Study aim: To investigate the effect of virtual reality on trunk control in children with developmental delays Design: randomized controlled trial , single blind, parallel group Settings and conduct: The children hospital Faisalabad Participants/Inclusion and exclusion criteria: • Willing to give consent. • Both gender male/female • Age limit 3-8 years (11) • Able to follow visual and verbal commands (16) • Gross motor function level II-IV (11) • Those with an appropriate cognitive level to understand a VR exercise program • Inability to follow instructions • Other Neurological disorders (polio, epilepsy, seizures, trumatic brain injury) • Malgnanices and Infectious disorders ( encephalitis, meningitis, malignancy, tumors ) • Patients having musculoskeletal problems ( fracture, congenital hip dysplesia) • Spastic CP with Ashworth scale 2 + • Any surgery within last 6 months • A diagnosis of Autism or attention deficit disorders • Psychiatric disorder Intervention groups: Group A receives baseline treatment utilizing neurodevelopmental treatment (NDT) principles, focusing on trunk control through three stages of exercises: initial stage for dynamic co-activation, second stage for weight shift facilitation, and third stage for trunk rotation induction. Group B, the study group, undergoes 24 sessions of baseline treatment combined with immersive virtual reality (VR) protocol over 8 weeks. Sessions last 30 minutes, with 15 minutes of NDT followed by 15 minutes of playing VR games targeting trunk control and gross motor function. Games involve dynamic adaptations for head and trunk movements to promote engagement and motor learning. Main outcome variables: The trunk control measurement scale

Study aim: To determine the effect of neurological music therapy on cognitive function, emotional well being and quality of life among older adults with mild cognitive impairment. Design: randomization simple random sampling technique with lottery method, parallel group Settings and conduct: allied hospital Faisalabad Participants/Inclusion and exclusion criteria: Both Male and female Presence of MCI (Montreal Cognitive Assessment score < 26) Being able to walk safely A low level of physical activity assessed by means of a physical activity questionnaire. Age 60-80 years En Older adults with visual impairment and those with hearing problems History of cardiovascular disease Presence of neurological disorder ( Parkinson's disease, multiple sclerosis ) Patients having Serious motor deficits Patient having difficulty in moving and communicating Left-handed or ambidextrous Patient having diagnosis of severe cognitive impairment such as dementia. Presence of depression Intervention groups: The MMT group participated in a multi task MMT program consisting of exercise therapy with music and use of the Naruko clapper. The STT group participated in exercise sessions that involved the same movements as those in the MMT group. However, in these sessions, the instructor (single task) counted out the movements without accompanying background music or the Naruko clapper. Main outcome variables: • Cognitive function • Physical Function • Quality of life

Study aim: The present study is aimed at recording the average intensity of pain experienced by the patients after root canal procedure through rotary devices which are not used in common practice by the dentists in our community and comparing it with older techniques such as manual hand files which are more commonly used. Design: In this non blinded randomized control trial subjects were divided into two interventional groups by lottery method. There were 30 subjects in each. The patients were asked to mark their pain on a Numeric pain intensity scale at 6-, 12-, 24- and 48- hour postoperative intervals. Settings and conduct: Out-patients in the department of Operative dentistry, Rehman College of Dentistry, Peshawar Participants/Inclusion and exclusion criteria: The inclusion criteria were patients of both gender of age between 20 to 50`years, incisors and canines with irreversible pulpitis, periodontally sound tooth, with no systemic diseases, no radiographic changes on periapical radiograph and restorable teeth. Excluded were subjects who had taken pain medication 12 hours prior to the treatment. Subjects unable to understand the consent and the procedure itself. Intervention groups: In the manual instrumentation group the cleaning and shaping of the root canals was done by NiTi K-files. In the rotary instrumentation group cleaning and shaping of the root canals was done by HyflexNiTi rotary system. In order to keep equal apical diameter, the final apical preparation in both groups was kept similar.. The patients were asked to mark their pain on a Numeric pain intensity scale at 6-, 12-, 24- and 48- hour postoperative intervals. Main outcome variables: Pain perceived by the subject at given time post operative intervals.

