Background Stroke is a major cause of disability with mainly affecting trunk mobility and function. The purpose of this study is to determine the effectiveness of core stabilization exercises versus conventional therapy on trunk mobility, function, ambulation, and quality of life of stroke patients. Design Assessor blinded randomized control trial. Setting Ibrahim polyclinic—Shadman, Ch Muhammad Akram teaching hospital-Raiwind, Rasheed hospital-Defence. Subjects Chronic ischemic stroke patients. Intervention Control group (n = 21) underwent conventional treatment for stroke for 40 min/ day, 5 times/ week for 8 weeks. Experimental group (n = 20) received core stability training for additional 15 min along with conventional treatment. Main measures Main outcome measures were Trunk impairment scale (TIS), functional ambulation category (FAC), stroke specific quality of life (SSQOL) and trunk range of motion (ROM). Results The differences between the control group and experimental group post-treatment were statistically significant for trunk impairment, functional ambulation, quality of life, and frontal plane trunk motion (p-value < 0.05) with higher mean values for core stabilization training. The frontal plane trunk mobility and rotation showed non-significant differences post-treatment (p-value > 0.05). Conclusion This study concluded that core stabilization training is better as compared to the conventional physical therapy treatment for improving trunk impairments, functional ambulation and quality of life among patients of stroke. The core stabilization training is also more effective in improving trunk mobility in sagittal plane. This study is registered in Iranian Registry of Clinical Trials IRCT20210614051578N1 and was approved by the local research ethics committee of Riphah International University.
Children who sustain brachial plexus injuries after birth face significant functional limitations due to a variety of sequelae affecting the shoulder, elbow, or forearm. These effects could be permanent or temporary. It is critical for proper joint development to maintain complete passive mobility while neurological function is being restored. Children with Erb’s palsy are more likely to have weak muscles, which can be found by ultrasonography Objective: To determine the effects of physiotherapy on strength, range and function in children with Erb’s palsy. Methods: It was a clinical trial conducted at physiotherapy department outpatient at General hospital Lahore. A sample of 46 children aged between 0-10 years, with the C5 and C6 lesion and with limited range of motion were included while children with any history of previous or recent trauma or surgery to upper limb and to the other roots of brachial plexuses was excluded. Modified Mallet scale and active movement scale was used as outcome measures. The coin toss technique of randomization was adopted, with 'Heads' assigned to strengthening exercises and 'Tails' assigned to general treatment. Independent sample test was employed to assess pre and post differences. Physiotherapy treatments included neurodevelopmental approaches to improve proprioception input, orthosis, and electrical current stimulation. Free weights, resistance bands and manual resistance were used in the strength training. The active range of motion was evaluated using goniometry, and a baseline measurement was generated using a modified mallet scale. The treatment was given every day for six months. Post-intervention measures were implemented two, four, and six months following the intervention. SPSS 25.0 was used for data analysis. Results: The finding showed that pre-interventional oxford scale muscle strength for experimental group showed the mean and standard deviation (1.434± 0.5068), control group (1.65± 0.48) while Oxford scale muscle strength post intervention showed the results with the mean and standard deviation for the experimental group 3.13± 0.54 and control group 2.65± 0.48 and showed significant p value less than 0.005. Conclusions: The study concluded that physiotherapy integrated approach improved upper limb strength, ranges and functional abilities in patients with Erb’s Palsy.
Dry needling is a technique in which thin monofilament-based needles are inserted into soft tissues, especially trigger points in muscles. It is being used in a range of neuromuscular pain syndromes such as shoulder impingement syndrome in current study. In physical therapy, it is narrowly referred to as an intramuscular procedure for the treatment of myofascial trigger points (MTrPs). Objective: To compare the conventional physical therapy with and without dry needling on pain, range of motion, and functional disability in patients with shoulder impingement syndrome. Methods: It was randomized controlled trial conducted on 66 patients of shoulder impingement syndrome based on inclusion criteria and divided randomly allocated equally in two groups of 33 in each of conventional therapy and dry needling group. The outcome measures used were numeric pain rating scale for pain, DASH for hand arm function and shoulder ranges of motion. The SPSS 25.0 was used to analyse data. The descriptive statistics was applied, and inferential statistics was applied based on findings of tests of normality. Results: The results showed that the post interventional pain score was 1.43±1.37, 32.11 for conventional group and for experimental group that of 1.60±1.02, 34.89 with non-significant difference 0.544, while DASH score was 27.02±13.22, 38.85 for conventional group and for experimental group that of 19.92±11.20, 28.15 with significant difference 0.024. The results for flexion, abduction, internal and external rotation were non-significant with p value >0.05. Conclusions: It was concluded that although there was significant improvement in pain, range of motion and function in both of dry needling and conventional groups, however, pain and shoulder ranges improved equally in both groups without a statistically significant difference while that of disability improved significantly in dry needling group
Objective: To determine the effect of whole body vibration (WBV) therapy on gait dynamics in chronic stroke patients in a tertiary care hospital. Methods: The present study was randomized, assessor-blinded, parallel-group, clinical trial conducted at Physiotherapy Department, Lahore General Hospital, Lahore, Pakistan, from November 2017 to April 2019. After taking written informed consent, 64 chronic stroke patients were randomly allocated (1:1) to routine physiotherapy (RP) group (n=32) and whole-body vibration (WBV) group (n=32) by computer random number generator method. Twelve sessions of vibration therapy were given to WBV group with an amplitude of 3 mm and frequency of 20Hz. Sessions comprises of 5 bouts of 120 seconds with 60 seconds rest intervals for 6 days/week x 2 weeks in erect standing position. The outcome measure was score of Timed Up and Go test (TUG test) and 10 Meter Walk test (10MWT) before and after intervention. Mann Whitney U Test and Wilcoxon Signed Rank test were used to analyze data. Results: After 2-week intervention, significant difference was seen in TUG, 10 Meter Walk test Slow Speed (10MWTSS), 10 Meter Walk test fast speed (10MWTFS) score for both treatment groups (p-value<0.05). However patients in WBV group had better improvement as compared to patients in the RP group. Conclusions: Initiation of walk and Walking Speed improved with Whole-body vibration therapy in chronic stroke survivors in Pakistan. Clinical Trial Number: IRCT20190328043131N1 Key Words: Stroke, Whole body Vibration, Rehabilitation, Walk Initiation, Walking Speed, Continuous...
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