Foundation University Journal of Rehabilitation Sciences

Importance of Health Policy and Systems Research for Strengthening Rehabilitation in Health Systems: A Call to Action to Accelerate Progress

Walter R. Frontera, MD, PhD — 2024-01-31

Effects of 6 weeks of step aerobics training on pulmonary functions among female students with sedentary lifestyle

Syeda Rida Fatima — 2024-01-31

Background: Sedentary lifestyle is among the leading cause of cardiovascular and respiratory diseases over the globe. Aerobic conditioning is among the beneficial intervention to improve pulmonary function and manage the complications caused by sedentary life style.

Objective: To determine the effects of step aerobics training on pulmonary function among female students with Sedentary Lifestyle.

Methods: This RCT was conducted in Margalla Institute of Health Sciences from February to July 2019. Nonprobability convenient sampling was employed to collect sample of 80 students, randomly allocated into groups (40 per group) by coin toss method. Group A performed step aerobics and Group B performed cycling for 6 weeks. Pulmonary function test (FVC, FEV1, PEF) and 3-minute step test was performed at baseline, after 2, 4 and 6 weeks in both groups. Heart rate and oxygen saturation was monitored pre and post exercise.

Results: The mean age of Group A is 22.43±2.49 and Group B is 21.80±2.04. Results showed statistically significant difference in respiratory function between groups. Significant improvement of respiratory function was observed in group A which performed aerobics program as compared to group B. The level of significance was set on p <0.05.

Conclusion: Step aerobics is considered beneficial in improvement of pulmonary functions and is a good alternative for conditioning program for female adults. Cycling also improved pulmonary function but the progress was slow as compared to step aerobics which showed quick impact in improving pulmonary function test.

Clinical Trial Number: NCT04051788

Effects of dry needling on pain, range of motion and function in patients with upper cross syndrome

Komal Uroj — 2024-01-31

Background: In upper cross syndrome, upper trapezius, levator scapulae, sub occipital, sternocleidomastoid, pectoralis major and minor become tight. Whereas, the phasic muscle including lower and middle trapezius, deep neck flexor and serratus anterior muscle weaken.

Objectives: To determine the effects of dry needling on pain, range of motion and function in upper cross syndrome.

Methods: This randomized clinical trial was conducted at Sheikh Zaid Hospital Rahim yar khan. Ethical approval REC/RCRS/20/1049 was obtained from Riphah International University Lahore. Group A was treated with dry needling along with conventional therapy and group B was treated with conventional therapy and 34 subjects were allocated in both groups. The duration of study was of 2 weeks with 1 session per week. The pre and post intervention scores were taken for Visual analogue scale, Neck disability index and neck range of motion. The data was analyzed using SPSS 25.

Results: There was no significant difference (p<0.05) between groups based on demographic data at baseline. The BMI in group A was 24.38(1.14) and in group B 23.19(2.59). The mean difference of VAS in group A was 2.89(1.68) with CI [1.98, 3.76] (p<0.05) and in group B was 2.87(1.03) with CI [2.33,3.42] (p<0.05). The mean difference for NDI in group A was 21.25(10.85) with CI [15.46, 27.03] (p<0.05) and in Group B was 14.68(8.42) with CI [10.20,19.17] (p<0.05). In VAS and NDI between group analysis did not show significant result (p>0.05).

Conclusion: Dry needling along with conventional therapy only improves range of motion but in term of pain and functionality, dry needling and conventional therapy are equally effective.

Clinical Trial Number: NCT04674904

Frequency of urinary incontinence in post-partum multiparous women

Sharjeel Tasneem — 2024-01-31

Background: Urinary incontinence (UI) is a widespread condition of uncontrollable urine leakage that has been strongly linked to natural delivery problem impacting one's wellbeing and quality of life.

Objective: The objective of study was to determine frequency of urinary incontinence in postpartum multiparous women in Karachi.

Methods: A descriptive cross-sectional study by using non-probability convenient sampling technique was conducted at different hospitals of Karachi in a duration of seven months, June 2020 to December 2020. A total of 267 women aged between 18 to 40 years, undergoing postpartum period after normal deliveries in last one year were included in the study. Ethical permission was taken from the Institutional review board of Hayat Institute of Rehabilitation Medicine. A consent form in their native language was taken before recruiting into the study. They were asked to fill the questionnaire Bristol Female Lower Urinary Tract Symptoms (BFLUTS). Data entry and analysis was done through SPSS version 26 and descriptive analysis was done. Data was presented in frequency and percentages, however, demographic information was presented in mean and standard deviation.

Results: A total of 267 women were recruited, the mean ±SD of age in years was 30.6 ±5.087 while all women were housewives. Females experienced symptoms like urgency 13.48%, bladder pain occasionally at 80.15%, and frequent visits to the toilet to urinate 41.2%. The current study discloses that 61.16% experienced urinary incontinence.

