Effects of lower limb cycle training on echocardiographic parameters of left ventricle in dilated cardiomyopathy patients

Objective: To determine the effect of lower limb ergometric training on echocardiographic parameters of left ventricle in dilated cardiomyopathy [DMC] patients. Study Design: Randomized control trial. Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan, from September 2016 to February 2017

Methodology: Clinically stable patients with DCM [n=60], were randomly allocated into an interventional group with two month interventional program and a non-trained control group [n=30 each]. Treatment protocol for interventional group was lower limb ergometer exercise for 8 weeks, 4 days/week. Pre and post-treatment echocardiography was done in both groups at baseline and after 8 weeks. SPSS 21 was used for data analysis

Results: The median [IQR] age of the patients was 51 [18] years in interventional group and 62 [11] years in control group. Male to female ratio was 18:9 in control group and 17:12 in Interventional group. Statistically significant results were detected within the groups regarding ejection fraction [EF], left ventricular internal dimension systole [LVIDS] and left ventricular internal diastolic dimension [LVIDD] [p<0.001]

Conclusion: Exercise training with lower limb ergometer was effective in improving the ejection fraction and left ventricular dimensions in patients with dilated cardiomyopathies

Effect of early

Objective: To determine the effect of

Study Design: Randomized control trial

Place and Duration of Study: BARMWT Hospital, Rawalpindi, from March to August 2015

Methodology: A randomized controlled trial was conducted on 174 CABG and valvular heart disease patients undergoing cardiac surgical procedures. After selection of sample via non-probability purposive sampling, they were randomly allocated into interventional group [n=87] and control group [n=87]. Treatment protocol for experimental group was

Results: The patients' mean age was 51.86 +/-13.76 years. Male to female ratio was 132:42. Statistically significant differences in respiratory rate and SpO[2] [p=0.000 and 0.000, respectively] were found between both groups. Among ABG's, PCO[2] and pH showed significant differences with p values of 0.039 and <0.001, respectively. No significant differences were observed between both groups regarding electrolytes [Na[+], K[+], Cl[-], p-values of 0.361, 0.575 and 0.120 respectively] and creatinine [p=0.783]. Marked improvement in oxygen saturation, dyspnea and a fall in systolic BP was seen in interventional group. There was also observed to be a reduction in the length of ICU stay among interventional group patients as frequency with percentage of total stay was compared to control group

Conclusion: Early physical activity [

Effectiveness of proprioceptive neuromuscular facilitation techniques as compared to traditional strength training in gait training among transtibial amputees

Objective: To determine the effects of proprioceptive neuromuscular facilitation [PNF] techniques as compared with the traditional prosthetic strength training [TPT], in improving ambulatory function in subjects with transtibial amputation

Study Design: Randomized control trial

Place and Duration of Study: Artificial Limb Centre of Fauji Foundation Hospital, Rawalpindi, from July to December 2014

Methodology: Patients with lower-limb amputation was selected through purposive sampling and randomly assigned into PNF group [n=31] and traditional group [n=32]. The baseline and follow-up of 04 weeks treatment session was provided and measurement was noted through the locomotor capabilities index

Results: The locomotor capabilities index abilities had significant difference in both groups. The mean index was 23.93 for PNF and 18.18 for TPT [p > 0.05], and the knee muscle strength was also significantly different [p > 0.05]. There was no significant difference in gait parameters

Conclusion: Proprioceptive neuromuscular facilitation technique is better in improving the locomotor abilities and knee muscle strength as compared to traditional training. The basic gait parameters have same effect in both groups

Task oriented training improves the balance outcome and reducing fall risk in diabetic population

Objectives: The objective was to determine the balance impairments and to compare task oriented versus traditional balance training in fall reduction among diabetic patients

Methods: The randomized control trial with descriptive survey and 196 diabetic patients were recruited to assess balance impairments through purposive sampling technique

Eighteen patients were randomly allocated into two groups: task oriented balance training group TOB [n=8] and traditional balance training group TBT [n=10]

The inclusion criteria were 30-50 years age bracket and diagnosed cases of Diabetes Mellitus with neuropathy

The demographics were taken through standardized ft valid assessment tools include Berg Balance Scale and Functional Reach Test

The measurements were obtained at baseline, after 04 and 08 weeks of training

Results: The mean age of the participants was 49 +/- 6.79. The result shows that 165[84%] were at moderate risk of fall and 31[15%] were at mild risk of fall among total 196 diabetic patients

There was significant improvement [p <0.05] in task oriented balance training group for dynamic balance, anticipatory balance and reactive balance after 8 weeks of training as compare to traditional balance training

Conclusion: Task oriented balance training is effective in improving the dynamic, anticipator and reactive balance

The task oriented training reduces the risk of falling through enhancing balance outcome

Effect of aerobic exercises on stuttering

Background and Objective: Stuttering is one of the most common speech disorders in adolescents than adults. Stuttering results in depression, anxiety, behavioral problem, social isolation and communication problems in daily life. Our objective was to determine the effect of Aerobic Exercises [AE] on stuttering