Study aim: Aim of the study is to assess the efficacy of intravenous cyclophosphamide as compared to oral cyclophosphamide in the treatment of primary membranous nephropathy. Secondary objective is to document side effects of both regimens Design: Two arm parallel unblinded, Randomized control trial. Sample size is 58. 29 patient in each group. Randomization will be done by lottery method. It will be a singe center study. Settings and conduct: Indoor and out patient department of Nephrology department of Jinnah hospital. It will be non blinded study. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1. Serum Anti-Phospho Lipase A2 Receptor positive or IgG4 positivity on Immunofluorescence. 2. Biopsy–proven Idiopathic Membranous Nephropathy high risk group (Spot Urine protein/ spot urine creatinine Ratio more than 8g/g). 3. Biopsy –proven Idiopathic Membranous Nephropathy, moderate risk group that has failed to respond to conservative therapy for 6 months. Exclusion Criteria: 1. Patients with clinical, histologic, or serologic evidence of secondary Membranous Nephropathy. 2. Active or ongoing infection/ Recent infection. 3. Allergy or contraindication to cyclophosphamide. Intervention groups: Patients will be assigned into two groups randomly. Non probability / consecutive sampling technique will be used. One group will be given intravenous cyclophosphamide, 500mg/m2 on 2, 4 and 6 months and steroid on 1, 3 and 5 month as per modified ponticelli regimen. Control group will be given oral cyclophosphamide 2 mg/kg/day on 2, 4 and 6 months and steroids on 1,3 and 5 months as per modified ponticelli regimen. Main outcome variables: Spot urinary protein: creatinine ratio. Serum creatinine. Side effects like anemia, thrombocytopenia, leucopenia, any infection or hospitalization and malignancy.

Study aim: To compare the combine effect of cervical isometric with shoulder isometric exercises on pain, function and forward head posture in patients with cervical spondylosis. To find the correlation of factors affecting on pain, function and their management in the patients with cervical spondylosis Design: A community based, single blind, parallel group, randomized controlled trial Settings and conduct: Study conducted in Water and Power Development Authority teaching Hospital Lahore the trial is single blind, the participants and data analyzed were blinded they did not know, they belong to which group either experimental and control group Participants/Inclusion and exclusion criteria: Both male and female, 30-60 years, Diagnosed patients by orthopedic surgeons, No previous surgical /steroidal history in last six months, Patients having symptoms of radiculopathy Exclusion Criteria: Pregnant women, History of previous cervical surgery, Vertebral compression fracture, History of malignancy, Rheumatoid disorder and other systemic problems, Any infectious disease like osteomyelitis, tuberculosis, ankylosing spondylitis etc. Intervention groups: Group A (experimental) was received cervical isometric exercises with shoulder isometric exercises. Group B (control) was received cervical isometric exercises without shoulder isometric exercises. Main outcome variables: Compare the combine effect of cervical isometric with shoulder isometric exercises on pain, function and forward head posture and correlation with factors

Study aim: To analyze the comparative effects of integrated neuromuscular inhibition technique and active release technique in patients with upper trapezius myofascial trigger points. Design: Two arm parallel group Randomized trial with participant blinded. Randomization was centralised and computerised with concealed randomization sequence carried out through a randomization software. Settings and conduct: The trial is conducted in Riphah International university Faisalabad Campus. Subjects are chosen according to inclusion criteria. Subjects are blinded as the don't know their treatment protocol and group. Participants/Inclusion and exclusion criteria: Inclusion criteria: Participants aged between 20 to 35 years; Work/sedentary activity of 5 hours per day; Minimum of 4 months of neck pain due to trigger points; Decreased cervical lateral flexion and rotation Exclusion criteria: History of whiplash injury, fracture or other congenital disorders; Cervical radiculopathy, radiculitis or myelopathy or vascular syndromes; Degenerative conditions of cervical spine e.g., spondylosis; Any deformity of cervical and thoracic spine or scapular deformity; Participant received any treatment of neck in past 3 months; VAS score >7 Intervention groups: Group A: Integrated neuromuscular inhibition technique. Intermittent Ischemic compression for 15 seconds, Strain-Counterstrain for 20-30 seconds, Muscle Energy Technique in which isometric contraction held for 7-10 seconds and stretch held for 30 seconds (3-5 repetitions) Group B: Active Release Technique - 3 sets with 10 repetitions Main outcome variables: Neck pain; Cervical lateral flexion and rotation; Neck disability

