Study aim: • The purpose of the study is to evaluate the effects of manually applied percussions as opposed to mechanically applied percussions Design: The research will use a prospective randomized control trial as a study design. a study design in which participants are randomly assigned to either an experimental or control group. A hypothesis may be tested to see which variables are most likely to be significant explanatory factors. Settings and conduct: These investigations will be carried out in pediatric general ward and pediatric intensive care unit in Memon Medical Institute Hospital Karachi. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Children who will admit with symptoms of lower respiratory tract infection • Pneumonia patients of age 3months-15 years • Pneumonia patients who are confined to a hospital bed for an extended period of time. Exclusion criteria: • Over fractures, spinal fusion, or osteoporotic bone. • Over tumor area. • If a patient has a pulmonary embolus. • If a patient has a condition in which hemorrhage could easily occur. • In recent neurosurgery, head down position is contraindicated. • If patients has a hyper-reactive airways(cystic fibrosis) and severe bronchospasm (asthma) though, not an absolute contraindication Intervention groups: The targeted population for this research will pediatrics population admitted under diagnosis of pneumonia in Memon Medical Institute Hospital. Main outcome variables: • There will be no significant effects of manual and mechanical percussions. • There will be no significant effects of chest physiotherapy of admitted peadiatrics patients. • There will be significant effects of manual and mechanical percussions. • There will be significant effects of chest physiotherapy of admitted peadiatric patients.

Faisalabad; City : Faisalabad, Pakistan; Study Population: Patients suffering with non-specific neck pain

Study aim: This study aims to compare the effects of blood flow restriction training and routine physical therapy on clinical and functional outcomes in patients with lateral epicondylitis. Design: Parallel groups randomized clinical trial with blinded outcome assessment Settings and conduct: This clinical trial is conducted at Wasim General & Orthopaedic Hospital Gojra. The patients in control group have received routine physical therapy treatment including application of TENS, moist heat pad and stretching exercises (06 reps with10 secs hold) and strengthening exercises (10 reps with 10 secs of resistance application). The patients in experimental group have received blood flow restriction resistance training in addition to routine physical therapy treatment. In this training, limb occlusion pressure (LOP) is measured of affected upper limb. BP cuff is applied at deltoid level to restrict the blood flow at 30% LOP and then patient is asked to perform resistance exercises in 04 sets with 30 reps in 1st set and 15 reps in other 03 sets. Each participant(of both group)has 03 session per week for 06 weeks. Only data assessor is blinded. Participants/Inclusion and exclusion criteria: Patients of both genders having diagnosed unilateral tennis elbow in 20-50 years of age are included in the study. Patients who received steroid injections for tennis elbow in last 06 months, patients having cardiovascular diseases, bleeding disorders, peripheral diseases, hypertension, hypotension, tumor, trauma, systematic or skin diseases are excluded from the study. Intervention groups: There are two intervention groups. The control group is receiving routine physical therapy treatment alone and experimental group is receiving blood flow restriction training along with routine physical therapy treatment. Main outcome variables: The study outcome variables are pain, range of motion, functional disability and quality of life.

Study aim: To determine the effects of mobile application, dexteria fine motor skills on hand dexterity and grip strength in chronic stroke patients. Design: Randomized controlled trial Settings and conduct: • Jinnah Hospital Lahore(JHL) • Ittefaq trust hospital Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria Age: 40 to 60 years both male and female • Six months to 2 years post stroke • Participants must be able to open and close their fingers (even only 2 cm of movement) • Before stroke there must be fully functional hand • Normal or intact vision where as exclusion criteria is • Neurological disorders other than stroke for example multiple sclerosis or Parkinson disease. • Upper extremities acute orthopedic conditions. • Any cardiopulmonary complications • Medically unstable patients. Intervention groups: Conventional hand therapy group: The control group received conventional hand function rehabilitation therapy including, strengthening exercises which consist of palm down wrist flexion exercise, dexterity( shifting exercise) and fine motor skills(nine peg hole exercise) this protocol is given for 30-60 minutes session with 10 minutes of rest duration, 3 times per week for one month. Dexteria App therapy Group: The experimental group received an additional mobile application therapy including , dexterity fine motor skills, bowling game, scribble game and peglight game in addition to the conventional therapy for hand function. This protocol is given for 30-60 minutes session with 10 minutes of rest duration, 3 times per week for one month. Main outcome variables: • The Nine Hole Peg Test (NHPT) • Fugl-Meyer Motor assessment (FMA) • The Box & Block Test (BBT) • hand dynamometer