Methods: A quasi trail was conducted at National Institute of Rehabilitation Medicine [NIRM] from January to June 2015

Thirty patients were selected and placed in three different groups Experimental Group A, [EG = 10 patients, age between 7-14 years], Experimental Group B [EG =10 patients age between 15-28 years] and control group -group C, [CG = 10 patients, age between 7-28 years]

Patient who stutter were included in this study and those with any other pathology or comorbidity of speech disorders were excluded

The assessment tool used was Real-Time analysis of speech fluency scale. Participants in all the groups received speech therapy while only the EG - A and B received aerobic exercises [AE] using treadmill and stationary bicycle along with the speech therapy. Pre-interventional and post interventional assessments were analyzed using the SPSS 21 in order to determine the significance of new treatment approach and the effectiveness of physical therapy on speech disorders

Results: All the groups showed significant treatment effects but both the EG groups [Group A, Group B] showed high improvement in the severity level of stuttering as compared to control group C. The results also showed that AE treated group B had significant difference in p-value [p=0.027] as compared to control group [p<0.05] while experimental group A had no significant difference [p > 0.05] between these groups

Conclusion: The eclectic approach of aerobic exercises with the traditional speech therapy provides proximal rehabilitation of stuttering

Efficacy of cervical spine mobilization versus peripheral nerve slider techniques [neurodynamics] in cervicobrachial pain syndrome

The objective of this study was to compare the efficacy of cervical spine mobilization versus peripheral nerve slidertechniques [neurodynamics] incervicobrachial pain syndrome. The study design was arandomized interventional study. This study was conducted at the Armed Forces Institute of Rehabilitation Sciences [AFIRM], Rawalpindi from August 2014 to January 2015. Forty patients [n=40] were included by using purposive sampling technique. Patients of Age 30 to 60 years with Radiating neck pain, Limited ROM of neck and Pain persisting for more than 2 months, were included in study. Then randomly divided into two groups, each group contains 20 participants. One group was treated with neck mobilization and other was treated with neurodynamic treatment protocol. Pain and Active Range of Motion [AROM] was measured by Visual analog scale [VAS] and Inclinometer respectively. Neck Disability Index was also used. Patients were assessed before and after six week intervention. Data was analyzed on SPSS 20 and Independent t Test was used to compare the results of two groups. Pain was measured on VAS, the mean of Mobilization and Neurodynamics were [2.0+1.892 vs.4.8+2.397] respectively. There is significant [p<0.05] difference between two groups. There is also significant [p<0.05] difference for Range of Motion between two groups. The mean value for NDI of both groups were [14.5+7.564 vs 26.80+11.484]. It also shows better treatment is mobilization. The results of this comparison between two single interventions indicate that cervical mobilization treatment in neck pain is more useful than anneurodynamic treatment. For daily practice, we can recommend treatment according to the expert guidelines investigated

Pes planus and genu vallgum; factors associated

Pes planus [flat foot] is a musculoskeletal abnormality of lower limb, often associated with some degree of malalignment at the knee i.e. genu valgum [knock knees]. In majority of cases, these deformities resolve by themselves during infancy and childhood, but if they persist in adolescent age, then there is no chance of resolution and might pose serious problems for the individual in the future

Objectives: The objective of this study was to determine the factors associated with pes planus and genu valgum in adolescents. The two main factors under investigation were physical activity and dietary habits of adolescents and their effect on these lower limb musculoskeletal conditions

Material and methods: A case-control study was conducted on 400 [161 cases and 239 controls] school- going adolescents [11-16 years]. After completing the demographic data and recording the height and weight of each participant, the diagnosis of pes planus was made on the basis of physical examination and special tests. The data for genu valgum was collected by the measurement of clinical tibiofemoral angle. A selfreport questionnaire was used to collect other relevant data such as the symptoms experienced by the individuals. Data was analyzed on SPSS 21

Results: Out of 400 adolescents, there were 171 males and 229 females. The physical activity level of cases was 2.17 +/- 0.70, slightly less than that of control group 2.32 +/- 0.76. The diet score of cases [11.087 +/- 3.75] did not differ much from that of controls [11.214 +/- 3.75]. Tibiofemoral angle of cases was 15.7 +/- 3.42 degrees valgus for controls it was 14.1 +/- 3.49 degrees valgus. There was also a greater trend of cases towards overweight [12.8% cases and 7.43% controls] and obesity [5.84% cases and 2.62% controls], whereas the frequency of controls was higher in underweight [19.8% cases and 27.5% controls] and healthy/ normal weight category [55.5% cases and 66.8% controls]. Other associated symptoms such as foot pain, knee pain, trauma to foot and knee, difficulty in running and jumping activities etc were also found to be in higher frequency in cases as compared to in controls along with significant gender differences

Conclusion: Our study results showed that reduced physical activity can be a factor for causation of flat foot and knock-knees but the difference in diet habits was not very significant between cases and controls. Therefore unhealthy diet is not a very considerable factor in the contribution to musculoskeletal conditions in lower limb. There was a direct link between obesity and pes planus, along with a greater TFA. There was also a higher incidence of knee pain in the flat foot cases who complained of foot pain along with various other associated symptoms

