Objective: The objective of this study is to compare effect of balloon blowing exercise & incentive spirometer on Chest expansion, Improvement in lung volumes and capacities, Level of dyspnoea, and on Improvement in progression of walk in post-thoracotomy stable patients. Study Design: Randomized Controlled Trial Place and Duration of Study: Study was conducted in thoracic surgical ICU of Gulab Devi Hospital, Lahore for the period of 6 months from September 2018 - February 2019. Patients and Methods: The sample size was calculated through Open Epi, and it was 48. 24 subjects were assigned to control group A and 24 to experimental group B through non-purposive random sampling technique. Data was collected at base line, 3rd and 5th day after exercise therapy on above stated outcome measures, by using Tape Measure, Digital Spirometer, RPE Scale and Pedometer respectively, from non-critical post-thoracotomy patients. Control Group-A performed routine respiratory physiotherapy + incentive spirometry and Experimental Group- B performed routine respiratory physiotherapy + balloon blowing exercise. Results: BBE + routine respiratory physiotherapy was found equally effective on mentioned outcome measure as Incentive Spirometry + routine respiratory physiotherapy in stated patients. (P >0.05) Conclusion: Based upon statistical analysis, it can be concluded that incentive spirometer can be replaced with balloon-blowing exercise with conventional/routine respiratory physiotherapy in thoracotomy patients who have lung surgeries, to overcome post-op pulmonary complications or to achieve the same outcomes as that of incentive spirometer. Keywords: BBE, Incentive Spirometer, Routine Respiratory Physiotherapy, Post-Thoracotomy Patients
Background: Literature shows that cerebral palsy becomes challenging disability with the passage of time. Various treatment protocols are used to treat balance and coordination problems during rehabilitation programs however effective techniques are still needed to address spasticity and limited range of motion. Objectives: To determine the effects of stationary cycling on spasticity and range of motion in diplegic cerebral palsy children. Methods: An interventional study design (Quasi study design) was conducted in Rising Sun Mughalpura branch and Compass Schools for Special Education Lahore in 6 months from Feb 2019 to Aug 2019, after approval of synopsis. 68children with Spastic Diplegic Cerebral Palsy meeting inclusion criteria were enrolled in the study. Sample size was estimated using formula for Sample Size determination in health studies version 2.0.21 WHO. The static bicycle was used as an intervention tool. Two readings were taken before and after treatment. The data was analyzed by using IBM SPSS 20. Qualitative variables age, weight, gender and height were expressed as percentages. As the data found was parametric with a homogenous impression, paired sample t test was used to compare mean score at pre-post levels for ashworth scale and range of motion at knee and ankle joints. A p value less than 0.05 were taken as significant. Ashwroth Scale was used for spasticity and for Range of Motion goniometer was used. Results: The paired sample statistics of pre-post testing of Ashworth Scale Score for calf muscles (M= 1.02, SD= 0.79), while for hamstring muscles (M= 1.13 SD= 0.84) with the significant p value 0.00. Knee and ankle range was (M=9.70, SD= 0.54) and (M=0.82, SD= 2.69) respectively, with a significant p value 0.00 for both. Conclusion: It is concluded that stationary cycling has significant role in decreasing spasticity and increasing range of motion in children with diplegic spastic cerebral palsy.
