Effects of elongation longitudinaux avec decoaption osteo-articulaire and post-facilitation stretching technique on pain and functional disability in mobile users with text neck syndrome during COVID-19 pandemic: A randomized controlled trial.

BACKGROUND: Adolescent smartphone users have developed a variety of musculoskeletal conditions due to their use of smartphones. ELDOA (Elongation longitudinaux avec decoaption osteo-articulaire) is based on maximizing facial and spinal stretching by assuming specific posture for 1 minute and post facilitation stretching is also a type of muscle energy technique that is used for chronically shortened or tight muscles. This aimed to compare the effects of post-facilitation stretching technique and ELDOA on neck pain and functional disability in mobile users experiencing Text neck syndrome during COVID-19. METHODS: This single-blinded randomized control trial with a parallel group design was conducted at the Department of Physiotherapy Safi Hospital (Faisalabad, Pakistan) from September 2021 to April 2022. Forty smartphone users between the ages of 18 and 35 who had a Neck Disability Index score of >10 due to neck pain without unilateral arm symptoms participated in the study. Of the 40 participants, twenty were randomly assigned to the ELDOA group and twenty were assigned to the post facilitation stretching group, and each group received 3 weekly sessions of treatment for 6 weeks. The Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and Smartphone Addiction Scale (SAS) were used to measure pain intensity, functional disability, and smartphone addiction at baseline and after 18 sessions of treatment. SPSS version 22 was used to enter and analyze the data. To find comparisons between groups an independent sample t test was used, and a paired sample t test was used to find the difference within each group. RESULTS: Post-treatment values showed statistically significant difference between groups. ELDOA group showed greater improvement in pain (P < .03) with 95% CI [-1.33, -0.068] and functional disability (P < .05) with 95% CI [-4.44, 0.143] at 6th week. There was no statistically significant difference (P = .35) with 95% CI [-28.6, 10.4] between the two groups regarding smartphone addiction. The NPRS, NDI, SAS scores were significantly different within each group with P < .05. CONCLUSION: The study concluded that ELDOA method and post-facilitation stretching both were effective in treating neck pain and functional disability. However, ELDOA method was superior to post-facilitation stretching effects on neck pain and functional disability among patients with text neck syndrome.

Analyzing the determinants of sustainability of China Pakistan Economic Corridor (CPEC) projects: an interpretive structural modelling (ISM) approach.

China Pakistan Economic Corridor (CPEC) is a game changer initiative of South Asian Pacific Rim. It has great importance for almost all Asian countries. Its success is expected to dictate the economic development of the stakeholders. The aim of this study is to evaluate the essential determinants deriving the sustainability of CPEC projects. The design of the study comprises of the review of literature, data collection, and analysis. Population under study is the folk of stakeholders of CPEC. Sampling envisages on purposive sampling design, i.e., 14 experts from within the stakeholders. Primary data is collected in the field setting through a survey questionnaire appropriate for the study. ISM is used for modelling and MICMAC for analysis and classification using inductive approach. The findings of the literature survey show that there are 23 prime determinants of sustainability of CPEC projects. The results of ISM show that 13 determinants are at Level-I, nine at Level-II, and one determinant namely "economic globalization" is at Level-III being the most critical and driving determinant. The findings of MICMAC show that only one determinant is classified in independent quadrant, and all the remaining determinants are in linkage quadrant, whereas, no determinant is shown in autonomous and/or dependence quadrant. But most of the determinants have potential to be classified in dependent and independent quadrants. It is intimately evident that the results of MICMAC corroborate the results of ISM. It is useful for folk of the stakeholders by way of developing an understanding about the multitude of determinants, intra-determinant relations, prioritizing the determinants for policy decisions, and/or for building future studies. This study has some limitations, e.g., the study uses qualitative approach and answers what and how questions that do not quantify the relations or tell the cause of indicated relations.

Surge in Economic Growth of Pakistan: A Case Study of China Pakistan Economic Corridor.