Comparison of Self-Assessment with Peer and Student Assessment in Evaluating the Overall Performance of the Faculty

To evaluate the overall faculty performance by comparison of Self-assessment with peer and student assessment. A comparative cross sectional survey. Study was conducted from January to June 2012 in Riphah College of Rehabilitation Sciences, Riphah International University Islamabad. This research study was conducted among students of Doctor of physical therapy [DPT], post-professional Doctor of physical Therapy [PPDPT], and Master of Science in speech language pathology [MS-SLP], and faculty members at Riphah College of Rehabilitation Science [RCRS], Riphah International University Islamabad. The total sample size was 730, including 700 students and 30 faculty members. A questionnaire was developed according to likert scale, and after a pilot study on 20 student and 10 faculty member to determine the reliability. The questionnaire was circulated among all the 30 faculty members and 700 students, including 500 undergraduate and 200 post graduate students of all the 3 programs. The data was analyzed and Wilcoxon [Kruskal-Wallis] was applied at 95% level of significance for all the 3 groups. The group [A] included assessment of the performance of the faculty members done by the students, group [B] done by other faculty members, and group [C] included self assessment done by faculty members. The averages were calculated to determine the overall performance of the faculty members as assessed by themselves, other faculty members, and the by students as well, afterwards the averages of 3 groups were compared. the overall performance of the faculty members was graded as 71% [P=0.015] as evaluated by the students, 77% [P=0.009] as evaluated by other faculty members, and 73% [P=0.011] as evaluated by the faculty members through self assessment. It is concluded that there was no significant difference in the performance of the faculty members, as assessed themselves, by the students and the other faculty members

Identifying and Comparing the Different Learning Styles of Health Professional Students

To compare the learning styles of first year MBBS, BDS and DPT students. This study was carried out at Islamic International Medical College Rawalpindi [IIMC], Riphah College of Rehabilitation Sciences [RCRS], Islamic International Dental College Islamabad [IDC], Pakistan between February 2013 and June 2013. It was a descriptive cross sectional study. A sample of 83 first year MBBS, 81 first year DPT and 36 BDS were recruited. Kolb's inventory [1985] was used for collection of data. It was analyzed by using SPSS 20.p value of <0.05 was considered significant. A confidence interval of 95 was maintained. Frequency of learning style showed that 38.2% of MBBS students are assimilators, 59.7% of DPT students are Accommodators and 15.2% of BDS are Converger. It is concluded that the majority of students of the different disciplines have different learning style. So teacher must be aware of this fact and plan according to the learning styles of the students

Identify learning style in students of medical discipline

To find out the frequency of different learning style in students of first year doctor of physical therapy [DPT] and to formulate future academic plan according to the needs of students. This descriptive study was conducted from 1[st] October to 30[th] November 2012 at ripah University, Rawalpindi, Pakistan. A sample of 81 students from first year of Doctor of Physical Therapy was recruited. The Kolb's learning inventory was used for collection of data. Out of 81 students, 12.2% were male and 86.6% were females. Frequency of four learning style showed that 22% and 14.6% 52.98% students were accommodators and converge respectively. 11% of the total students were diverges. The relationship of gender and learning style 22% male and 78% female were accommodators. It concluded that the majority of students were accommodator. It means that greatest strength lie in carrying out plans and experiments and involving themselves in new experiences

Role of testicular interleukin-1 alpha tIL-1alpha in testicular physiology and disease

This review focuses on the role of the cytokine interleukin-1a [IL-1a] in the testis; elaborating upon its importance during the complex process of spermatogenesis while relating this cytokine to some of the pathophysiological states affecting the testis. IL-1a, a proinflammatory cytokine, is expressed constitutively by the intact adult rat testis where it acts on germ, Sertoli and Leydig cells to regulate germ cell proliferation and steroidogenesis. The sequence identity of testicular IL-1a matches with the one secreted by activated macrophages in systemic immunity. The classical macrophage IL-1a is produced as 32 kDa precursor protein which is processed to mature 17 kDa IL-1a and a 16 kDa propiece. The rat testicular IL-1a, mainly secreted by Sertoli cells, was found to have molecular heterogeneity that can be observed both at the transcriptional and the translational levels. In the rat testis, two transcripts were found to be expressed with 941 bp and 767 bp [that lacks 174bp] which were translated into 32 kDa and 24 kDa precursor proteins, respectively. The 32 kDa precursor protein is processed to the 17 kDa mature IL-1a. Identical transcripts are also shown to be present in cat, dog and pig. Most of the functional role is assigned to the mature 17 kDa IL-1a isoform. However, functional analysis of recombinant rat IL-1a isoforms showed that there was a clear biopotency difference between these forms in order of 17 kDa IL-1a>32proIL-1a>24proIL-1a. Furthermore, the mature 17 kDa tIL-1a has also been implicated in pathologies such as orchitis, relapse of acute lymphoblastic leukemia [ALL] in the testis and infertility disorders in men. Thus, tIL-1a may play an important functional role both in coordination of normal testicular physiology as well as in contributing to the disease states in the testis