Foundation University Journal of Rehabilitation Sciences

Etiological factors manifesting cerebral palsy in Pakistan: A narrative review

Ammara Rafique — 2024-07-29

Cerebral Palsy (CP) is an umbrella term for a group of neurological abnormalities that impair a person’s ability to stand, balance, walk, and maintain posture. It is caused by injury or anomalies in the developing brain, which tend to happen before or soon after birth or in early childhood. This article gathered the pooled etiological factors of CP in different cities of Pakistan. An extensive search approach was developed using three search themes: Cerebral Palsy, Etiology, and Pakistan(i). The published literature from different databases (CINAHL, Cochrane Database, Google Scholar, NCBI-PubMed, and Scopus/Elsevier electronic) was searched with no publication date limitation. All titles and abstracts were reviewed, as well as full texts of relevant articles were gathered from cross-sectional, cohort, descriptive case studies, pilot, prospective, and retrospective studies of CP patients in Pakistan. Birth Asphyxia is depicted as a major etiological factor for the manifestation of CP reported in various cities of Pakistan. The etiology implicated in CP is discussed in detail along with the directions for future research.

Importance of incorporating scapulothoracic stabilization exercises into neck physiotherapy

Manahil Shahid — 2024-07-29

Navigating treatment protocols for sacroiliac joint dysfunction: A comprehensive guide

Ayesha Arshad — 2024-07-31

Fatigue Matters: Rethinking Knee Osteoarthritis Management for Improved Walking Performance

Wania Maheen — 2024-07-31

Advancing care in Pakistan: The role of physical therapy in dementia

Sunnainah Naveed — 2024-07-31

Building Young Athletes: The Role of Physical Fitness in Sports

Muhammad Furqan Hassan — 2024-07-31

Frequency of myofascial temporomandibular disorder in fibromyalgia patients

Sana Saleem — 2024-07-31

Background: Fibromyalgia is a rheumatic disorder with key symptoms being widespread chronic pain, cognitive difficulties, sleep disorders, and fatigue or tiredness. There is a relation between temporomandibular disorders (TMD) and fibromyalgia due to their shared epidemiological, pathophysiological, and clinical symptoms.

Objective: To determine the frequency of myofascial temporomandibular disorder in fibromyalgia patients.

Methods: It was a descriptive cross-sectional study. The ethical approval was obtained having reference number LCPT/DPT/20/540. A total of 264 participants with age ranges from 30 to 60 years, both males and females diagnosed with fibromyalgia according to the American College of Rheumatology Criteria were included in this study. The Fonseca Anamnestic Index (FAI) questionnaire was used in order to diagnose temporomandibular disorders in participants who were previously diagnosed with fibromyalgia.

Results: 22.7% of participants (n = 60) were found to have no TMD according to the FAI scoring. 30.6% (n = 81) showed symptoms of mild TMD, 26.1% (n = 69) showed moderate TMD and 20.5% (n = 54) showed symptoms of severe TMD. The most common complaint was tiredness and muscular pain during chewing 59.1% (n = 156), followed by headaches 44.3% (n = 117).

Conclusion: A higher prevalence of myofascial temporomandibular disorder (TMD) was reported among the participants, with almost one-third experiencing mild symptoms. Notably, chewing-related pain and frequent headaches were prevalent issues.

Translation, cross-cultural adaptation and validation of the Quebec back pain disability scale to urdu language

Somiya naz — 2024-07-31

Background: Back pain is one of most prevalent health issues. The Quebec Back Pain Disability Scale (QBPDS) is a frequently used tool for back pain. Quebec Back Pain Disability Scale was translated into Urdu so that Urdu speaking population can appropriately report their back pain experience.

Objectives: To translate and across cultural adapt QBPDS into Urdu (QBPDS-U) as well as to evaluate QBPDS-U’s psychometric properties in patients having non-specific low back pain (NLPB).

Methods: The ethical approval obtained had reference number SN/73/19. The QBPDS was forward and backward translated and culturally modified into Urdu, according to Mapi Research Trust Guidelines. To assess the psychometric properties, there were 200 NLPB patients and 50 healthy individuals recruited for the study. The QBPDS-U, Oswestry Disability Index (ODI), visual analogue scale for pain (VAS_pain), and Visual Analogue Scale for disability (VAS_disability) were used. Patients responded to all questionnaires, as well as the global rating of change scale (GROC), after three weeks of physical therapy. Reliability, factor analysis, validity, and responsiveness were examined.

