Normative data of modified Romberg balance test for risk of fall in elderly population of Pakistan.

OBJECTIVE: To generate normative data of modified Romberg balance test for the risk of fall among the elderly. METHODS: The crossectional study was conducted from July 1 to December 31, 2021, and comprised healthy adults of either gender aged 60 years and above from different cities of Pakistan. The participants were screened for balance issues using the Patient Reported Outcomes Measurement Information System Global Health Questionnaire. All th eindividuals were subjected to the modified Romberg balance test. Data was analysed using SPSS 21. RESULTS: Of the 2004 participants, 1,041(51.95%) were males and 963(48.05%) were females. The overall mean age was 70.36+6.20 years and mean body mass index was 21.92+3.08kg/m2. Overall, 207(10.33%) participants passed all the 4 conditions of the modified Romberg balance test. CONCLUSIONS: With increasing age, the capability to perform modified Romberg balance test decreased, increasing the chance of fall among the elderly.

Effects of 8 weeks functional training programme on posture control and functional mobility in spastic hemiplegic cerebral palsy.

OBJECTIVE: To determine the impacts of functional training versus conventional training on posture control and functional mobility in spastic hemiplegic cerebral palsy children. METHODS: The randomised clinical trial was conducted at the Rehab Cure physiotherapy centre, Lahore, Pakistan, from January to September 2020, and comprised children of either gender aged 4-14 years, diagnosed with cerebral palsy, gross motor functional classification system level II or III, and no mental retardation. The subjects were randomised into conventional therapy group A and functional training group B. Intensity of exercises was gradually increased each week, starting from 10 reps to 20 reps. The subjects received treatment 3 times a week for 8 weeks, and each session lasted 45-60 min. Paediatric Balance Scale, Trunk Control Measurement Scale, Five Times Sit to Stand Test and Timed-Up-and-Go test were used at baseline and post-intervention. Data was analysed using SPSS 21. RESULTS: Of the 14 subjects, there were 7(50%) in each of the two groups. Overall, there were 8(57.14%) males and 6(42.86%) females with a mean age of 7.57±1.86 years. Significant improvement was noted in both groups post-intervention (p<0.05), but intergroup differences were not significant (p>0.05). CONCLUSIONS: Both functional training and conventional therapy significantly improved postural control and functional mobility in spastic cerebral palsy children, but intergroup differences were not significant. Clinical Trial Number: IRCT20200909048676N1.

Perception of massage application among clinicians and parents in spastic cerebral palsy: Qualitative study.

OBJECTIVE: To explore the perceptions about traditional massage and its modified techniques among clinicians and families of the patients with spastic cerebral palsy. METHODS: The qualitative, cross-sectional study was conducted from November 2019 to August 2020 in Sialkot, Pakistan, after approval from the ethics review committee of Riphah College of Rehabilitation Sciences, Islamabad, and comprised neuro paediatricians and paediatricians in Group A, parents of children with spastic cerebral palsy aged 8-15 years in Group B, and musculoskeletal physiotherapists and orthopaedic manual physical therapists in Group C. The professionals in groups A and C had a minimum of 5-year paediatric experience in government and teaching hospitals. Data was collected using a semi-structured pilot-tested questionnaire. Qualitative approach and thematic code analysis was used to analyse the collected data. RESULTS: Of the 26 subjects, 10(38.5%) were in Group A, 8(30.7%) in Group B and 8(30.7%) in Group C. Overall, there were 16(61.4%) males and 10(38.5%) females. Among the professionals, experience ranged 5-38 years in Group A, and 5-9 years in Group C. The identified themes were reforms in recommendations, and application of massage techniques, with the participants overwhelmingly favouring termination markers to prevent increase in hypertonicity in spastic cerebral palsy. CONCLUSIONS: Termination markers of massage should be considered in interventions to improve outcomes in children with spastic cerebral palsy.

Comparison of SAME verses CIMT on upper-limb functions in chronic stroke: A pilot randomized control trial.

OBJECTIVE: To compare the effects of Same Arm Movement Therapy versus Constraint Induced Movement Therapy in improving upper-limb functions in patients of chronic stroke. METHODS: The pilot, assessor-blind, randomised control trial was conducted from February to September 2020 at the Spine and Physiotherapy Rehab Centre, Riphah Rehabilitation Centre, Lahore, Pakistan, and comprised patients of either gender aged 30-60 years having any type of stroke for a minimum 3 months. They were randomised into group A which received same arm movement therapy for 8 weeks of mental rehearsal of upper limb movements during 45min supervised sessions three times a week and structured independent sessions twice a week, and group B which received constrain induced movement therapy for eight weeks of daily intensive training of the affected extremity for two hours per day, five days per week for eight weeks in association with restriction of the non-affected extremity for 10 hours a day. Measurements were taken at baseline and post-intervention. Data was analysed using SPSS 21. RESULTS: Of the 22 patients, 5(22.7%) were male and 17(77.3%) were female. The average age in group A was 54.91±5.89 years compared to 53.18±6.61 years in group B. All 22(100%) patients had ischaemic stroke. Intragroup comparisons showed significant progress in both groups (p<0.05), but intergroup comparisons showed non-significant differences (p>0.05). CONCLUSIONS: Both the study interventions had similar effect on upper limb functions among chronic stroke patients. RCT: Iranian Registry of Clinical Trials: RCT20200620047848N1 https://www.irct.ir/trial/49054.