China Pakistan Economic Corridor (CPEC) is considered a massive investment that can change the economic scenario of Pakistan. The purpose of the study is to examine the contribution to the economic growth of the sectors where CPEC is investing. This research uses time-series data for 31 years to investigate the impact of macro-economic variables like foreign direct investment (FDI), human capital investment (HCI), transport investment, and information communication technology (ICT) on the economic growth of Pakistan. The results of Fully Modified Ordinary Least Square Regression Specification (FMOLS) show a positive nexus between FDI, HCI, and economic growth while economic growth and ICT show a negative relationship. The results for the impact of transportation infrastructure on economic growth are statistically insignificant. This research suggests that an increased focus on building knowledge, expertise, and skillset of human resources will help in reaping the benefits of CPEC's investment. Future researchers can increase the period of the study to ascertain the implicit or explicit impact of CPEC on economic growth. The results also suggest that policymakers and researchers should focus on developing human capital to reap the investment benefits of CPEC.

Systematic review of the application of virtual reality to improve balance, gait and motor function in patients with Parkinson's disease.

BACKGROUND: Virtual reality (VR) is an advanced technique used in physical rehabilitation of neurological disorders, however the effects of VR on balance, gait, and motor function in people with Parkinson's (PD) are still debated. Therefore, the systematic review aimed to determine the role of VR on motor function, balance and gait in PD patients. METHODS: A comprehensive search to identify similar randomised controlled trials was conducted targeting 5 databases including Web of Science, PubMed, CINHAL, Cochrane Library, and Physiotherapy Evidence Database. A total of 25 studies were found eligible for this systematic review, and the methodological assessment of the quality rating of the studies was accomplished using the physiotherapy evidence database scale by 2 authors. RESULTS: Out of the 25 included studies, 14 studies reported on balance as the primary outcome, 9 studies were conducted to assess motor function, and 12 assessed gait as the primary outcome. Most studies used the Unified Parkinson disease rating scale UPDRS (part-III) for evaluating motor function and the Berg Balance Scale as primary outcome measure for assessing balance. A total of 24 trials were conducted in clinical settings, and only 1 study was home-based VR trainings. Out of 9 studies on motor function, 6 reported equal improvement of motor function as compared to other groups. In addition, VR groups also revealed superior results in improving static balance among patient with PD. CONCLUSION: This systemic review found that the use of VR resulted in substantial improvements in balance, gait, and motor skills in patients with PD when compared to traditional physical therapy exercises or in combination with treatments other than physical therapy. Moreover, VR can be used as a supportive method for physical rehabilitation in patients of PD. However, the majority of published studies were of fair and good quality, suggesting a demand for high quality research in this area.

Work-related musculoskeletal disorders among Pakistani construction workers: Prevalence, characteristics, and associated risk factors.

BACKGROUND: Worldwide, approximately 350 million people are currently employed in the construction industry. OBJECTIVE: To determine the prevalence, pain characteristics, and associated risk factors for musculoskeletal disorders (MSDs) among construction workers in Pakistan. METHODS: This study was a cross-sectional survey conducted from February to August 2019 among 666 construction workers. The data were collected using a questionnaire consisting of 4 sections: demographic information, a numerical pain intensity rating scale, a Nordic questionnaire to report prevalence, and pain characteristics. SPSS was used for data entry and analysis. RESULTS: The mean age of the construction workers was 34.49 years. Participants who reported pain were 397 out of 666 and 269 were those who reported no pain. The 12-month prevalence of pain among construction workers in more than one body area was 89% (n = 591) and the 7-day prevalence was 52% (n = 343); lower back pain was the most common type of pain with a 12-month prevalence of 27% (n = 180) and a 7-day prevalence of 17% (n = 112). Regarding the characteristics of the pain, 26% (173) of the workers suffered pain occasionally, 27% (180) participants had pain for≤2 hours per day, and 32.9% (219) had dull pain. Moreover, a significant relationship was found (p < 0.05) between MSDs and age, lifestyle, work experience, smoking habits, and absence from work. CONCLUSION: Musculoskeletal pain is highly prevalent, with lower back pain being the most commonly reported type. Absence from work and disability in performing normal daily activities have been reported as consequences of musculoskeletal pain. Moreover, this study underscores the importance of targeted preventive healthcare measures for construction workers.

Psychometric Properties of the Urdu Translation of Berg Balance Scale in People with Parkinson's Disease.

