Foundation University Journal of Rehabilitation Sciences

Integrating functional fitness into rehabilitation: The science of high-intensity functional training

Zara Khalid — 2025-01-31

Impact of Dietary Intake on Severity of Multiple Sclerosis

Aleena Jafar — 2025-01-31

Background: Multiple sclerosis is a medical condition and there is no exact cure. Around 2.8 million people suffer from multiple sclerosis worldwide. Several environmental factors also play an important role in the progression of disease. The objective of this study is to determine the effect of diet on the severity of multiple sclerosis.

Material and Method: A cross-sectional study was conducted using nonprobability convenient sampling through a Google form from November 2021 to March 2022. The sample size for this study was 195 calculated by using Rao soft software. The semi-structured questionnaire includes a part of the food frequency questionnaire, the Multiple sclerosis quality of life-54 questionnaire, and Multiple sclerosis symptoms. Both males and females above 18 years of age, participants not having other neurological disorders other than MS, not having steroids, or a history of relapse from the past 6 months were included in this study. The institutional review board of PSRD College of Rehabilitation Sciences has granted permission to proceed with an authorization letter (PSRD/CRS/AJ/REC/Letter 26).Data entry, analysis, and interpretation were done using the SPSS software version 26.

Result: The mean age was 36.93±12.24 years. Most of the participants consuming carbohydrates (83.1%), proteins (72.3%), and antioxidants (73.3%) reported that their symptoms were much better from the past year (p value<0.001). Whereas the participants consuming dairy products reported their symptoms were worse than the last year.

Conclusion: This study concluded that some Carbohydrates, proteins and antioxidants have positive effects on MS whereas dairy products show negative effects on multiple sclerosis severity.

Prevalence of Carpal Tunnel Syndrome in motorbike mechanics

Mohammed Suleman — 2025-01-31

Background: Carpal tunnel syndrome (CTS) affects approximately 3-5% of the general population.

Objective: The aim was to assess the prevalence of carpal tunnel syndrome among motorbike mechanics and evaluate the diagnostic accuracy of various clinical tests for detecting CTS in this population.

Methods: A cross-sectional study was conducted on 82 mechanics working in different motorbike workshops in the twin cities of Rawalpindi and Islamabad. Those Motorbike mechanics who had more than 1 year of experience were selected, 4 special tests, Upper limb tension 1 (ULTI), Phalen’s maneuver, carpal compression test, and tinels sign along with a self-administered Boston Carpal tunnel Questionnaire (BCTQ) were used. Data was collected from individuals aged 18 to 35 years.

Results: A total of 82 motorbike mechanics participated in this research out of which 13 (15.9%) reported the symptoms of CTS. According to the symptom severity scale of BCTQ 36(43.9%) were asymptomatic, 39(47.4%) mild, 7(8.4%) moderate and none of them reported severe or very severe symptoms. According to functional status scale, 63(76.8%) reported no symptoms, 14(17.1%) were mild and 5(6%) moderate and with no severe or very severe symptoms reported. Furthermore, ULT1 accounts 14(17.1%), CCT 12(14.6%), Phalens maneuver 11(13.4%) and Tinel Sign 8(9.8%) for positive symptoms respectively.

Conclusion: This study concluded a low prevalence of carpal tunnel syndrome (CTS) among young to middle-aged motorbike mechanics. However, those working over five hours a day had a higher susceptibility to CTS, regardless of age

Correlation between freezing of gait and fear of fall in patients with Parkinson Disease

Sannia Nadeem — 2025-01-31

Background: Parkinson’s disease (PD) is a degenerative movement disorder characterized by the presence of Lewy bodies in the midbrain and the loss of dopamine producing neurons in the substantia nigra. PD presents with a wide range of symptoms, encompassing both motor or non-motor aspects.

Objective: To assess the relationship between gait freezing and fear of falling in individuals diagnosed with Parkinson’s disease.

Methods: A cross-sectional study having ethical approval number LCPT/DPT/18/804 was conducted on 72 PD patients at Stage III (Hoehn & Yahr), aged between 55 to 75 years, using convenient non-probability sampling. Participants were recruited from multiple hospitals in Lahore, while patients with comorbidities, cognitive dysfunction and secondary Parkinsonism were excluded. Gait freezing was assessed using Freezing of Gait Questionnaire (FOG-Q), with a validity of 0.96 and reliability 0.95; whereas, fear of falling was evaluated using Fall Efficacy Scale- International (FES-I), which has a validity of 0.84 and reliability 0.95 among PD patients. The duration of study was 6 months from June 2022 to Jan 2023.

Results: Among the 72 patients, 42 individuals (58.3%) were male, while 30 individuals (41.7%) were female. Mean age of study subjects was 62.09±5.93 years. The results of the study showed that freezing of gait and fear of fall were moderately positively correlated, with the correlation coefficient of r= 0.611 and a p-value of < 0.001.

Conclusion: Moderate Correlation was reported between gait freezing and fear of falling in individuals diagnosed with third stage of Parkinson’s disease.

Comparative effectiveness of PNF technique and Mulligan Concept of mobilization on Pain, Range of Motion, and Functional Mobility in Text Neck Syndrome

Ali Husnain — 2025-01-31

Background: Text neck syndrome (TNS), a chronic progressive condition caused by excessive use of handheld devices, is a growing health concern affecting millions worldwide.

Objective: The aim of this study was to compare and analyze the effective treatment protocol between Proprioceptive Neuromuscular Facilitation (PNF) technique and mulligan mobilization technique on TNS.