Conclusion: This study concludes that urinary incontinence is moderately found in postpartum multiparous women.

Bumping along: Healthcare students' perspectives on interprofessional education

Tayyeba Iftikhar — 2024-01-31

Background: Global regulatory bodies and the PM&DC (Pakistan Medical and Dental Council) share a competency framework that emphasizes the importance of graduates being effective communicators and collaborators in the healthcare system to achieve positive patient outcomes. However, due to unclear roles, conflicting power dynamics, and varying educational qualifications among healthcare professionals, effective interprofessional teamwork is often not realized, leading to suboptimal outcomes.

Objective: To evaluate the attitudes and readiness of healthcare students towards inter-professional education.

Methods: This comparative cross-sectional study was conducted from March to August 2020 by utilizing a prevalidated inventory called the Readiness of Interprofessional learning scale (RIPLS) to assess the readiness of students in healthcare programs. Data was collected using Google Forms, and the Kruskal-Wallis Test was employed to compare perceptions among the four groups.

Results: 157 students completed the questionnaire, resulting in a response rate of 58%. All four groups demonstrated high readiness for mutual learning (mean rank=78.78) although physiotherapy students had higher scores (mean rank=79.36) compared to the other groups, while nursing students had the lowest scores (mean rank=77.92).

Conclusion: The positive attitude of students towards interprofessional education and collaboration highlights the need for integration with other healthcare disciplines at both the curricular and co-curricular levels. Clinical case studies, problem-based learning, and simulations can be effective methods for fostering students' understanding of each profession's role.

Comparison of post isometric relaxation and post facilitation stretching techniques on hamstring muscle flexibility in collegiate athletes: A randomized clinical trial

Hafiz Zohaib Ahmad — 2024-01-31

Background: The multi-jointed nature of the hamstring muscles causes them to shorten which impacts the biomechanics of the pelvis and lumber region. Hamstring tightness is more common in women than in males.

Objective: To compare the effect of post-isometric relaxation and post-facilitation stretching in improving hamstring muscle flexibility among collegiate athlete's athlete.

Methods: Study was a randomized clinical trial. Patients following the inclusion criteria from Pakistan Sports Board, Lahore were categorized in two groups; group A and group B. Male patients aged from 18 to 35 years, with a history of hamstring muscle tightness (bilateral) or acute hamstring injuries were included. Group A was treated with post isometric relaxation and conventional treatment while group B received post facilitation stretching and conventional treatment; for 4 weeks and with 3 sessions per week. The baselines data was taken for range of motion, sit and reach test, active knee extension test, and straight leg raise and lower extremity functional scale.

Results: There were a total of 17 male volunteers in each group. Group A's mean age was 28.58±3.9, years whereas group B's mean age was 29.25±4.4 The groups' respective Lower Limb Functional Scores (LEFS) were 58.41±4.84 in group A and 40.52±2.85 in group B, with a p-value of less than 0.05. Lower limb functional score (LEFS) within the groups with p <0.05 was 22.17±8.63 and 40.52±2.85.

Conclusion: The current investigation found that post-isometric relaxing and stretching both improve hamstring flexibility.

Clinical Trial Number: NCT05727501

Physical activity and sleep quality in association to mental health among physical therapy students in different universities of Karachi: A cross sectional survey

Muhammad Mehran Haider — 2024-01-31

Background: Quality sleep is vital for mental function, with its deprivation reducing alertness and impairing concentration. Similarly, a lack of physical activity leads to problematic living and mental health issues such as depression and anxiety. Therefore, the main reason of this study was to solely focus on physiotherapy students and the effect of sleep and physical activity on their mental health.

Objective: The research project aimed to observed physical activity and sleep quality in association to mental health among physical therapy students in different universities of Karachi

Methods: A cross-sectional study on 360 DPT students in various. Karachi universities was conducted after obtaining approval from the Institute of Physical Medicine and Rehabilitation. The participants, DPT undergraduates aged 18-28 years, were selected through convenient sampling. Exclusion criteria included diagnosed systemic diseases or psychological conditions. The study utilized PSQI, DASS-21, and IPAQ shortform tools. Fisher's exact test was employed to analyse variable associations.

Result: The sample's mean age was 21.75 years, Range= 18-28 years. Most (80.60%) were females. Almost all were single (94.90%), and 97.5% were poor sleepers. However, no association was found between sleep quality and depression, anxiety, or stress levels (p values = 0.117, 0.181, 0.293).

Conclusion: The study revealed no association was found between poor sleep and physical activity levels with depression, anxiety, and stress in physiotherapy students, even though many face poor sleep. Students with poor sleep quality had higher physical activity levels than those with good sleep quality.