Study aim: To compare the effects of Vestibular Rehabilitation Therapy and Task-Oriented Circuit Training on Gait, Balance and fear of falling in Elderly Population. Design: Randomized Clinical Trial Settings and conduct: Allied Hospital Faisalabad- Old Age Shelter Home Faisalabad Participants/Inclusion and exclusion criteria: Inclusion criteria: age of participants 60 y/o or more; have fallen at least once in the last 12 months; taking more than 15 s in the timed up-and-go (TUG) test; both genders; identified as medium fall risk on BBS (21-40)/56. Exclusion criteria: balance disorders(neurologic, vestibular, etc.); organic conditions. Intervention groups: Task-Oriented Circuit Training: The protocol will included: Sit to stand, Stand up and walk (6 m),Walking over inclined surface (3 m), Step, Taking an object from the ground while walking (6 m), Slalom (6 m),Climb and descend stairs, Touch different point marked a semicircle on a mirror with the feet, Reaching to object while standing, Standing on a movable platform Vestibular Rehabilitation Therapy: Head movement: backward and forward bending, turning from right to left, Balancing on a mat and swiveling eyes, Standing on a sports mat, walking on the spot, and rotating the head on both sides, Alternately shift weight toward one limb while maintaining partial weight bearing on the other, keeping the sight on a fixed target object. Repeated for the opposite side, Standing on foam with closed eyes and rotating the head on both sides, Forward and backward walking with a side-to-side head turn, Sitting on a ball with feet on foam, eyes closed, and bouncing slightly while turning the head from side to side, Marching in place. The sessions will be 20 to 30 minutes; 3 days per week for 6 weeks. Main outcome variables: Timed Up-and-Go (TUG) Test; Dynamic Gait Index; Falls Efficacy Scale-International(FES-I)

Study aim: To find out the effectiveness of Piriformis stretch and muscle activation exercise among patients with Piriformis syndrome. Design: The design of this study is Randomized, parallel clinical trial. Randomization is done by Lottery method. In this method the researcher gives each participant of the trial a number. Researchers draw numbers from the box randomly to allocate participants in two groups. Settings and conduct: The study is conducted at Arif Memorial Teachning Hospital. in this trial participants are blinded through concealment to avoid baisness. Participants/Inclusion and exclusion criteria: Inclusion criteria: suffering from Piriformis syndrome; both male and female; being at the age between 20 and 50 years. Non-inclusion criteria: The condition be a complication of hip surgery or fracture Intervention groups: Intervention group: All the patients of this group will be treated by Piriformis stretch. Control group: All the patients of this group will be treated by muscle activation exercise. Main outcome variables: Pain intensity; Low back Disability

Study aim: To compare the efficacy of Kinesio Taping after Mandibular 3rd Molar Extraction in terms of Post Op Swelling And Trismus Design: A simple randomized controlled clinical trial with a parallel group design of 154 patients, enrolled between October 2023 and January 2024 and followed for one week after the enrollment of last patient. Settings and conduct: Trail will be performed in Oral and Maxillofacial Surgery Department of AFID. Two groups will be made by simple randomization of patients getting surgical removal of Mandibular third Molars. One group (intervention)will get K taping done post operatively un addition to normal post operative care and second group (control) will have usual post operative care. Participants/Inclusion and exclusion criteria: Inclusion Criteria Having physical status 1 according to ASA classification Surgical extraction in mandibular third molars. Teeth which score =/>5 on Pederson's difficulty index for removal of impacted third molars EXCLUSION CRITERIA Patients having beard or any other hindrance in application of K- TAPE Patient with odontogenic infection Patient with medications that can alter pain perception. Teeth which score <5 on Pederson's difficulty index for removal of impacted third molars Intervention groups: Kinesio Taping will be performed in one group after 3rd Molar Extraction and No intervention will be performed in other group after 3rd Molar Extraction Main outcome variables: Post Operative Swelling Post Operative Trismus

