Background The upper limb functional index is broadly used outcome measure for musculoskeletal disorders of the upper limb. The main objective of the study was to translate and validate the upper limb functional index (ULFI) outcome measure in the Urdu language. Methods Upper limb functional index was translated into Urdu language using Beaton et al. guidelines through forward and backward translation along with the expert committee reviews. Two fifty (n = 250) Urdu-speaking patients with sub-acute or chronic conditions of upper limb musculoskeletal disorders were included in the study. The mean age was 32.33 ± 4.67 years. The data were collected from the physical therapy department of The University of Lahore Teaching hospital. All participants completed the upper limb functional index-Urdu (ULFI-U), Numeric pain rating scale (NPRS), Quick Disability of arm, shoulder, and hand (QuickDash), and (health survey) SF-12 at baseline while only ULFI-U at day three. Reliability was assessed through internal consistency by Cronbach’s alpha and test-retest reliability by intra-class correlation (ICC). Content validity was measured by Lynn and Lawshee method. Spearman’s correlation has been used to measure criterion validity. The construct validity was measured through hypothesis testing. The structural validity has been explained through factor analysis by exploratory factor analysis (EFA) using Maximum likelihood extraction (MLE) with Promax rotation. Results The English version of ULFI was translated into the Urdu language with minor alterations. The Urdu version ULFI has demonstrated high levels of reliability with intra-class correlation (ICC2,1= 0.91) and Cronbach’s alpha (α = 0.94). The content validity index found as 0.808, the criterion validity for ULFI-U correlating with quick Dash was found excellent (r = 0.845) and ULFI-U established strong correlation with 6 domains of SF-12(r = 0.697 to 0.767) and weak correlation with its 2 domains and NPRS(r = 0.520). A two-factor structure was obtained using EFA. Conclusions The ULFI-U is a valid and reliable patient-reported outcome (PRO) that can be used to assess upper limb musculoskeletal disorders in Urdu-speaking patients. Trial registration This study was registered in the U. S National Library on clinicaltrial.gov under registration no. NCT05088096. (Date: 21/10/2021).
Objective: To determine the association of panel reactive antibodies (PRA) with complement-dependent cytotoxicity (CDC) cross-match in Pakistani pre-renal transplant recipients. Study Design: Cross-sectional study. Place and Duration of Study: Immunology Department, Armed Forces Institute of Pathology, Rawalpindi from Oct 2017 to Oct 2018. Methodology: A total of 162 patients referred to the Department of Immunology for pre-transplant workup for renal transplantation were included. Informed consent was taken, and detailed history was recorded. Frequency and percentages were calculated for cross-match positivity and most frequent anti-HLA antibodies. Results: Panel reactive antibodies (PRA) were present in 48 patients (30%), while complement-dependent cytotoxicity (CDC) cross-match was positive in 16 patients (10%). Out of 141 male patients, 35 (25%) were positive for PRA, while 10 (7%) had positive CDC cross-match. Out of 21 female recipients, 13 (62%) were positive for PRA, and 6 (28%) had positive CDC crossmatch. One male patient positive for CDC cross-match was negative for PRA. Patients positive for both CDC cross-match and PRA have an average mean fluorescent intensity (MFI) of more than 4000. CDC cross-match and PRA were strongly associated, whereas no significant association was found between CDC cross-match and anti-MIC antibodies. Conclusion: Complement dependent cytotoxicity (CDC) cross-match and panel reactive antibodies (PRA) should be routine in patients undergoing renal transplants as alone CDC cross-match can give false negative or false-positive results. At the same time, CDC cross-match lacks detection of anti MIC antibodies involved in graft rejection.
Cervicogenic headache may imitate those usually connected through essential headache problems. Objective: To determine the effects of ischemic compression and positional release procedure on pain and Headache Disability Index in Cervicogenic headache. Methods: Data were collected from Physiogic Physiotherapy Clinic Lahore, for 6 months. Quasi Experimental study was conducted on 18 patients of Cervicogenic headache. All were randomly allocated to ICT group and PRT group, both groups were treated for 12 sessions in 4 weeks. NPRS, HDI were used to measure the treatment effect before and after treatment of 12 sessions in 4 weeks. Data was analyzed by SPSS 21. Results: There were 9 (50.0%) participation with mean of 26.22 and SD 2.90 in group A and 9 (50.0%) participants with mean of 24.55 and SD 2.55 in group B. Across the gathering correlation of VAS, KOOS AND AKPS with mean difference and standard p value of pre and post treatment values and within group comparison of VAS, KOOS AND AKPS showed significant difference in Group A as compared to group B. Conclusions: Result showed that significant difference found between the mean values of both technique after treatment (Post-Treatment) in HDI & NPRS in the favor of PRT because there is more variation in mean of PRT as compared to IC technique.