Study aim: In order to investigate the effect of different frequencies of TENS in urinary incontinence the current study was planned as no such study was done in not only Pakistan but Asia. The study will investigates the effect of TENS at two frequencies among patients post-stroke urinary symptoms

Muhammad Physiotherapy and Rehabilitation Center, Multan, Pakistan. After approval obtained from the

Study aim: 1. To check efficacy of active segmental stretching and 30-minute walking on pain reduction. 2. To check life’s quality in fibromyalgia patients. Design: A parallel group, single blinded, randomized controlled trial conducted on 62 females diagnosed with fibromyalgia between August to November 2022 with a 6 week follow up. Settings and conduct: This study was conducted in orthopedic department of Aziz Bhatti THQ hospital, Gujrat Data analyser is only blinded in our study because he does not know which and how interventional exercises were performed by patients. Participants/Inclusion and exclusion criteria: Inclusion: Female from 20 to 65 year old diagnosed with fibromyalgia in outpatient/inpatient clinics or by America College of Rheumatology Criteria in general population. Exclusion: Joint disorders (Grade 4 arthritis, hip or knee arthroplasty, rheumatoid arthritis) that can cause hindrance in the exercise program. Respiratory diseases or cardiovascular diseases (heart failure, cardiac pacemaker, uncontrolled arterial hypertension) that would prevent physical exercise. Pregnant and post-partum women. Intervention groups: Active segmental stretching group: Participants undergone through a 6-week supervised exercise program involving active segmental stretching of muscles mostly involving large muscles (paravertebral, gluteus, quadricep, hip abductor, latissmus dorsi, pectoral, trapezius and calf stretches). Each exercise was held for 30 seconDS 30- minute walking group: participants only undergo 30 min of brisk walk in bouts of 15 minute with no other specific exercises or Each intervention was done thrice a week for first three weeks and four time per week for the next three weeks Main outcome variables: Fibromyalgia impact questionnaire-revised (FIQR) for symptoms and impact of Fibromyalgia Numeric pain rating scale for pain SF-12 for quality of life

Settings and conduct: Department of gastroenterology tertiary care hospital Rawalpindi Pakistan

will be conducted at Muhammad Physiotherapy and Rehabilitation Center, Multan, Pakistan. After approval

Lahore, Pakistan. Participants/Inclusion and exclusion criteria: Inclusion criteria: male and female(40

Study aim: To determine the efficacy of thalidomide in the treatment of transfusion dependent thalassemia. Design: Randomized Controlled Trial, single group study of 55 patients with non blinded outcome assessment. Non probability convenience sampling. Settings and conduct: This study will be conducted at Department of Pediatrics, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. This study will be conducted after approval from Ethical Review Board (ERB) of Sheikh Zayed Hospital and University of Health Sciences, Lahore. Participants/Inclusion and exclusion criteria: inclusion criteria: thalassemia patients aged 2- 15 years Exclusion criteria: Patient with liver, renal, cardiac, pulmonary, neurological deficits or thrombotic episodes. Intervention groups: Patients diagnosed with beta thalassemia diagnosed according to clinical characteristics and hemoglobin electrophoresis were included in this study according to the selection criteria. At the time of treatment the patients will interviewed and tested for pre-treatment variables which include hemoglobin levels, transfusion rate. All the patients will then be given 2-5mg/kg thalidomide for 6 months as prescribed by the consultant and these variables will be tested again. Response rate will be tested on the basis of operational definition. The principal investigator will follow up with all the patients and see post-treatment results. Main outcome variables: This study will help us determine if we can use thalidomide in the treatment of beta thalassemia patients for reduction of transfusion, increase Hemoglobin level and response rate.

Study aim: To compare effects of Janda’s approach with Bruegger’s exercise on clinical outcome in patient with lower cross syndrome. Design: two arm parallel group randomized trial with single blinded and single center Settings and conduct: Physiotherapy department of Dr. Khalid Clinic Lahore Pakistan

National Medical center, Karachi, Pakistan. The patients were divided into 2 treatment groups; group 1 was