Methods: The study with the ethical approval number GCUF/ERC/23/2419 was a quasi-experimental design and used purposive sampling. Data was collected from patients with ages between 18 and 40 years, history of neck pain in the previous 3 months, visual analogue scale (VAS) ? 5/10, and those who used mobile phones more than 5 hours per day were included in this study. Group A (n=15) received PNF technique; diagonal pattern and contract-relax, and group B (n=15) was treated with Mulligan’s Mobilizations with Movement (MWM). Visual analogue scale, neck disability and cervical ROMs were analyzed by IBM SPSS version 24. Shapiro-Wilk Test was used to check normality of data and, paired T-test and independent T-test used to analyze within group and between groups comparison.

Results: The study compared pain levels and neck disability and cervical range of motion in two groups. Between groups analysis group A showed only significant difference in variable neck flexion (p?0.001) while both groups indicated significant improvements in visual analogue scale, neck disability index and ROMs; flexion, extension, and rotational movements independently i.e. p-value<0.05.

Conclusion: In this study, both PNF and Mulligan mobilization techniques significantly improved pain, range of motion, and functional mobility in individuals with TNS.

Effects of Exer gaming on upper extremity function and activities of daily living in Sub-Acute Stroke patient (Randomized Controlled Trial)

Yamna Mazher — 2025-01-31

Background: Stroke or cerebrovascular accident (CVA) can be defined as the quick loss of brain function caused by the alteration in circulation of blood to brain which may be ischemic or hemorrhagic.

Objective: To determine the effectiveness of exergaming compared to conventional treatment on upper extremity function and activities of daily life in sub-acute stroke patients.

Methods: Study with ethical approval REC/RCRS/20/2032 was conducted at Services Hospital Lahore. On the basis of diagnoses of left and right sided ischemic or hemorrhagic first strokes, with age from 45 to 65, at least six months and more than one month post-stroke, and cumulative Mini Mental State Examination scores of 19 or higher (MMSE) criteria 32 subjects were recruited and were allocated to Group A and B. Fugal Meyer Assessment (Upper Extremity) (FMA-UE) and Stroke Impact Scale (SIS) Version 3.0 were used to assess upper extremity motor function and activities of daily living (ADLs). Group A received Exer game therapy and Group B received conventional treatment. The patient received sessions five times a week, 30 minutes/ day for one month. Outcomes were evaluated at Pretreatment, four weeks and eight weeks interval.

Results: Results show that patients belonging to both Exer gaming group and conventional group showed improvement. When comparing the two groups’ upper extremity motor function and daily living activities, there was a statistically significant difference found (p value < 0.05).

Conclusion: It is concluded that Exer gaming was more effective as compared to the conventional treatment improving level of function in upper limbs and activities of everyday living

Clinical Trial Number: NCT04750746

Prevalence and association of Obesity and Knee Pain among women of Karachi

Maimuna Waseem — 2025-01-31

Background: Knee pain is more prevalent among adult women and is linked to central obesity, which is marked by an accumulation of excess abdominal fat.

Objective: The purpose of this study was to determine the prevalence and association of central obesity and knee pain among women.

Methods: This cross-sectional study with ethical approval number - 2023/78. SBBDU/DIRS was conducted from May 2023 to September 2023 and consisted of participants from Government Hospitals and Educational Institutes of Karachi Sindh, Pakistan. Data was collected from the sample of 150 women, included through convenient sampling technique. Nordic Musculoskeletal Questionnaire and Numeric Pain Rating Scale was used to collect data regarding knee pain whereas central obesity was determined by measuring waist circumference.

Results: Of the total 150 participants, 63.3 % had knee pain during the last 12 months and 36.7 % women has functional limitations due to knee pain, while 63.3 % women reported no activity limitation due to knee pain. Additionally, 43.3 % women had knee pain during last 7 days, with 36% describing the pain as moderate. A significant negative association was found between waist circumference and knee pain over the last 12 months (p = 0.003) and the last 7 days (p = 0.001).

Conclusion: The study highlights a high prevalence of knee pain among women in Karachi, with many reporting knee pain over the past year. A significant negative association was observed between central obesity and knee pain, indicating that as waist circumference increases, knee pain tends to decrease.

Correlation of physical fitness with fatigue in females with Premenstrual Syndrome

Iqra Imtiaz — 2025-01-31

Background: Premenstrual syndrome is a common clinical condition that happens 5-7 days before the onset of menstruation. It causes a set of psychophysiological symptoms among which fatigue is a common complaint.

Objective: To determine the correlation of physical fitness with fatigue in females with Pre-menstrual syndrome.

Methods: This analytical cross- sectional survey (Ethical and IRB review number: IRB # 066-24) was conducted in Shifa Tameer-e-Millat University Islamabad, Pakistan from May 2024 to August 2024. A total of 377 female students (18-28 years) were selected through non-probability convenient sampling technique. University students who were married, or using any other medications and those who do not fall under the criteria of Premenstrual Syndrome were excluded. Self-structured demographics questionnaire, Premenstrual Syndrome diagnostic questionnaire based on American College of Obstetrics and Gynecology (ACOG) criteria and Fatigue severity scale were used in this study. For the assessment of cardiorespiratory fitness, 20 m shuttle run test was performed, while muscle strength was assessed through Manual Muscle Testing. Speed and flexibility were determined by 4×10 m running test and sit and reach test respectively. Data analysis was done by using SPSS software version 23.

Results: The study found weak, non-significant correlations between VO2max and fatigue (r=0.055, p=.289). Upper limb strength showed weak, non-significant correlations with fatigue (r=-0.018, p=.727). Lower limb strength had very weak, non-significant correlations with fatigue (r=0.035, p=.500). Agility had weak, non-significant correlation with fatigue (r=-0.005, p=.923). Flexibility showed weak, non-significant correlations with fatigue (r=0.078, p=.131)

Conclusion: The study conclude that physical fitness levels may not play a substantial role in alleviating fatigue symptoms in premenstrual syndrome.