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 compare the effects of Mulligan technique and muscle energy technique in patients with adhesive capsulitis.
Methods: The randomised controlled trial was conducted at the Department of Physiotherapy, Government Mian Munshi Hospital, Lahore, Pakistan, from September 1, 2019, to March 31, 2020, and comprised patients with adhesive capsulitis who were randomised into Mulligan mobilisation Group A and muscle energy technique Group B. The outcome assessor was kept blinded to the treatment plan. Pain, range of motion and functional disability were measured using Visual Analogue Scale, universal goniometer and Shoulder Pain and Disability Indexat baseline, and subsequently at the end of third and sixth weeks. Data was analysed using SPSS 24.
Results: Of the 78 subjects, 39(50%) were in each of the two groups. Group A had 11(28%) male and 28(72%) female patients, while Group B had 20(51%) male and 19(49%) female patients. Both groups showed significant improvement (p<0.001), and inter-group comparison showed the difference to be non-significant at baseline and third week (p>0.05).However, post-intervention difference showed significantly better results in Group A compared to Group B (p<0.05).
Conclusion: Mulligan technique was found to be more effective than muscle energy technique in improving range of motion, and in reducing pain and functional disability.
Clinical Trial Number: IRCT 20200605047660.
https://www.cochranelibrary.com/es/central/doi/10.1002/central/CN-02171904/full
Key Words: Adhesive capsulitis, Mulligan technique, Muscle energy technique.
Incidence of neck pain is increasing day by day due to changed, sedentary, non-ergonomic environment and life style. This becomes the reason of an increased load of human resource and cost. To shed this load of resources and cost, it’s essential to sort out means which give real relief to this increasinglysignificant problem. To compare outcomes of sustained natural apophyseal glides (SNAGs) versus Maitland manual therapy in improving non-specific neck pain. It was a quasi-experimental study design. The study was conducted in Chaudhary Muhammad Akram, Teaching & Research Hospital, Lahore and SuriyaAzeem Teaching Hospital, Lahore within six months from June 2015 to December 2015. A total of 75 subjects with non-specific neck pain using non-probability convenience sampling technique who fulfilled the specific inclusion and exclusion criteria were randomly allocated to three groups; group 1 received SNAGs,group 2 Maitland mobilization and group 3 conventional treatment. Baseline, post-intervention and follow up readings were taken through numeric pain rating scale (NPRS) for pain intensity, neck disability index (NDI) for functional status,goniometer for range of motion and manual muscle testing for muscle strengthof neck. The subject in each group were given twelve sessions, with three sessions a week. Data were analyzed through statistical package of social sciences (SPSS) 21. The results of each group showed pre-treatment pain intensity for group 1 was 7.04+1.338 that changed to 3.52+0.714 and for group 2 it was changed from 7.52+0.872 to 5.16+0.850 and 7.16+0.943 to 5.12+0.781 for group 3. The NDI score for group 1, 2 and 3 were 31.56+5.560, 25.040+7.086 and 25.560+5.477 that were changed to 13.120+2.759, 16.360+2.899 and 12.600+2.020 respectively. The one way ANOVA test compared mean of three groups and p-value for painintensity after treatment was p=0.000 and for functional status p=0.000. The study showed that SNAGs mobilization was more effective in the management of non-specific neck pain and also conventional treatment improved functional status of neck than Maitland mobilization.
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