An experimental study on comparison between proprioceptive neuromuscular facilitation technique and conventional physical therapy on lower extremity function of cerebral palsy

Background: Cerebral palsy (CP) has prevalence of 2 to 2.5 per 1000 live births. Causes of CP are still not known significantly. There are many risk factors of CP are known now a days. CP can cause other secondary abnormalities in musculoskeletal system like low muscle power, tightness, and many other bony and structural changes and also in gait. There are five different levels of gross motor function in which level I is the highest level and level V is the last level. This classification is according to the GMFCS. Objective: To determine the efficacy of conventional therapy and PNF techniques in reducing spasticity and improving gross motor function in subjects with cerebral palsy. Methods: Total 36 patients were divided equally into 2 groups. They were assessed at pretreatment, 4th and 8th session of treatment using GMFCS and Modified Ashworth Scale. Group A received PNF stretching (Contract-Relax Method) and Group B received Muscle passive stretching. Results: At post treatment assessment, PNF group had the highest score for GMFCS score (U=155.0, p=0.812), hip flexors spasm (U=121.50, p=0.178), knee flexors spasm (U=129.0, p=0.270), knee extensors spasm (U=152.00, p=0.731) foot dorsiflexors spasm (U=143.50, p= 0.530), foot planter flexors spasm (U=155.00, p=0.817) and on the other hand conventional treatment group had the high score in hip extensors spasm (U=114.50, p=0.098). Conclusion: It is concluded that both the techniques are helpful to enhance the GMFCS score and to reduce the spasticity. PNF stretching has the more positive effects on improving the GMFCS score than that of conventional muscle stretching, in reducing lower limb spasticity except the hip extensors where conventional muscle stretching was more effective

Prevalence of work related musculoskeletal disorders among physiotherapists of Multan

Background: Work related musculoskeletal disorders are increasing day by day in hospitals and clinics due to high demand activities. These disorders decline the efficiency of therapists and result in social as well as economic losses. These injuries mostly occur due to abnormal postures and poor ergonomics. Aim and objectives: The purpose of this study was to rule out pain which disturbs the daily living of physiotherapists due to work related musculoskeletal disorder. This study also helps physiotherapists to improve their skills, technique, posture, ergonomics and all the other factors that are related to these disorders. Method: Survey was performed among physiotherapists that are performing duties in government hospitals, private clinics and all the other settings in Multan. This study included 100 physiotherapists of Multan. Self-design questionnaire as well as a Nordic questionnaire was used to collect data about WRMSK disorders. Data was gathered and was observed statistically. Results: 89% of physiotherapist were having had work related musculoskeletal disorder & 11% had no complaint, 75% female and 25% male & 23 to 50 years age population data was taken & the study observed that novice practitioner are at the increased risk of developing work-related musculoskeletal disorder & 45% were non specialized and 55% were specialized. The most commonly affected regions were upper back, low back and hip joint respectively. Conclusion: Upper back pain, lower back pain and hip pain were the most common complications among physiotherapists. Manual therapy shows association with the prevalence of MSK disorder

Prevalence and severity of urinary incontinence among females after normal vaginal delivery

Background: Urinary Incontinence is the most common disorder associated with women after vaginal delivery due to the weakening of pelvic floor muscles. More than 50% of females experience urinary incontinence. It is defined as the involuntary leakage of urine. The condition is common not only in older women but also in young nulliparous women. Objective: The key objective of the study was to determine the prevalence and severity of Urinary Incontinence after normal vaginal delivery. Method: The study was Cross-sectional and there were 160 participants in the study. The study was conducted at the Physical Therapy department and Gynaecology Ward of Fauji Foundation and Geo hospital Lahore. The data was collected from women who had delivered between the ages of 20-40 years. The data collection was done by using Incontinence Severity Index that was used as primary outcome measure. Results: A total of 160 responses were received, based on inclusion and exclusion criteria. Among respondents, females in the age group of 20-25 had a rate of urinary incontinence with 31.3 percent. Results showed that females in the age group of 25-30 had high BMI and had a high rate of urinary incontinence with the range of 61.3 percent. As result, there was a positive correlation of urinary incontinence between age and score that ranged from 0.185. There was a positive correlation of urinary incontinence between the score and BMI that ranged between 0.174. Conclusion: This analysis revealed that there was a high prevalence rate of urinary incontinence among females after delivery that had a correlation with age

EFFECTS OF STATIC STRETCH VERSUS HOLD RELAX IN IMPROVING FLEXIBILITY OF TIGHT HAMSTRINGS

Introduction: Hamstrings are a group of muscles which acts on two joint systems, performing multiple functions, thus prone to various injuries. Muscle tightness can be caused by active or passive mechanisms. Active mechanism involves shortening by spasm or contraction while passive mechanism involves postural adaptation or scarring for muscular shortening. Nevertheless, hamstring muscles usually become tight regardless of active or sedentary lifestyle. It is proved that hamstring tightness is the main leading factor to the risk of disorders of the knee and spine. This study was designed to find out immediate effect of Hold Relax versus Static Stretch on hamstrings tightness. Material & Methods: Seventy subjects were included (age 18-30) without excessive hamstring muscle flexibility and were randomly assigned to the one of two stretch groups. Group A was treated with static stretching and Group B was treated with hold relax technique. The left leg was treated as a control and did not receive any intervention. The Right leg was measured for Range of motion pre and post stretch intervention. Data was analysed with paired sample t-test and independent sample t-test to see the effectiveness of hold relax and static stretch in hamstring tightness. Self-made questionnaire was used and asymptomatic participants having tight hamstrings were included in the study after their consent form was signed. Only those subjects who fulfilled inclusion criteria were included in the study. Results: Paired sample t-test for both case and control group showed that there was significant improvement in the hamstring flexibility as the p value for both groups were less than 0.05 (p value 0.00). So, both HR and SS improves SLR. Independent sample t-test showed that there was no significant difference between the two groups as p value was greater than 0.05 (p value 0.011). So, both of these treatment techniques have same effect in the improvement of hamstring tightness with mean difference -3.543 and standard error 1.360. Conclusion: The results of this study concluded that both Hold Relax and static stretch techniques are equally effective in the release of hamstrings tightness