Number: https://clinicaltrials.gov/ct2/show/NCT04769531.

Hamstring Tightness Among Individuals With Neck And Low Back Pain: A Cross Sectional Study In A Public Sector Institute Of Karachi.

Objectives: To determine the frequency of hamstring tightness and its impact among patients with chronic neck and low-back pain. METHODS: The analytical, cross-sectional study was conducted at the outpatient department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, from September 10, 2021, to January 31, 2022, and comprised patients of either gender aged 18-40 years with non-specific cervical and lumbar pain for more than 3 months. The participants were divided into 2 groups. Group A included those with chronic neck pain and group B included participants with chronic low-back pain. Clinical assessment was done to measure hamstring tightness and pain by using the active knee extension test and the visual analogue scale, respectively. Data was analysed using SPSS 24. RESULTS: Out of 104 participants, there were 52(50%) males and as many females. The overall mean age was 28.15±5.10years. There were 52(50%) subjects in each of the two groups. Hamstring tightness was found in 73(70.2%) subjects. Patients with chronic low-back pain reported more tightness of hamstring muscle 38(73.1%) than those with chronic neck pain 35(67.3%) (p>0.05). CONCLUSIONS: Hamstring tightness was frequent among patients with chronic neck pain and low-back pain though not significantly.

Frequency of median nerve tightness and its association with upper limb functions among smartphone users of a public sector university, Karachi.

OBJECTIVE: To determine median nerve tightness in smartphone users, and to compare the upper limb functions between those with and without median nerve tightness. Methods: The cross-sectional, observational study was conducted at the Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, from March 2020 to January 2021, and comprised subjects of either gender aged 20-40 years who had been using smartphone for >1 year. Body mass index was calculated. The participants were evaluated using upper extremity functional index-15. A hand-held dynamometer was used to assess handgrip strength, and a pinch meter assessed the pinch strength. Manual upper limb tension test 1 was used for median nerve tightness. Frequencies and percentages were drawn for all categorical variables. Data was analysed using SPSS 22. RESULTS: Of the 277 subjects, 198(71.5%) were females. The largest group 176(63.5%) was aged 21-25 years. The mean upper limb functional index was 84.24±15.09. Also, 113(40.8%) subjects were positive for left-side median nerve tightness and 122(44%) were positive on the right side. There was no significant association between median nerve tightness and upper extremity function (p>0.05). The association, however, was significant with the duration of mobile usage in years (p<0.05). Conclusion: Prolonged overuse of smartphone may lead to symptoms of median nerve tightness, but it was not found to have an effect on upper limb function, handgrip and pinch strength.

Physiotherapy practices for patients undergoing coronary artery bypass grafting: A cross-sectional study.

OBJECTIVE: To evaluate physiotherapy practices in the rehabilitation of patients undergoing coronary artery bypass grafting. METHODS: The cross-sectional study was conducted from October 2016 to January 2017 in cardiac care units of two private and two government hospitals in Karachi, and comprised physiotherapists dealing with patients undergoing coronary artery bypass grafting. Data was collected using a modified and validated version of 'tucker q' questionnaire. Data was analysed using SPSS 21. RESULTS: Of the 101 physiotherapists, 60(59.4%) were females and 41(40.6%) were males. The overall work experience was 4.89+2.08 years. Of the total, 60(59.4%) physiotherapists used air suctioning in preoperative physiotherapy practices. Relaxation techniques were used by 86(85.10%) professionals and postural drainage by 85(84.20%), while breathing exercises were used by 65(64.4%) subjects in postoperative physiotherapy practices. CONCLUSION: Physiotherapists were found to be more or less keeping abreast with advances made regarding managing patients undergoing cardiac artery bypass grafting.

Frequency of sleep disturbance with chronic low back pain: a cross sectional study.

OBJECTIVE: To determine the frequency of sleep disturbance among individual with chronic low back pain, and to explore the association between the two. METHODS: The cross-sectional study was conducted from January to March, 2017, at the Physiotherapy Department of the Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, and comprised patients of either gender aged 18-40 years with at least a three-month history of chronic low back pain. . Data was collected using insomnia severity index for sleep disturbance and Rolland Morris questionnaire for disability due to chronic low back pain. Data was analysed using SPSS 21. RESULTS: Of the 110, patients 68(62%) were males. The overall mean age of the sample was 31.79±6.18 years. Mean functional disability score was 13.66+2.44, while 84(76.4%) had sleep disorder; 78(70.9%) having sub-threshold insomnia, and 6(5.5%) with clinical insomnia of moderate severity. There was a positive intermediate correlation between sleep disorder and functional disability (p<0.05). CONCLUSIONS: Frequency of sleep disturbance was high in patients with chronic low back pain. There was an intermediate positive correlation between the two.

Importance of Multifidus Muscle Activity as a Treatment Outcome Measure in Chronic Low Back Pain.

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