BACKGROUND: The most common assessment tool used in clinical settings to detect changes in balance performance is the Berg Balance Scale (BBS). Thus, the purpose of this study was to translate the BBS into Urdu and investigate the psychometric properties (acceptability, internal consistency reliability, interrater reliability, construct validity) for individuals with Parkinson's disease (PD). METHODS: Eighty patients of either gender with idiopathic Parkinson's disease, stages I-III on the modified Hoehn-Yahr (H&Y) scale, with intact cognition according to the Mini Mental Score Examination (MMSE) score (greater than or equal to 24) and independent of transfers, were included in this study. The BBS was translated according to international guidelines based on forward and backward translation processes. The test-retest reliability as well as intra- and inter-observer reliability was assessed by calculating the intra-class correlation coefficient (ICC). The internal consistency of the entire BBS score was assessed by calculating Cronbach's α. The convergent validity was assessed by correlating the scale with the Unified Parkinson Disease Rating Scale (UPDRS) parts II and III and the Activity-specific Balance Confidence Scale (ABCS). The construct validity was assessed using a factor analysis. RESULTS: The mean age of the subjects was 62.35 ± 5.74 in years (range: 60-87 years). The ICC for intra- and inter-observer reliability was 0.95 (p < 0.0001) and 0.99 (p < 0.001), respectively. Cronbach's α was calculated as 0.81, which showed acceptable internal consistency of the Urdu version of the BBS. The test-retest reliability (ICC) of the Urdu version of the BBS was determined as 0.97 for the total score, and ranged from 0.66-0.95 for individual items. In terms of validity, the Urdu version of the BBS was correlated with the ABCS (in the positive direction) and UPDRS-II and III (in the negative direction) (r = 0.53, p < 0.001; r = -0.68, p < 0.001, r = -0.78, p < 0.0001), respectively. CONCLUSION: The Urdu version of the BBS is a reliable and valid scale to be used in balance assessment of population diagnosed with PD with excellent psychometric properties.

Integrating green business strategies and green competencies to enhance green innovation: evidence from manufacturing firms of Pakistan.

Green innovation has become a norm and crucial element of success for modern firms. Manufacturing firms come up with alternative ideas to achieve green innovation. This study proposes that green innovation can be enhanced by amalgamating green business strategies and mastering green competencies within a firm. It isolates itself from previous research by focusing on inherent internal competencies, which could bolster green innovation performance. This integration not only helps firms achieve green innovation but could also improve green value co-creation. Meanwhile, green value co-creation will also mediate the relationship between integrated competencies and green innovation. Data has been collected from the managers of original equipment manufacturers within Pakistan via survey. A total of 319 responses were analyzed using partial least squares structural equation modeling, and empirical results support the proposed hypotheses. The study's findings suggest that green competencies coupled with green business strategy positively influence green value co-creation and green innovation. Moreover, green value co-creation elevates firms' green performance and help firms to achieve green innovation. Consequently, theoretical and managerial implications are presented, which adds to this study's significance under the dynamic capability view.

The Impact of Green Religiosity on The Green Product Switching Behavior in Pakistan: The Role of Green Personal Values and Green Altruism.

Prior studies have fallen short when examining the impact of religiosity on consumer values toward environmental preservation and green product switching behavior in religion-dominating countries. Moreover, green altruism has also received inadequate attention, and its role in causing green product switching behaviors remains unexplored. To address this gap, we introduce two novel constructs: green religiosity and green altruism. We examined their impact on consumers' values and switching behaviors regarding green products while using the value-belief theoretical underpinnings to posit our hypothesis. A survey approach is employed in the Electronics industry in Pakistan to validate our assertions. A total of 623 respondents' data were analyzed using structural equation modeling. The findings reveal that green religiosity positively impacts personal values and switching behavior in green products. In addition, green values partially mediate the relationship between green religiosity and green product switching behavior. Green altruism strengthens the relationship between personal values and product switching behavior as a moderator. Collective findings suggest that religion can play a crucial role in reshaping consumers' attitudes toward environmentally friendly products and influence their values regarding the preservation of the environment.

Effectiveness of sustained natural apophyseal glides in females with cervicogenic headache: A randomized controlled trial.

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal glides (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.