Study aim: To compare the direct and indirect sinus lifting techniques for maxillary bone augmentation in patients receiving Implants Design: Single Blinded Randomized Controlled Trial Settings and conduct: Trail will be performed in Oral and Maxillofacial Surgery Department of AFID. Two groups will be made by simple randomization of patients getting sinus lifting done for placement of Dental implants in the Maxillary Molar region . One group will get the sinus lifting done via Direct method and second group will get it done by Indirect method.Patients will be randomized by using lottery method and concealed lottery tickets will be used for the purpose of blinding. Participants/Inclusion and exclusion criteria: INCLUSION Having physical status 1 according to ASA classification Bone Height Less than 5mm in Maxillary Molar Region EXCLUSION Pregnant women, nursing mothers, smokers Patient with infection in Maxillary Molar Region Patients Having Sinus Pathology Patient with medications that can alter pain perception. Intervention groups: Direct Sinus Lifting will be performed in one group and indirect in Other for Augmentation of Vertical Bone Height Main outcome variables: Post Op Pain; Post Op Swelling; Gingival Swelling; Implant Stability; Patient's Compliance

Study aim: The aim of this study is to compare the per and post-operative analgesic efficacy and adverse effect profile of ultrasound guided paravertebral plane block versus epidural anesthesia in patients with bronchiectasis planned for partial pneumonectomy. Design: Parallel group, single center, interventional randomized controlled trial Settings and conduct: Done at Combined Military Hospital, Rawalpindi Participants/Inclusion and exclusion criteria: Inclusion criteria included all ASA-II and III patients between ages 60-70 years presenting in the thoracic surgical department for partial pneumectomy for bronchiectasis. Exclusion criteria included patients with major cardiac or respiratory disease, low ejection fraction, allergy to bupivacaine or nalbuphine, unwilling to be included in the study, infection at site of block, coagulation disorders or spine deformity or having contraindication to epidural insertion. Intervention groups: The patients will be divided into the paravertebral group (PVB) (n=45) and epidural group (n=45). The method of sampling was non-probability consecutive sampling via lottery method. Patients in the paravertebral group (PVB) were taken to the procedure room before starting the procedure. Paravertebral block was given in sitting position with the arms of the patient extended. Confirmation correct needle placement was done by deflection of the pleura downwards on injecting 2 mL of saline. Patient in the epidural group were prepped for procedure and 18 G epidural catheter after priming was inserted in the T8 vertebral space. Main outcome variables: Primary variables measured were per-operative analgesia requirement, patient satisfaction for pain relief 24 hours after surgery and 24- hour total dose of analgesia needed. Secondary variables observed were hypotension, nausea, shivering and respiratory depression.

Study aim: The aim of this study is to compare analgesic efficacy and patient satisfaction when comparing the intercostal nerve block versus erector spinae block in patients presenting with traumatic multiple rib fractures. Design: Randomized controlled trial Single center randomized interventional study Settings and conduct: Conducted at Combined Military Hospital (CMH) Gujranwala Patients in Group E received intravenous 0.5% bupivacaine with 2% lignocaine diluted in distilled water to make a total volume of 20 ml given according to block guidelines under ultrasound guidance furnished by NYSORA. Patients in Group I received the similar titration of drug as 3 ml aliquots in each intercostal space under ultrasound guidance according to block guidelines furnished by NYSORA as well. Participants/Inclusion and exclusion criteria: Total 380 participants randomized into two groups of 190 each Inclusion criteria included all male and female patients between ages 25-55 years presenting in the operating room for pain relief with regional block with multiple rib fractures (>2 ribs) not requiring surgical intervention admitted for observation. Exclusion criteria included patients with metastatic disease, major cardiac or respiratory disease, low ejection fraction, post chemotherapy, allergy to lignocaine or bupivacaine, patients with advanced polytrauma causing hemodynamic instability, patients with oxygen saturation less than 92% after supplemental oxygen, patients with flail chest or pneumothorax and patients unwilling to be included in the study. Intervention groups: Group E: To receive erector spinae block Group I: To receive intercostal nerve block Main outcome variables: Primary variables measured were mean time to first rescue analgesia, total dose of intravenous analgesia needed in 24 hours and patient satisfaction for pain relief on the Likert scale 24 hours after intervention.

