BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.
Objective: To compare the effectiveness of subtalar mobilization with movement (Mulligan technique) with conventional physiotherapy treatment for the management of planter fasciitis. Material and Methods: A single blinded randomized trial was conducted at the Prime Care Hospital, Faisalabad, Pakistan from January 2017 to August 2017. Sixty Participants were divided into intervention and control groups through a computerized random numbers. Intervention group was treated with subtalar mobilization with movement (Mulligan technique), and control group was given conventional physiotherapy for three-weeks. SPSS 20 was used for data analysis. Results: The mean age of the participants in the intervention group was 32.40 ± 8.02 years and the control group 32.59 ± 7.00 years. The mean BMI in intervention and control groups was 25.35 and 25.67, respectively. The result of our study showed that there were significant differences (P-value <0.05) between the VAS values before and after the intervention in the 3rd week between the intervention and the control group. Moreover, the intervention group showed more reduction in disability (p=0.03) compared to the control group. Conclusion: Our study concluded both methods to demonstrate benefits. However, Subtalar mobilization with movement (Mulligan technique) plus rigid tapping reduced pain and disability more effectively than conventional physiotherapy plus rigid tapping in patients with planter fasciitis. All protocols for this clinical study were registered with WHO recognized Clinical Trial Registry, with the registration number RCT20200221046567N2. Key Words: Heel pain, plantar fasciitis, physiotherapy, mobilization, mulligan technique, taping.
Objective The objective of this study was to assess school backpacks and associated problems across school going children aged 8–12 years in Lahore, Pakistan. Self-perceived pain related to bag pack use, correlation between self-reported pain and perceived weight of bag pack, duration of bag pack carriage and the method of bag pack carriage were evaluated. Methodology A cross-sectional survey was conducted on 3500 students from different private schools across Lahore. Both male and female students from the age of 8–12 years that were present on the day of the study with no apparent physical deformity or any musculoskeletal disorder were included in the study. Questionnaire used in this study was a modified questionnaire from a previous study.Data collected through questionnaire was coded into SPSS version 18.Data was represented in the form of graphs, tables, cross tabs and bar charts. Chi square test of association was applied with p value<0.05 considered as significant. Results The results indicate that 82% of students surveyed carry bag packs, 54.66% of the students perceived the weight of their bag pack heavy, 40.22% medium while only 5.12% reported their bag pack lightly weighed. Pain was higher in individuals who perceived their bag pack weight heavy (i. e., 48%) pain, who carried their bag pack for over 20 min (44%) pain and over 30 min (56%) pain, respectively. Similarly percentage of pain was higher in individuals who carried their bag pack at one shoulder (i. e., 74%) pain. Conclusion The results of the present study show that there is a relationship between bag pack use, duration and method of bag pack carriage this suggests that heavy, medium and light bag packs may have damaging effects for the school going children. A study to compare children who follow and that do not follow the recommended guidelines should be conducted to find out the guidelines could help reduce back pain, the bag pack guidelines have addressed bag pack weight and duration of carriage should be considered.
Coccydynia is a painful condition of the coccyx that can have various etiologies. Females are affected five times more than males by this condition. In addition to being chronic and difficult to manage, its symptoms can be detrimental to quality of life. Objective: To determine the prevalence of coccydynia among postpartum women. Methods: In this study, 881 postpartum women were selected through non probability convenience sampling from obstetrics and gynecology ward of Allied Hospital, Faisalabad. Self-structured questionnaire was used which contains different sections; section 1 contains Demographic information of the participants; section 2 contains subjective and Objective assessment. Two tests straight leg raise and per rectal were performed confirm coccydynia. SPSS version 21.0 were used to enter and analysis the data. Results: Test According to SLR test, 396(45%) were positive and 485(55%) were negative in SLR test. According to PR test, 538(61%) were positive and 343(39%) were negative in PR test. The finding of the study shows that 538(61%) postpartum females have coccydynia. A significant relationship was found between Coccydynia and the method of delivery (p<.005), position with less pain (p<.001), and intensity of pain (<p.001). Conclusions: Coccydynia is most commonly found in postpartum women based on the results of this study. Coccydynia was also significantly associated with the method of delivery, the position with less pain, and the intensity of the pain during childbirth
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