Aim: To compare the effects of the Mulligan two-leg rotation technique (TLR) and the Muscle Energy Technique (MET) on hamstring flexibility. Methods: The Double-blinded randomized controlled trial was conducted among 108 subjects including both males and females with the age group of 18-35 years and on examination having hamstring tightness measured by an Active Knee Extension (AKE) Test. Group A was given Mulligan’s Two leg rotation (TLR) technique with routine physiotherapy, and Group B was given Muscle energy technique (MET) with routine physiotherapy. A total of 12 sessions were given to both groups, 3 sessions per week. Data was calculated at baseline and after every 6th session. Results: Group A had 50% males and females and Group B had 53.7% males and 46.3% females. There was a significant improvement in the flexibility of the hamstring with the application of Mulligan-TLR and MET. However, the increase in AKE range of motion was higher in MET compared to the Mulligan TLR group. Mann-Whitney U test was used to compare the mean between the two groups and shows a significant difference in values of Numeric Pain Rating scale (NPRS) (P˂0.005) and AKE (P˂0.005) after 12 sessions. Conclusion: The study demonstrated that both techniques are effective in improving hamstrings flexibility but better results are shown with MET. Therefore, it is concluded that both can be administered in clinical practice for improving hamstring flexibility. Keywords: Knee, Low back pain, Pain
Background: Pelvic floor dysfunction is the inability to relax and integrate the pelvic muscles appropriately. Constipation, bladder/bowel incontinence, and frequent bladder urges are the common symptoms. Objective: To determine the effects of physical therapy on pelvic floor dysfunction among women. Methods: It was a randomized controlled trial conducted between February to December 2021. About 72 patients were included using convenient sampling and they were equally divided into an experimental group receiving pelvic floor physical therapy and a control group receiving routine care. The woman aged between 18 to 60 years having pelvic floor dysfunction were included in the trial. Patients with pelvic organ prolapse more than stage II, urinary or vaginal tract infections and inability to understand or follow instructions were excluded. The assessment was made at baseline and after 4th week of intervention. Variables like age, body mass index and parity were presented as mean and standard deviation. The normality of the data was assessed using the Shapiro-Wilk test. The difference between pre and post-treatment readings was calculated using paired sample t-test for this parametric data. Statistical significance was set at p≤0.05. Results: The demographics including age, body mass index and parity were found to be 49.31 (12.43%), 25.71(4.56%) and 2.6(0.81%) in the pelvic floor physical therapy group and 51.23 (9.37%), 26.33(5.32%) and 2.2(93%) in the control group respectively, without any significant difference (p-value>0.05). After treatment at the 4th-week assessment, peak perineometer values (cmH2O) were found to be 6.4(5.8) in the experimental group versus 10.3(6.7) in the control group, pelvic floor distress inventory short form 27.43(17.6) versus 42.8(31.8) and short form of pelvic floor impact questionnaire 9.86(4.39) versus 16.87(6.78), with a significant difference in favor of physical therapy group (p-value>0.05). Conclusion: The study concluded that pelvic floor physical therapy is significantly better as compared to the control group for relieving pelvic floor dysfunction including its control, coordination and distress.
Objective: To determine effects of respiratory muscles training on cardiopulmonary parameters and quality of life in patients with dilated cardiomyopathy. Methodology: This Randomized Control Trial was conducted in Shifa International Hospital Islamabad from September 30, 2019 to December 31, 2019 and 22 patients with Dilated Cardiomyopathy were screened. Subjects were divided into 2 groups by sealed envelope sampling method. Bruce protocol according to ACSM guidelines (3 days per week, starting at shorter duration 5-20 min and progress to 30-40 min) was applied in Group 1. Bruce protocol same as in group 1 combined with Incentive spirometry (10-15 repetitions) and slow breathing technique was applied in Group 2. Tools and Outcome measures of study were EF, LV End systolic dimension, LV End diastolic dimension, QOL, PFT (FEV1, FVC, PEF and FEV1/FVC) and Vitals. Data was analyzed on SPSS version 21. Results: All patients in both groups were male with mean age of 51.65±6.5. Group 2 had improvement in LV End systolic dimension (pre training- 53.73+10.57, Post Training- 52.00+11.84), LV End diastolic dimension (pre training- 56.45+13.21, Post Training-55.45+14.08) as compared to Group 1 with LV End Systolic dimension ( pre training- 52.00+6.89, Post Training-51.56+6.71), LV End Diastolic dimension ( pre training- 60.00+6, Post Training-60.00+6.000). Conclusion: Respiratory muscles training by using bruce protocol combined with slow breathing and Incentive spirometry has significant effects on cardiopulmonary parameters and QOL in patients with dilated cardiomyopathy. Keywords: Congestive heart failure, dilated cardiomyopathy, Bruce protocol, Incentive spirometry, slow breathing exercise.
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