Study aim: Treatment efficacy of oral versus intravenous iron supplementation in improving the serum iron and hemoglobin status of patients with chronic kidney disease not on hemodialysis or erythropoietin Design: Single center, parallel group, randomized controlled interventional trial Settings and conduct: Department of Medicine, PEMH Rawalpindi Participants divided into the intravenous iron supplementation group (Group I) (n=105) and the oral iron supplementation group (Group O) (n=105). Participants/Inclusion and exclusion criteria: Inclusion criteria included all male and female patients over the age of 18 years not on hemodialysis or erythropoietin diagnosed as anemia with a baseline Hb of less than 13 g/dl in males and less than 12 g/dl in females with established chronic kidney disease with a GFR (glomerular filtration rate) of less than 60ml/min for more than 90 days assessed using the CKD-EPI equation and/or hyper albuminuria with urine albumin  30 mg in 24 hours or urine albumin to creatinine ratio (ACR)  30 mg/g. Exclusion criteria included patients on dialysis, erythropoietin or use of erythropoietin stimulating agents (ESAs) in the last 3 months, patients with advanced liver, cardiac or ESKD (end-stage kidney disease), drug allergies to iron and its supplemental form during therapy or previous known history or unwilling to be included in the study. Intervention groups: Intravenous iron group (Group I) (n=105) Oral iron group (Group O) (n=105) Main outcome variables: Primary variables observed were changes in the serum iron, Hb, transferrin and TIBC. Secondary variables observed were the adverse effect profile seen with both treatment regimes

Study aim: To compare the efficacy of buffered local anesthetic with non-buffered local anesthetic in terms of pain reduction and speed of onset of anesthesia. Design: It was a randomized, parallel group, double blinded, single center study including 100 patients in total. Settings and conduct: This randomized controlled trial was conducted at Armed Forces Institute of Dentistry in the outpatient department of Oral & Maxillofacial Surgery from March 2020 to Dec 2022. Participants/Inclusion and exclusion criteria: The physical condition of all patients was evaluated, and those with systemic diseases for which injections of lignocaine with adrenaline were contraindicated, were excluded from the study. Intervention groups: The study included a total of 140 TMD patients that were randomly assigned to two groups: Buffered Group (A) (n=50) and Non- Buffered Group or Control Group (B) (n=50). Buffered local anesthesia was made by adding 0.18 ml of 8.4% solution of sodium bicarbonate to a 1.8ml cartridge of 2% Lignocaine with adrenaline 1:100,000 leading to a 1:10 dilution. All procedures were done by a single maxillofacial surgeon, who was unaware of the type of LA given to the patient. Main outcome variables: Pain intensity was assessed using the Visual Analog Scale (VAS) and speed of onset of anesthesia measured in seconds from point of retrieval of the needle.

Study aim: To compare effects of virtual reality and routine physical therapy on balance and postural control in adulthood population having risk of fall Design: Randomized clinical Trial. single-blinded, 64 samples, parallel groups, randomized by computer-generated method and further concealed envelop method used for allocation in the group. In the envelope, 1 will be code for the control group and 2 will be code for the experimental group. Settings and conduct: The study will be conducted at the Department of Physiotherapy Al-Noor Hospital Pasrur, Sialkot with the approval of UIPT UOL. The study will be single-blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Age 40-65 years. • Both gender • Capable of walking with and without any assistance • Having normal and corrected visual and auditory acuity • Having Berg Balance Scale Score from 21-40. • Can understand instructions. • Individuals with disease, diabetes mellitus, knee osteoarthritis grade 1 on Kellgren and Lawrence scale will also be included. Exclusion Criteria: • Any comorbidity. • A history of other neurological, cardiovascular, or orthopedic diseases affecting postural stability • All patients having a pacemaker or a history of serious cardiac event or of cardiorespiratory dysfunction • Severe cognitive impairment or aphasia leading to difficulty in communication Intervention groups: INTERVENTION GROUP (Virtual Reality Exercise) The intervention group will be receiving simulated balance exercises in the form of 30–60-min sessions on a weekly basis (5 days) for 6 weeks. For simulated balance exercises, Xbox Kinect will be applied, which is a game console simulating balance exercise in the game environment and allows a person to move freely and have diverse positions. Main outcome variables: Balance and Postural control.