Study aim: To compare the effects of Semont and Epley’s maneuver in patients with Benign Paroxysmal Positional Vertigo (BPPV) using Patient Specific functional scale and Activity based Confidence (ABC) scale Design: Randomized Control Trial RCT, Single blind study Study groups: Epley's and Semont group Phase: N.A Sample size : 24 Randomization: In this study simple random sampling technique is used by sealed envelop method by using a computerized random number generator. The study is single blinded as participants is not aware of the intervention group they are placed in. Study center: Single center study Settings and conduct: Health care unit in Islamabad (ENT department) In this study simple random sampling technique is used by sealed envelop method by using a computerized random number generator. The study is single blinded as participants is not aware of the intervention group they are placed in. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Diagnosed Benign paroxysmal positional vertigo • Patients with recurrent rotatory vertigo attacks proceeded by rapid and/or gravity-dependent head movements • Patients with active daily life activities between ages 20 to 65 years • Patients having positional dizziness Exclusion criteria: • Patients who have any neuromuscular comorbidity • Patients on any kind of drug or sedative during study • Patients with epilepsy or on epileptic drugs • Patient with highly impaired vision • Bilateral Benign paroxysmal positional vertigo Intervention groups: There are 2 groups . 1. Epley's Group 2. Semont Group Main outcome variables: 1. Patient specific functional scale to evaluate functional scale 2. Activity based confidence scale to evaluate confidence level

Study aim: To compare the effects of core muscles strengthening exercises with routine physical therapy on trunk balance and functional mobility in stroke patients. Design: Single blinded, Randomized controlled trial Settings and conduct: Mubarak Medical Complex Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1) Patients who has the first on set of ischemic stroke.2)Age between 40-60 years. 3) Medically stable, understand and follow simple verbal instructions. 4) Both male and female with chronic stroke (6 months post stroke). 5) MMSE > 24 Exclusion Criteria: 1) Patients who could not communicate (severe aphasia). 2) Participants having neglect of paretic limb 3) Participants with severe spasticity (modified ash worth scale score >3). 4)Patient having visual and sensory deficit. 5)If patient had a neurological disease affecting balance other than stroke, such as cerebellar disease, Parkinson’s disease or vestibule disease. Intervention groups: All the participant who came to physiotherapy department was considered and screened for chronic phase of stroke.74 patients were allotted in two groups i.e.; group A(RPT) and group B(RPT+ Core strengthening exercises) via lottery method, 37 in each group. Consider the inclusion and exclusion criteria before concerning them in study. Both groups will receive the routine physical therapy. Patient in A group will be treated by routine physical therapy and in B group with routine physical therapy plus core strengthening exercises. Dosage:- 30 minutes RPT in both groups and core strengthening exercises with 7-10 repetitions for 15-20 minutes with adequate rest interval in experimental group.  Duration: - Four sessions/week (alternative days) and treatment last for 8 weeks. Main outcome variables: 1: Trunk Balance 2: Functional Mobility

Study aim: The aim of the study is to find out The effectiveness of neuromuscular electrical stimulation on motor function of hand in hemiplegic ischemic chronic stroke patients. The effectiveness of neuromuscular electrical stimulation on strength of hand in hemiplegic ischemic chronic stroke patients. Design: Randomized, parallel group with single blinded study. Sealed envelops were used. Settings and conduct: the trial is conducted in Sheikh Zayed hospital, RYK. Single blinded study design is used in which all the participants are kept blinded. Participants/Inclusion and exclusion criteria: Inclusion criteria: Hemiplegic patients having single episode of ischemic chronic stroke diagnosed by the neurologist. Male and female patients between 40 to 60 years of age.39 Duration of stroke, more than 6 months with spastic paralysis. Exclusion criteria: Participants with unstable condition I.e., recurrent stroke. Implanted electrical devices(pacemaker, defibrillator etc). Intervention groups: control group will receive routine physical therapy. Experimental group will receive neuromuscular electrical stimulation in addition to routine physical therapy. Main outcome variables: there are 2 main outcome variables 1.Fugl meyer motor assessment scale 2.Hand held dynamometer

Study aim: To determine effectiveness of core stabilization exercises versus conventional therapy on trunk mobility, function, ambulation and quality of life of stroke patients Design: Randomized control trial Settings and conduct: To take readings at pre-treatment and post-treatment levels, outcome assessors were recruited, who were blinded to the treatment group. Participants/Inclusion and exclusion criteria: 45-65 years of age, sitting achieved by patient for at least 10 seconds were included. Exclusion criteria: severe cognitive and communication disorders that can effect interaction with patient. Intervention groups: In conventional group patients were given range of motion exercises, mobility exercises like transfers and gait training, stretching, tone reduction, task oriented training and compensatory approach. Task oriented training emphasized on hemiplegic side. For upper limb, different objects were placed on table and patient was asked to use them. For ADL training combing, brushing, eating activities were performed. Reaching and grasping activities were taught in sitting position. Mat activities were performed with special emphasis in sitting positing. Group B: In experimental group core stability training was done by increasing frequency of repetition from 10 to 20 repetitions according to patient condition .Core stability consisted of abdominal drawing in maneuver for contraction of transverses abdominis. After training of ADIM movements of pelvis with and without ADIM were performed. Pelvic control exercises comprise of anterior- posterior tilt, lateral shift and transverse rotation. Bed exercises were bridging exercises. Curl up was done with progression from straight reaching, with diagonal reaching and with arms crossed. Multifidus exercises were performed. Main outcome variables: Trunk function: trunk impairment scale; functional ambulation categories; stroke specific quality of life scale