Frequency and severity of neck pain among undergraduate students using screen devices

Haseeb Muhammad Khan — 2024-01-31

Background: Screen use time has been on the rise among the students, which has detrimental effects on their health. One of the most frequent complaints from users is neck pain that predisposes individuals to functional limitations and persistent pain, which may result in poor academic performance.

Objective: To determine the frequency and severity of neck pain among undergraduate students using screen devices.

Methods: A descriptive cross-sectional study was conducted at Bashir Institute of Health Sciences from June to

October 2022. A sample of 80 students was selected using the non-probability convenient sampling technique to evaluate the relationship between screen device usage and neck pain. The participants were the undergraduate students, both male and female with age ranging from 18 to 25 years. Data was collected using a self-structured questionnaire and Numeric Pain Rating Scale and was analyzed by SPSS version 25.

Results: The findings showed that a substantial proportion of participants, specifically 71 (88.75%) reported experiencing neck pain at least once during or after device use. Moreover, the frequency of neck pain was found to be 73.8% annually, 43.8% within the last month, and 22.5% at the time of assessment. Moderate pain intensity was reported by 41 (51.3%) participants, while 22 (27.5%) reported mild pain on the Numeric Pain Rating Scale.

Conclusion: The study concluded that neck pain is frequently reported in students using screen devices with the majority having moderate level of pain severity.

Association of stress and sleep quality among the health sciences students: An analytical study

Rameeza Razaq — 2024-01-31

Background: Stress termed as a state of both mental and physical tension and sleep quality defined as how well an individual sleeps, stress and sleep quality regarded as significant physical and mental health determinants.

Objectives: To determine frequency of stress and sleep quality and to determine association between stress and sleep quality among health sciences students of Sialkot.

Methods: The cross-sectional study was conducted after ethical approval on a sample of 264 students in Sialkot. A convenient sampling approach was utilized. The sample was gathered from private medical colleges of Sialkot having undergraduate health sciences students. Perceived Stress Scale (PSS) was employed to assess the levels of stress in students and Pittsburg sleep Quality Index (PSQI) was used for student's sleep quality. The Data was analyzed through SPSS software, version 22. Chi-square test was used (p-value ≤0.05 was considered significant).

Results: Study comprised of 264 undergraduates having a mean age of 20.82±1.34 including 224 (84.4%) females and 40 (15.2%) males. Study showed high prevalence of stress and poor sleep quality with statistically significant association (p=0.027). Majority of students were experiencing poor sleep quality 232 (87.9%). 15 (5.7%) participants had low stress, 191 (72.3%) students were at the level of moderate stress and 58 (22%) were at severe stress level due to bad sleep quality.

Conclusion: The study concluded that there was high frequency of stress and poor sleep quality with significant association between stress and sleep quality but no significant association with demographics in targeted health sciences undergraduate students in Sialkot.

The frequency of dizziness among mild to moderate traumatic brain injury patient

Maham Ahmad — 2024-01-31

Background: Traumatic brain injury (TBI) is one of the leading factors of disability and death in population after any vehicle accident. Dizziness is one of the common complaints caused by TBI affecting their normal activities of life.

Objective: To determine the frequency of dizziness in mild to moderate traumatic brain injury patients.

Methods: The descriptive cross-sectional study was conducted on 78 patients, after receiving ethical permission from University. The sample was collected through nonprobability convenience sampling technique. The patients were selected according to the designed inclusion criteria in which male and female patients of 20 to 60 years of age with mild to moderate traumatic brain injury having GCS score of 9-15 were enrolled in the study. The dizziness handicap inventory was used for assessment of dizziness. The data was analyzed using software of SPSS version 26 in which frequency and percentage were determined.

Results: Among 78 patients, 44.23±12.42 was the mean age, 57.7% were male and 42.3% were female. Furthermore, 11.5% were mildly handicapped, 47.4% were moderately handicapped and 41% were severely handicapped due to dizziness.

Conclusion: It was concluded that dizziness is highly prevalent among mild to moderate TBI patients that made them moderate to severely handicap in performing their normal activities of life.

A multidisciplinary approach to temporomandibular disorders (TMD): The role of physical therapy

Sabah Afridi — 2024-01-31

Practicing emerging therapeutic interventions without proper knowledge: A growing concern among physical therapists

Sana Shahzad — 2024-01-31

Vibration therapy: An adjunct to neuro-rehabilitation in cerebral palsy

Ayesha Ahmad — 2024-01-31

From awareness to action: Propelling virtual reality into routine physiotherapy in Pakistan

Zainab Rahman — 2024-01-31

Lack of utilizing evidence based training protocols for fitness training and injury prevention in athletes: The need to promote sports physical therapy in Pakistan

Hammad Najam — 2024-01-31