Study aim: This study aims to find out synergistic effect Berberis aristata and metformin in lowering blood glucose level in diabetic patients.Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels Design: Lottery method, community bases,parallel group, double blinded, randomized control trial. Settings and conduct: Study will be conducted at Muhammad Institute of Medical and Allied Sciences Multan after approval from Institutional ethical committee. Participants/Inclusion and exclusion criteria: Inclusion criteria: Age group of 25-70 years Both Genders (Male, Female) Hypertensive patients Married and unmarried Educated and uneducated Diabetic patients Exclusion criteria: Any type of mental disability Lactating females Having any type of physical disability History of chest pain, bronchitis, asthma, angina, MI Chronic illness related to cardiorespiratory ailments Any type of major surgery• Pregnant females Intervention groups: Patients will be recruited by using the lottery method into three groups. Informed consent will be taken from patient. Group A will be treated with Berberis aristata (550 mg twice a day) orally. Group B will be given metformin orally (500 mg). Group C will be given both Berberis aristata and metformin (550/250 mg once). The treatment regimen will be 6 weeks. Blood glucose, blood pressure, blood cholesterol, respiration rate, heart rate, ketone bodies, HbA1c, DDS score and oxygen saturation of all the patients with diabetes type-2 at baseline and after 6 weeks. Main outcome variables: Cardiometabolic and cardiorespiratory parameters including Blood glucose, blood pressure, blood cholesterol, respiration rate, heart rate, ketone bodies, HbA1c, DDS score and oxygen saturation

Study aim: To find out what is better in reducing neuropathic pain and increasing balance and functional reach between plantar massage and reflexology foot massage among patients with peripheral neuropathy Design: A randomized clinical trial with two parallel intervention groups, a study of phase 3 with 18 people in each group, 36 in total. Settings and conduct: Allied hospital Faisalabad General hospital Samanabad Participants/Inclusion and exclusion criteria: Both genders are between 35 and 60 years old. Diagnosed patients with grade II peripheral neuropathy. Ability to stand on both feet. Can perform the given instructions. There was no cardiac problem. No fracture, injury, or amputation of the lower or upper limb. Any neurological problem. No foot or toe ulcer. There is no peripheral thrombosis. Ambulation difficulties or using any walking devices were excluded. No vision impairment. Intervention groups: Group A: Plantar massage group Group B: Reflexology foot massage group Main outcome variables: Pain Balance Functional reach

Study aim: This study investigates the f Comparative Effects Of Neural Slider Technique And Neural Tensioner Technique On Wrist Pain, Function, And Grip Strength In Pregnant Women With Carpel Tunnel Syndrome Design: Simple Random Sampling technique Settings and conduct: Allied Hospital Faisalabad Madinah Teaching Hospital Participants/Inclusion and exclusion criteria: INCLUSION Age 22-35 years Unilateral CTS females in third trimester of pregnancy Discomfort, tingling, or sensations of paraesthesia in the thumb, the index, the middle, and the radial half of ring finger VAS score (24-hour maximum pain): 4–7 cm at 10 cm VAS scale Positive Tinel’s sign Positive Phalen’s test EXCLUSION Undergone any form of conservative treatment within the last month Prior neurovascular surgery within the last six months pertaining to the same area of the body CTS as a result of a fracture of the upper extremity or trauma to the median nerve Undergone previous surgery for CTS Exhibit severe thenar muscle atrophy Psychosocial problems Intervention groups: Using the inclusion criteria as a guide, patients will be evaluated for symptoms of carpal tunnel syndrome. A diagnosis will then be made after confirmation using phalen's test and tinel sign. Subjects who fulfil the requirements will be asked to sign a consent form. Participants will be randomly assigned to either Group A or Group B once they complete the consent form. In Group A neurodynamic slider technique will be given with tendon gliding exercises, while group B will receive neurodynamic tensioner technique with tendon gliding exercises for 3 weeks. Treatment sessions will be 9 sessions, 3 sessions per week on alternative days. Outcome measures will pain, assessment of functional status and hand grip. Main outcome variables: • Wrist Pain • Functional status • Grip strength

Study aim: The aim of the study is to comprehensively compare the efficacy of breathing exercises and low-intensity circuit training as therapeutic interventions for asthma patients. This will help patients of asthma to become more independent. Design: Pragmatic,community based,parallel group,double blinded, randomised control trial. There will be 357 patients that we will enroll.Study will be done form April-July 2024. Settings and conduct: 1. Azeem Hospital Multan 2. Sughran Wazeer Child Clinic Hospital Multan 3. South Punjab Hospital Multan 4. Muhammad Rehabilitation Clinic (Muhammad Institute of Medical and Allied Sciences Multan) after approval from institutional ethical comittee Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients of 18-40 years, diagnosed asthmatic patients, both genders. Exclusion criteria: Patients with vascular neoplasia, fibromyalgia, radiculopathy, neuropathy, tumor, joint fractures, and vestibular problems, heart problems, not willing to participate, pschycological unfit patients, pregnant/lactating ladies were excluded. Intervention groups: Group-A will be given breathing exercises and group-B will be given low-intensity circuit exercises for 12 weeks. Breathing exercises for group-A includes pursed lip breathing, diaphragmatic breathing and breath holding exercises. For group-B low intensity circuit exercises includes walking, running and abdominal crunches. Main outcome variables: Lung capacity, forced expiratory volume, exercise capacity and quality of life.

