Objective: To investigate the level of self-efficacy and disability in patients with rheumatoid arthritis (RA) and to examine the relationship of patient self-efficacy and disability with age and disease duration. Methods: A cross-sectional survey was conducted at the department of rheumatology in JPMC, Karachi from June to November 2017. Patients who had RA as main disease, age above fifteen years, disease duration of three months or above and cognitively able to answer the questionnaires were consecutively included. Self-efficacy was measured by Arthritis Self-Efficacy Scale (ASES) and disability assessed by Health Assessment Questionnaire. The relationship between ASES and disability, age and disease duration were examined using Spearman's rho test. Statistical analysis was undertaken using SPSS for Windows, version 22. Results: Of 100 RA patients, 32% had average self-efficacy. Whereas moderate to severe disability existed in 59% of the patients. A spearman's correlation showed that arthritis self-efficacy was strongly correlated with disability (r= -0.751, p= <.0001), moderately with disease duration (r= -0.359, p= <0.0001) and weakly with age (r= -0.284, p= 0.004) whereas disability had direct moderate correlation with age and disease duration (r= 0.396, p= <0.0001 and r= 0.423, p= <0.0001, respectively). Conclusion:This cross-sectional survey concluded that average self-efficacy and moderate to severe disability exist in RA patients. Enhancing the patient's self-efficacy should be an essential part of a total treatment program of RA so that disability, treatment cost and visits to health care system could be reduced.

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Introduction: Stroke is one of the leading causes of death worldwide. Despite the glowing advancement of Virtual Reality Therapy (VRT), clear evidence about its effectiveness in stroke is still scarce. Hence it is essential to review the current information to provide up-to-date insight. Therefore the aim of this review is to evaluate the effects of VRT on the balance and Health-related Quality of Life (HRQoL) in patients with stroke.Data Sources: A literature search was done in Google Scholar, PEDro, Cochrane Library, Medline, Web of Science, and PubMed databases.Eligibility Criteria: We performed a systematic review of randomized controlled trials published from June 2014 to January 2020, evaluating the effects of VRT on the balance and/or HRQoL in stroke. Fourteen eligible trials were analyzed, of which, 7 studies focused on balance and 7 on HRQoL.Quality Appraisal: Methodological quality and risk of bias were assessed using the Cochrane tool.Results: Most of the trials supported the effectiveness of VRT in improving balance and HRQoL. However, few trials reported similar improvements in HRQoL using VRT via Nintendo WiiTM games and conventional physiotherapy.Conclusions: High to moderate evidence supports the effectiveness of VRT use in improving balance and HRQoL in stroke survivors.