Results: The QBPDS-U showed high internal consistency (Cronbach’s alpha=0.96) and excellent test-retest reliability (intra-class correlation coefficient=0.93). Factor analysis of QBPDS-U retained single factor structure. The QBPDS-U correlated moderately with VAS_disability and VAS_pain [(r=0.65), P<0.001], but strongly with ODI [(r=0.73), P<0.001]. Discriminative validity was confirmed by significant differences in QBPDS-U total scores between healthy individuals and patients (P<0.001). The responsiveness of the QBPDS-U was verified by a significant difference in change scores between the stable and better groups (P<0.001).

Conclusion: The QBPDS-U is a valid, reliable, and responsive tool for measuring disability in NLBP patients who speak Urdu.

Functional status in children with leukemia after chemotherapy: A survey based analysis in Lahore, Pakistan

Maria Shafiq — 2024-07-31

Background: Leukemia is a disease occurring due to a defective hematopoietic tissue that endangers the health and life of children. Children with leukemia have a decreased functional status. However, there is no literature examining the functional status of children with leukemia after their treatment.

Objective: The objective of this study was to assess the functional status of children with leukemia after chemotherapy.

Methods: This was a descriptive cross-sectional study conducted on 89 patients. The ethical approval was obtained having reference number LCPT/DPT/4566. Data was collected from Children’s Hospital, INMOL Cancer Hospital, Lahore General Hospital and Jinnah Hospital. The duration of the study was six months. The sampling technique used was non-probability Convenient Sampling. The Lansky Play-Performance scale was used to assess the functional status of leukemia in children. Newly diagnosed patients aged between 4 to 15 years were included in the study. Data was analyzed using SPSS version 21. Variables were presented in the form of percentages and frequencies.

Results: The results showed that out of 89 patients, majority of patients i.e. 46.1% (n=41) were found to be severely restricted, 41.5% (n=37) were found to face mild to moderate activity restriction n=41, 12.4% (n=11) were able to carry on normal activity, and no special care was needed.

Conclusion: The study concluded that majority of children with leukemia after receiving sessions of chemotherapy were moderately to severely restricted in performing their daily life activities.

Effects of open versus closed kinetic chain exercises on pain, instability and balance in athletes with chronic ankle instability

Muhammad Ahmed Sajjad — 2024-07-31

Background: The ankle joint is a key component of the body’s balance mechanism. Estimates show that foot and ankle injuries account for 27% of all injuries sustained by collegiate elite athletes.

Objective: The objective of this study is to evaluate the impact of activities involving an open versus a closed kinetic chain on pain, instability, and balance in athletes with a history of chronic ankle instability.

Methods: The ethical approval for the study was obtained having reference number REC/RCR/&AHS/22/0446. 30 male patients between the ages of 20 and 40 who had a history of chronic ankle injuries and balance issues in athletes from Pakistan Sports Board, Lahore were divided into two groups, according to the file number, the last even and odd digits were added to the open chain kinetic and close kinetic groups, respectively. Treatment for both groups lasted 4 weeks, with 3 sessions per week.

Results: The mean age of the open and close groups is 28.58+3.9, 29.25+4.4 respectively Between group analysis Open and close chain NPRS post data mean and SD 0.400.50±1.60 ,8.28± with p value <0.05. Total score of FAAM Open and close chain post data with p value >0.05. Within group analysis of open chain and close chain pre and post NPRS data with p value <0.05. Pre and post total score FAAM Open chain and close chain with p value < 0.05.

Conclusion: Both treatments are equally effective there is no significant difference between the groups.

Clinical Trial Number: NCT05717426

Barriers to paediatric cardiac rehabilitation among congenital heart diseases in twin cities of Pakistan: A cross sectional survey

Maria Razzaq — 2024-07-31

Background: Congenital Heart Disease (CHD) presents significant physical and psychological challenges for affected individuals and their families.

Objective: The purpose of this study was to identify the barriers to paediatric cardiac rehabilitation.

Methods: Descriptive cross-sectional study was conducted on 200 parents of patients with congenital disease in 1 year from 2022 to 2023. The study included biological parents of patients aged from birth to 12 years who had a medical history of congenital heart diseases such as cardiac myopathies, septal defects, and valvular defects. Patients with other congenital disorders were not part of the study. After taking ethical approval with ethical approval number: Riphah/RCRS/REC/01447, data was collected through cardiac rehabilitation barrier scale and analyzed by SPSS 21.

Results: The age distribution revealed that 94 (47%) participants from birth to 4 years, 68 (34%) were with 5-8 years, and 38 (19%) were with 9-12 years. 124 (62%) were male, while 76 (38%) were female, 112 (56%) had history of surgery while 88 (44%) had not. 52(26%) were strongly agree with the barriers of Ability to travel 81(40.5%). Work responsibilities 75(37.5%), Poor transportation 85(42.5%), long Distance 85(42.5%), Cost of the rehabilitation programs 68(34%).

Conclusion: The study concluded that the major barriers to paediatric cardiac rehabilitation were work responsibilities in addition to overall cost of treatment and travel.

The prevalence of neck pain in mobile gaming players among undergraduate students in Karachi, Pakistan

Mustafa Zaveri — 2024-07-31

Background: In recent years, mobile phones have become indispensable for communication and entertainment.However, the surge in mobile gaming and its diverse offerings has led to prolonged gameplay without adequate breaks. So, people often adopt flexed neck positions, leading to neck pain. This study aims to identify the prevalence of neck pain in undergraduate students addicted to mobile gaming.

Objective: The study investigates the prevalence of neck pain due to mobile gaming addiction among undergraduate students studying in Karachi.

Methods: This cross-sectional study involves 405 undergraduate male and female students aged between 18 to 24 years from different universities and institutes in Karachi after obtaining institutional ethical approval having reference number ASHEC-PT-0125/12/22. Participants completed a questionnaire that included demographic information, the NPRS scale, and NDI measures.

Results: The mean age was 21.3±1.9 years. The NPRS showed a 74.1% prevalence of neck pain, 46.9% reported mild, 23.7% reported moderate and 3.5% reported severe pain. Furthermore, 25.9% had no pain while playing mobile games on smartphones. Additionally, NDI showed 23.5% no disability, 43.7% found mild disability, 23.5% found moderate disability, 7.2% found severe disability and 2.2% found complete disability. There was a significant association between daily time spent playing games and NPRS (p-value < 0.05).

Conclusion: The study findings highlighted that 74.1% of the total participants reported neck pain and discomfort. Also, a significant association between neck pain and mobile device usage for gaming purposes was observed due to prolonged poor posture, repetitive neck movements, and excessive flexion of the neck.

Comparison of vestibular and somatosensory disturbances in community-dwelling older adults with balance disorder

Alieza Khalid — 2024-07-31

Background: Aging is natural process which is sometimes characterized by physical impairment and functional disability, leading to dependence. This study compares the effects of vestibular and somatosensory disturbances on balance performance and fall risk in older adults.

Objective: The study aims to determine and compare the effects of vestibular and somatosensory disturbances on balance performance and fall risk in older adults.

Methods: A cross-sectional study involving 402 older adults was conducted over a 12-month period. The ethical approval obtained had reference number Riphah/RCRS/REC/01427. The Berg Balance Scale was employed as a standardized tool to assess balance, the m-CTSIB was used to evaluate individuals’ reliance on sensory systems, and the Modified Dix-Hallpike maneuver was applied to detect vestibular dysfunction.

Results: The study included 52.6% females and 47.1% males, with an average age of 60.28±9.37 years. On the Berg Balance Scale, only 5% of participants were classified as high risk for falls, while 45.4% and 49.4% were in the moderate and low-risk categories, respectively. Results from the Modified Dix-Hallpike maneuver indicated 73.4% positive outcomes and 26.3% negative outcomes for vestibular dysfunction. Balance performance showed a mild positive significant correlation (P < 0.05). The multiple regression analysis, using the formula: Fall Risk=?0 +?1 (BBS)+?2 (m-CTSIB) demonstrated a mild to moderate negative correlation between m-CTSIB scores and fall risk.

Conclusion: The study highlights the prevalence of vestibular dysfunction in older adults and the critical role of sensory systems in balance, emphasizing the need for targeted rehabilitation to improve health outcomes and quality of life.