Study aim: To determine the effects of injury prevention program on speed, agility and power in cricket players. Design: Randomized Controlled Trial using fish and bowl method, a single blinded study, parallel group design having 44 patients. Settings and conduct: The study will be single-blind as assessors of the study will be kept blind about the allocation of patients to Model Town Cricket Ground. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 14-35 years of age, male athletes, athletes who have not participated in any injury prevention program. Exclusion Criteria: A medical history of lower extremity injury that required medical attention in the past 6 months, any systemic disorder, CVS disease, neurological disorder, bone fracture or surgery in the previous year, any psychosocial impairments which can hinder the study. Intervention groups: Group A: Group A will receive an injury prevention program (FIFA 11+ program) along with the baseline static stretching protocol. Group B: Group B will receive a dynamic stretching protocol along with the baseline static stretching protocol. Main outcome variables: Speed, Agility and Power

Study aim: this study aim is to compare the effects of Aerobic Exercise (Walking) Training and conventional physical therapy treatment in improving the quality of life in Chronic Stroke patient Design: two study group were made after taking the sample size of 60 by using the epitol website to online calculate the sample size and then divide into two groups.The sample was recruited through convenient sampling technique and then randomly assigned to the two groups. this will be single blinded study (assesor blind). Settings and conduct: Data was collected from following settings, • Haq orthopedic hospital sanda road lahore • Hijaz hospital gulberg lahore • Chudhary Muhammad teaching hospital lahore • Journal hospita our trial is single blind in which we have used the asssor blind technique through which the person who is taking the assesment after the treatment protocol is unawear Participants/Inclusion and exclusion criteria: Inclusion criteria • Age 45–75years. • Patients both Genders. • Chronic stroke • Lower limb should be functional atleast upto grade • Walking independently with or without of an assistive device Exclusion criteria • Stroke due to subarachnoid hemorrhage • Patients with any Systemic Illness(e.g. Rheumatism) • Patient with Mental disability Intervention groups: . Then participants were randomly divided into two groups. Interventional group : In group-A participants were given aerobic training (n=30) 30 minutes walk, 3 times a week for 12 weeks. Group-B participants were given conventional physical therapy including stretching and strengthening with massage to involved limb For 30 minutes, 3 times a week for 12 weeks They were tested before and after treatment session by using the outcome measuring tool morticity index and SF-36( HR-QOL) Main outcome variables: Quality of life

Study aim: 1. To investigate the effects of Microsoft Xbox Kinect-based Virtual Reality game training on the upper extremity motor rehabilitation of sub-acute post stroke survivors Design: Single Blind, Randomized Controlled Clinical Trial Settings and conduct: Trial will be conducted at Re Active Rehabilitation Center of The University of Faisalabad. The Trial is Single Blinded, Participants are blinded through Lottery Method. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Ischemic or hemorrhagic stroke, Stroke onset > 2 weeks and < 6 months • First-ever ischemic or hemorrhagic stroke confirmed by MRI or CT • Patients > age 25 • Unilateral upper extremity weakness, • Patients who could perform the reaching activity with their hemiparetic arm. • Both genders will be included • Voluntary shoulder, elbow and wrist movement which is able to perform In-game commands. Exclusion Criteria: • Patients with co-morbidities or neurodegenerative diseases, • Patients who are unable to follow verbal commands due to cognitive impairment or aphasia • Patients who are unable to participate Kinect-based VR due to any reason (e.g., visual impairment, hemi spatial neglect, apraxia) • History of seizures/fits, • Psychological illness, Intervention groups: Group A: In this group patients will be treated with routine physiotherapy combined with virtual rehabilitation. Xbox Kinect will used for training. The exercise program consists of stretching, strengthening and isometric exercises. Virtual rehabilitation consists of 30 minutes session 5 days per week for 4 weeks Group B: In this group patients will be treated with routine physiotherapy program. Routine physiotherapy will be performed 30 minutes 10 repetitions, twice a day 5 days per week for 4 weeks. Main outcome variables: Fugl-Meyer Assessment Brunnstrom Recovery Stages Modified Ashworth Scale The Motricity Index