Congenital muscular torticollis is a problem that arises at birth or immediately after birth in which the sternocleidomastoid muscle is shortened on the afflicted side, leading to an ipsilateral rotated of the head and a contralateral rotated of the face and jaw. To determine the effectiveness of physical therapy treatment in infants treated for congenital muscular torticollis, relevant articles published between 2011 and 2020 were located using electronic databases. A total of 9 studies out of 24 potentially relevant articles were reviewed. All studies were randomised controlled trials with 6-8 score on the Physiotherapy Evidence Database scale (Pedro scale) which showed high quality of methodology. The studies typically found significant statistical effects in the management of congenital muscular torticollis. Additionally, most of the studies reported increased adherence to exercise as another essential advantage. Conservative physical therapy management showed positive outcomes, and early physiotherapy referral showed significant reduction in treatment duration. Key Words: Conservative management, Congenital muscular torticollis, Infants, Paediatric physiotherapy, Physical therapy.
Objective: To determine the prescriptive/ normative data for the Lower Extremity Functional Scale in young adult healthy Population. Methodology: Descriptive cross-sectional study was conducted on 1500 participants of normal healthy population. Health of the Participants was assessed by using the SGA-Subjective Global Assessment form. The study comprised of a brief set of questions in which age [as a constant variable and categorized into 3 groups (20-30, 31-40, and 41-50 years)] and sex of the individuals were noted. Next, they were given the lower extremity functional scale (LEFS) questionnaire. The LEFS have twenty queries in four groups. For each query, 0 to 4 points can be obtained, so 80 points can be received in total-demonstrating optimum lower extremity function (Binkley et al. 1999). Data was analyzed by SPSS 21. Results: Result showed that mean outcome/ score for their LEFS for the entire human population was 74.12 (out of 80). Men and Women had mean scores (57.31 and 77.88 respectively). Women scores high as compared to men, as the scores decreases with increasing age. Conclusion: Result showed that Lower extremity functional scale scores vary according to the age and also the gender of the participants. Lower extremity functional score decreases with increasing age. Women have relatively higher scores than men. Key words: Lower Extremity Functional scale
Objective: To determine the intra-rater reliability of modified-modified Schober’s test for measuring lumbar flexion and extension in patients of lumbar radiculopathy. Method: The case-control reliability study was conducted at the University of Lahore Teaching Hospital, Lahore, Pakistan, from March to September 2020, and comprised lumbar radiculopathy patients of either gender aged 35-60 years in group A and healthy controls in group B. Lumbar flexion and extension were measured by the same examiner on three different occasions. A non-stretching measuring tape was used in which the first two measurements were taken using the modified-modified Schober’s test on the same day with a difference of 5 minutes, and the third measurement was taken three days later to assess reliability. To assess the test-retest reliability, intraclass correlation coefficient was calculated through two-way random analysis of variance. Standard error of measurement and minimal detectable change were also calculated. Data was analysed using SPSS 25. Results: Of the 40 subjects, 20(50%) were in group A with a mean age of 45.00+/-6.72 years, and 20(50%) were in group B with a mean age of 49.60+/-6.65 years. Overall, there were 16(40%) male and 24(60%) female subjects. Within-day lumbar flexion and extension measurements were highly reliable in controls (intraclass correlation coefficient 0.93 for flexion and 0.96 for extension) as well as in patients (intraclass correlation coefficient 0.94 for flexion and 0.95 for extension). ---Continue
A recent study shows that almost 78% of population have its neck in working position within 24 hours causing continuous stress on neck and shoulders which is forcing the neck in anterior or forward head posture. This may lead to upper back tightness and muscle spasm causing nagging to sharp pain. Hence, cervical pain and neck pain getting more attention. This study is designed to narratively review the prevalence of forward head posture in young adults Methods: A structured search on literature was done through various electronic and print data bases such as: Pubmed, cinhal, google scholar, science direct, cochrane library and scopus. Those studies were included in which age ranged from 20 to 45 years. Young adults from any profession were included. Those studies were excluded in which forward head posture was reported due to any systemic issue Results: A total of 120 studies had gone through in which 65 studies were short listed and on further review only 4 studies were included as they fit in proper methodology and hence, reviewed and reported. Studies reported a considerable variation in the prevalence with the clear greater incidence Conclusions: Forward head posture is a commonly seen disorder among young adults. Investigations and interventions in time along with knowledge of postural correction can deal with this raising problem.
According to the world health organization (WHO), lower back pain (LBP) is the most common healthhazard among workers and is among the top ten health hazards around the globe. The Global Burden ofDisease (GBD) 2010 stated LBP as amongst the top 6 diseases which cause disability injuries and otherchronic diseases. This is the impairment that poses the most economic burden on society as a whole,including individuals, businesses, and the government. This study aims to find out the factors that affectlower back pain among workers associated with different professions in Pakistan. Data were collectedfrom different databases, such as PubMed, Google scholar, and PEDro by using a predefined searchstrategy with proper Boolean terms ‘AND’ or ‘OR’ or ‘NOT’. The data were collected from theliterature available for past 10 years. Additionally, articles with relevant material and titles werereviewed for conducting the current research review. The most common risk factors that were seenalmost among all professions were static position and prolonged working hours, any work that demandsprolonged standing or sitting, bending or twisting, and improper lifting. Several professional workers areat high risk for developing LBP but among all the professions physiotherapists, sonographers, bankers,and shopkeepers were at higher verge for developing LBP. It was found that the prevalence of LBP isincreasing day by day and significantly affecting workers in every profession. Therefore, timelytrainings with proper ergonomic techniques could decrease LBP and increase economic productivity inPakistan. It can be said that good ergonomics for good economics.
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