Study aim: To find the effects of Dynamic Hug Exercise and Serratus Punch on Chest wall mobility, Dyspnea, Pulmonary function test and Strength of scapulothoracic muscle in COPD patients. Design: Two parallel groups, single-blinded, Randomized Controlled Trial with pre and post-assessment. Settings and conduct: Gulab Devi Hospital Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Stable mild to moderate COPD according to GOLD guidelines, • 40-60 years of age will be included. • Both genders will be included. • Stable hemodynamics (heart rate, blood pressure, temperature) • FEV1≥50 Exclusion Criteria: • Subjects having any kind of Infective pulmonary conditions. • The subjects with acute exacerbation. • Uncontrolled hypertension • Fracture at the clavicle, scapula, humerus, sternum or spine within previous 2 months • Patients with any diagnosed neurological, orthopedic and cardiovascular disease Intervention groups: Group A: it will be treated by pursed lip breathing, upper trapezius stretching. Group B: it will be treated by pursed lip breathing, upper trapezius stretching as well as dynamic hug and serratus punch. Main outcome variables: Dyspnea: Medical Research Council (MRC) Dyspnea Scale Pulmonary function test: Spirometry Cest wall expansion : measuring tape Pectoralis muscles, Lower trapezius and Serratus anterior strength: Handheld dynamometer

Study aim: To compare the combined effects of Retro walking exercises and Clamshell exercises on pain, strength and balance among Osteoarthritic patients. Design: Single blinded, Parallel, Randomized clinical trial Settings and conduct: This study will be conducted at Arif Memorial Teaching Hospital Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients who will above 40 years old and diagnosed with osteoarthritis or have previous knee pain will be included in this study. Exclusion criteria: Patients diagnosed with rheumatoid arthritis, having history of ankle or knee surgery or intra-articular injection in knee joint in past 1 year or having dizziness or balance problems and pregnant women will excluded from this study Intervention groups: There will be two intervention groups. Group A will be treated with clamshell exercise and group B will be treated with retro walking exercises and clamshell exercises Main outcome variables: 1. Numeric Pain Rating Scale will be used for knee pain intensity 2. Berg Balance Scale will be used to check balance while 3. Sit To Stand Test will be used to measure glutei strength

Study aim: To evaluate the effectiveness of the primal reflex release technique on calf tightness Design: Design of the study was randomized clinical trial, sample size was 32, parallel groups, single blind Settings and conduct: Madina teaching Hospital, Faisalabad and The University of Faisalabad Participants/Inclusion and exclusion criteria: Inclusion Criteria: Adult Age 20 to 30 years Both gender (male, female) Prolong standing for more than six hours from more than two months. Reduced ROM (ankle dorsiflexion<15). Tender nodules or tender points in calf muscles on deep palpation. NPRS showing more than 3(3-10). Exclusion Criteria: Lower limb surgery (six months). Medical or surgical complication e.g infection, necrosis, ulcer. Fibromyalgia. Congenital foot and ankle deformity e.g club foot, cleft foot, pes cavus. Lower limb fracture. Deep vein thrombosis both acute and chronic. Diabetic neuropathy. Intervention groups: Two interventional groups numbered as group A and group B in which group A received primal reflex release technique and group B received positional release technique while the baseline treatment was hot pack. Main outcome variables: Pain, ROM, Quality of life

Study aim: To find out the effects of thoracic mobilization with and without sling based thoracic active exercises on pain, function and quality of life in patients with non-specific neck pain. Design: It is a Randomized controlled trial. Sample size is estimated to be 44 i.e: 22 in each group. After adding drop out rate the sample size is 52 i.e: 26 in each group. There are two groups namely group A and group B. Group A will receive sling-based thoracic active exercises with thoracic mobilization and cervical manual therapy for 4 weeks while geoup B will receive thoracic mobilization and cervical manual therapy for 4 weeks. