The Healer Journal of Physiotherapy and Rehabilitation Sciences

A A Comparative Study; Active Release Technique Versus Mulligan Bent Leg Raise to Improve Hamstring Tightness in Asymptomatic Healthy Individuals in a Single Session

2024-04-01T11:16:09-07:00

Background: “Flexibility” is a physiological term to define joint excursion through its ROM that also involves contributions from joint and soft tissue structures. while “tightness” is defined as the decreased ability of that muscle to elongate from its neutral position. Active Release Technique (ART) is a soft tissue method that focuses on relieving tissue tension via the removal of fibrosis and adhesions, which can develop in tissue as a result of overload due to its repetitive use. The mulligan bent leg raise technique is used to improve the range of straight leg raises in subjects with low back pain or referred thigh pain and to improve the flexibility of the hamstring in clients with hamstring tightnessObjectives: To investigate and compare the effectiveness of two therapies—the active release technique versus Mulligan bent leg raise—in healthy individuals with hamstring tightnessMaterial and methods:This study was a quasi-experimental study with a sample size of 40 normal, healthy individuals ages 18 to 25. Subjects were divided into two groups: one group (group A = 20) received a single session of the active release technique, and the other group (group B = 20) received a single session of the Mulligan bent leg raise technique. All the subjects were evaluated through the straight leg raise test and the popliteal angle through the active knee extension test as pre-intervention and post-intervention measuring tools for hamstring tightnessResults:There was a significant difference between pre-values and post-values of popliteal angle (P<0.001) and passive straight leg raise test (P<0.001) between the active release technique group and mulligan bent leg raise group. The results also showed significant differences in popliteal angle and passive straight leg raise test post-interventional scores (P<0.001) within the groupsConclusion:both the active release technique and the mulligan bent leg raise technique proved to be significant in improving hamstring tightness in healthy asymptomatic subjects in a single session, but the active release technique proved to be more significant than the mulligan bent leg raise in improving hamstring tightness immediately after the application of these comparative interventionsKey words: Active release technique, Mulligan bent leg raise technique, straight leg raise, hamstring

Effects of Neuromuscular Electrical Stimulation on Motor Function of Hand in Patients with Chronic Ischemic Stroke: A Randomized Controlled Trial

2024-02-26T00:47:00-08:00

Background: Stroke is the leading cause of death and disability in many areas of the world. Underdeveloped, developing and developed countries all are showing marked increases in the ratio of stroke patients. Neuromuscular electrical stimulation is used widely for motor rehabilitation of hemiplegic stroke patients worldwide. Application of neuromuscular electrical stimulation on the affected musculature improves action potential and resulting muscle contraction. Objective: The objectives of the study were to find out the effects of neuromuscular electrical stimulation on motor function and strength of the hand in hemiplegic ischemic chronic stroke patients. Methods: A randomized controlled trial was conducted on chronic stroke patients gathered from Sheikh Zayed Hospital, Rahim Yar Khan. The participants were selected and allocated using the coin toss method. A total of 144 participants were selected and equally distributed into two groups. The sampling technique used was non-probability purposive sampling. Participants included in the study were male and female patients between 40 to 60 years, hemiplegic patients having a single episode of ischemic chronic stroke diagnosed by the neurologist. The Fugl Meyer assessment scale is used for the upper limb while handheld dynamometer is used both for assessment of strength. The normality of data was assessed using the Kolmogorov-Smirnov test. The between-group comparison was done by Mann-Whitney U test. The Wilcoxon rank test was used to see the difference between outcome measures at baseline and after the treatment. Results: The results showed that there was a significant difference of ≤ 0.05 between the control group and the interventional group. The mean score of the Fugl Meyer assessment scale at baseline was 7.46 and after four weeks of treatment was 9.90. On the other hand, the handheld dynamometer showed a score of 14.41 at baseline and 17.74 after four weeks of treatment. These marked differences in results between the two groups showed the significant effects of stimulation on the motor function of the hand in hemiplegic ischemic chronic stroke patients. Conclusion: It is concluded from the study that neuromuscular electrical stimulation is very effective in improving the motor function of the hand in chronic stroke patients.

Effects of Progressive Resistance Exercise Training on Endurance and Functional Mobility in Children with Spina Bifida

2024-02-13T13:04:11-08:00

Background: Spina bifida has been known as a neurological disorder characterized by common problems that are associated with lower extremities usually having issues with their movement, strength and performing activities of daily living. A lot of practices are carried out on children with spina bifida to help them regain their normal performance. Progressive resistance exercises are applied to children with spina bifida to help them gain power by making them capable of performing movements and their daily tasks and activities. Objective: To assess the effects of progressive resistance exercise training on functional mobility and endurance in children with spina bifida. Methods: Our study is a randomized controlled trial which was conducted in the Children’s Hospital, Lahore. The sample size for this study was calculated to be 20 using the two-proportion mean formula. The sampling technique employed was a non-probability convenience sampling technique to recruit children with spina bifida in our study. Two groups were made one was Group A, the experimental group which received the progressive resistance exercises while Group B, the conventional group received only simple active and passive range of motion exercises of lower extremities. The tool employed was the Patient Specific Scale while the data was collected and measured before and after treatment for both groups. Results: The results of the current study showed significant results in both the groups but Group A received Progressive Resistance Exercises showed statistically significant results within the group having a significant p-value=0.000. Group A showed an increase in its mean score of sit-to-stand by 7.00±2.62 whereas Group B showed an increase in the mean score of sit-to-stand by 5.7±2.90. Group A showed statistically more significant results. For walking, Group A showed an increase in mean score by 6.4±2.83 whereas Group B showed a score of 5.00±3.26. Conclusion: According to the results of the study, both treatment approaches of progressive resistance exercises and conventional exercises were effective but Group A, receiving the progressive resistance exercise training showed more significant differences in mobility and daily activities when compared with Group B, receiving only conventional exercise treatment.

Prevalence of Carpal Tunnel Syndrome in Pregnancy; A Cross-Sectional Study

2024-02-15T11:34:04-08:00

Background: Carpal tunnel syndrome is the most common compression neuropathy of the median nerve, which can occur or aggravate during pregnancy and sometimes needs surgery. The most common cause of complaints in pregnant women is carpel tunnel syndrome. The investigation is meant to report the prevalence of carpal tunnel syndrome in connection to pregnancy and evaluate how huge the infection was among pregnant females. Objective: To assess the prevalence of carpal tunnel syndrome in pregnancy. Methods: The study was cross-sectional and data was collected from surgical and gynecological departments of four major hospitals of Lahore which are General Hospital Lahore, Nawaz Sharif Social Security Hospital Multan Chungi Lahore, Jinnah Hospital Lahore, and Children’s Hospital Lahore and was compiled at University Institute of Physical Therapy of the University of Lahore. The study was completed 6 months after the approval of the synopsis. The size of the sample is 256 and used convenient sampling technique. Pregnant women who had been under 20-40 years and excluded those who had high-risk pregnancies, psychological conditions, chronic medical illnesses like cancer, cardiovascular disease, etc. A cross-sectional survey was done on 256 subjects at different hospitals in Lahore using the Carpal Tunnel Syndrome Questionnaire for Wrist or hand pain to determine the prevalence rate of pregnancy-related carpal tunnel syndrome data and is analyzed through the SPSS 21 version. Results: During the study period, 256 pregnant women attending different hospitals and 118 (46.0%) women were found to have carpel tunnel symptoms. Most of them were in 3^rd trimester of pregnancy 55.9%(143) followed by the 2^nd trimester 21.9%(56) and the least was in the 1^st trimester 22.3%(57). The most common complaint was numbness, particularly during the daytime (30.0%), while the least frequent symptom reported was pain. Conclusion: A large number of pregnant women suffer from the recurrent experience of carpal tunnel syndrome in pregnancy and it is first noted during the third trimester, but only in 50% of women symptoms vanish one year after delivery. Although pregnancy is typically viewed as a risk factor for this syndrome.

Association of Carpal Tunnel Syndrome with Body Mass Index among University Females

2024-02-20T10:51:03-08:00

Background: Carpal tunnel syndrome is caused due to the compression of the median nerve in the carpal tunnel1, it is one of the most prevalent upper extremity neuropathies. Individuals with this syndrome commonly complain of pain, paraesthesia, altered sensory perception, and hand and wrist weakness, which impairs daily activities and diminishes physical function. Objective: Evaluate the association of carpal tunnel syndrome with body mass index among university-going females. Method: An analytical cross-sectional study was conducted on female students of the University of Lahore and the University of Gujrat. Students were selected with different BMIs and ages between 18 to 30 years while data were collected by using a standardized questionnaire and by performing the Phalen test whereas BMI was checked by using weight in kilograms divided by height in meter square. However students with a history of hand trauma, radius/ulna or wrist fracture or injuries in last 3 months and those who had comorbidities previously undergone surgery to the shoulder inflammatory arthritis in last 3 months and congenital deformities were excluded.Ethical approval was taken from Institutional Review Board (IRB) of The University of Lahore, Punjab, Pakistan. A consent was taken from the participants before collecting data. Ensured that data would be used for only research purpose. The research project was approved by research and ethics committee of University of Lahore. Data were collected from females of university of Lahore and university of gujrat and by evaluating the carpal tunnel syndrome in university females by phalens test and boston questionnaire. For descriptive analysis, mean and standard deviation were calculated for quantitative variables whereas frequencies and percentages were calculated for qualitative variables. For inferential statistics, chi-square test was applied. Results: The study's results show that the mean age of participants (in years) is 22.30±2.04, body mass index of participants (in kg/m²) is 20.36±2.63. Conclusion: It is concluded that there is no association between BMI classes with p-value. As p-value shown in the results was 0.389. Therefore, both have no effects on each other, while BMI and Phalen's test have very weak positive co-relation with each other with a value of 0.045.