Objectives The isokinetic evaluation of the ankle joint is important in determining the effectiveness of the rehabilitation programme for the management of ankle sprains. This study aimed to determine the effects of physiotherapy programme on isokinetic variables in individuals with grade I ankle sprains. Methods Seven patients with acute grade 1 ankle sprain (15 days of ankle sprain) were recruited. They were provided with 7 days of protection, optimal loading, ice, compression, and elevation (POLICE) treatment, and the standard physiotherapy programme consisted of towel stretching and balancing exercises on one leg. Pain scale score was recorded daily during the physiotherapy programme. The isokinetic ankle strengths of the patient's injured and uninjured legs were compared before and after the physiotherapy programme. Isokinetic tests were conducted in painless range of motion for the injured leg. Results Pain was significantly reduced after the patients underwent the standard physiotherapy programme. No significant differences were observed in terms of the ankle peak torque, time to peak torque, and ankle plantar flexion-to-dorsiflexion ratio of the injured and uninjured legs. The injured leg showed significant improvement in terms of ankle eversion-to-inversion ratio (E:I) after 7 days of performing the standard physiotherapy programme. Conclusion Performing the standard physiotherapy programme for 1 week reduces pain and improves the ankle E:I in patients with grade 1 ankle sprain.
We have compared the density of nerve fibres in the synovium in club foot with that of specimens obtained from the synovium of the hip at operations for developmental dysplasia. The study focused on the sensory neuropeptides substance P; calcitonin gene-related peptide; protein gene product 9.5, a general marker for mature peripheral nerve fibres; and growth associated protein 43, a neuronal marker for new or regenerating nerve fibres. In order to establish whether there might be any inherent difference we analysed the density of calcitonin gene-related peptide-positive nerve fibres in the hip and ankle joints in young rats. Semi-quantitative analysis showed a significant reduction in the number of sensory and mature nerve fibres in the synovium in club foot compared with the control hips. Calcitonin gene-related peptide (CGRP) positive fibres were reduced by 28%, substance P-positive fibres by 36% and protein gene product 9.5-positive fibres by 52% in club foot. The growth associated protein 43-positive fibres also seemed to be less in six samples of club foot. No difference in the density of CGRP-positive nerve fibres was observed in the synovium between ankle and hip joints in rats. The lack of sensory input may be responsible for the fibrosis and soft-tissue contractures associated with idiopathic club foot.
Focal hand dystonia after stroke, a result of maladaptive plasticity, impairs hand function, affects daily activities, and undermines independence. A 59-year male patient, who had developed focal hand dystonia after suffering from ischemic stroke 5 years ago, received training following an injection of Botulinum Toxin A (BoNTA). Task-specific training for a duration of 60 minutes per day for 3 days per week was provided for 12 weeks. Assessments were done by using arm dystonia disability scale, action research arm test, Fugl-Meyer assessment of upper extremity, and stroke-specific quality of life. Substantial improvement was observed in all the parameters, at short-term follow-up.
Chronic mechanical neck ache is one of the most disabling conditions in general population which affects individuals’ Activities of Daily Living (ADLs). Objective: To compare the effectiveness of thoracic manipulation and MET on chronic mechanical neck ache. Methods: It was a single blind randomized clinical trial registered at ClivicalTrial.gov under trial registry no# NCT05138199. Non-probability simple random sampling was used to recruit over 30 patients. This study was conducted at Rawal General and Dental Hospital, Islamabad and at the Physiotherapy Clinic Rawalpindi. Two groups were made, group “A” was termed as control group and received MET (2 sessions/week) and group “B” was termed as experimental group and received thoracic manipulation (1 session/week), for six weeks each. Effect of these interventions were evaluated on frequency of pain, duration of pain and Numeric Pain Rating Scale (NPRS). As data were not normally distributed, we employed Wilcoxon Rank test for intra-group analysis and Man Whitney U test for inter-group analysis. Results: Both groups mean +SD of age, gender, and marital status was 26.27+8.55 and 1.60+0.49, 1.20+0.40, respectively. Wilcoxon Rank test showed marked difference within both groups as p-value was <0.05 and “r value >0.05” showed larger effect of interventions. Man-Whitney U test showed no significant difference between groups as p-vale was >0.05. Conclusion: Both manipulation and MET are effective for management of chronic mechanical neck ache and both have same impact on NPS.
Dysmenorrhea is a painful syndrome that accompanies the menstrual cycles. Objectives: The main objective of this research was to determine the effects of yoga exercises on pain and quality of life in female undergraduate students suffering from primary dysmenorrhea. Methods: After taking approval from Ethical review committee of Rawal Institute of Health Sciences, an observation type of cross-section survey was conducted in 470 young undergraduate female students of age between 17-26, suffering from primary dysmenorrhea. By non-probability sampling participants were divided into two groups. Group-1 was of those females who had active lifestyle and doing yoga exercises and group-2 were of those who had sedentary lifestyle and didn’t do any kind of exercise. To measure the outcome variables, EQ-5D-5L questionnaire was used to measure QoL & NPRS to measure pain. Data were taken at baseline and after 12th week. Wilcoxon rank test was used for within group analysis and Mann Whitney U test was used to compare mean between groups. Data was analyzed in SPSS software version 21 along with Microsoft Excel 2019. Results: 21.16+2.66 &22.27+2.53 was the Mean+SD of age of group-1 & group-2 respectively. Between groups analysis revealed that p-value for NPRS was <0.05 but was >0.05 in quality of life. Conclusion: Yoga exercises are safer and easiest way to manage pain of primary dysmenorrhea in undergraduate females without any drug use.
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