Study aim: To compare Mulligan Bent Leg Raise versus Mulligan Traction Straight Leg Raise on pain ‎intensity and hamstring flexibility in patients with non-specific chronic low back pain‎ Design: Two-arm, parallel-group, randomized trial with blinded postoperative care and outcome assessment Settings and conduct: The study was conducted at Health Care Physiotherapy, Sports, Spine& Rehabilitation ‎Center, Faisalabad, 116 Patients were randomly allocated ‎into groups, Group A received Mulligan Traction Straight Leg Raise (TSLR) while ‎Group B patients received Mulligan Bent Leg Raised Technique (BLR). Participants/Inclusion and exclusion criteria: Inclusion criteria:‎ Age between 30-50 years‎, Both gender (male & f0emale, Visual Analog Scale Pain Score 0-7 (Mild Pain 0-4, Moderate Pain 5-7)‎, Non-specific chronic low back pain involving segmental hypomobility and gross ‎limitation of lumber mobility and restriction of SLR, due to discomfort & pain, 15˚ more as compared to the non-involved side.‎ Exclusion criteria:‎Visual Analog Scale Pain Score 8-10 (Unbearable Pain)‎, Patient already taking treatment for last 6 months, any neurological disease, any physical disability, Pregnancy, history of any surgical procedure involving back or lower extremity. Intervention groups: Intervention group A: Traction Straight Leg Raise (TSLR)‎ The Mulligan traction straight leg raise technique was used therapeutically to decrease pain and ‎range of straight leg raise when it was limited due to tightness in hamstrings or dysfunction in ‎the lower back. Group B: Bent Leg Raised Technique (BLR)‎ The Mulligan bent leg raise method was used for improving the range of straight leg raise in subjects ‎with nonspecific chronic low backache in order to improve hamstring flexibility in individuals ‎with hamstrings tightness. ‎ Main outcome variables: Pain; range of motion

Study aim: To find out the outcomes of traction versus positional pain relief phenomenon in the managmnet of non specific neck pain. Design: It was single blind, parallel group, single center randomized clinical trial with sample size of 42 patients enrolled between November 2017 to April 2018. Settings and conduct: It was single blind, parallel group, single center randomized clinical trial, The study was conducted at Ittefaq Hospital Lahore. Participants/Inclusion and exclusion criteria: Patients with Age 25-55 years of both Genders, Presenting with complaint of non-specific neck pain. and Limitation of Cervical Spine Range of Motion were included And • Patient with red flag sign, cervical injury, radiating pain, advanced degenerative changes, history of headache and vertigo, any Systemic Illness(e.g. Rheumatism) and altered Mental status were excluded from the study. Intervention groups: Group A: Patients in this group were treated with neck isometrics, hot packs for 10 minutes and cervical traction for three times a week for four weeks. Group B: Patients in this group were treated with neck isometrics, hot packs for 10 minutes and Pain release phenomenon techniques 10×20 sec for three times a week for four weeks.. Main outcome variables: outcomes were measured as scores of visual Analogue Scale for Pain, Neck disability index for Functional outcomes and Range of motion.

, Children’s Hospital and the Institute of Child Health, Multan, Pakistan Participants/Inclusion and exclusion

hospital Lahore, Pakistan. Participants/Inclusion and exclusion criteria: Inclusion criteria

Study aim: To determine the effects of myofascial release with and without Emmett technique in iliotibial band syndrome. Design: A concealed,randomized, non blinded controlled trial with a parallel group design of 22 patients. Settings and conduct: Saba’s Physical Therapy, Rehabilitation and sports injury clinic 25/H Gulberg 3, Lahore. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: Patient's with Positive Ober’s Test ,both males and females and age 25 to 45 years EXCLUSION CRITERIA: Patient's with TFL (Tensor Fascia Lata) tightness ,any pathological and traumatic conditions, Fractures and Dislocation. If patient has already received few sessions of Manual Therapy treatment.Taking corticosteroids, analgesic or anti-inflammatory drugs.Treatment of lower limb myofascial pain or trigger points at the time of the study.Current or previous symptoms of pathology reported in the lower limbs Intervention groups: Patients of both the groups will receive Hot pack therapy for 20 minutes. Group A will receive Manual myofascial release to iliotibial band by having the subject to lie in the side lying position on the unaffected side. Then the therapist applied a few kilograms of force weight along the iliotibial band course proximally to distally. The therapist will repeat this for 6 minutes. Group B will receive manual myofascial release and the Emmett intervention with the subject sitting upright light, constant pressure via the middle finger (at a perpendicular angle to the skin) will be applied at both points, three times for 10-20s with 5-10s breaks between. After that the subject will be instructed to walk around the room for a minute. Main outcome variables: Numeric pain rating scale, Goniometer and vertical jump test are used for assessing pain, flexibility of Iliotibial band and power of lower limb respectively.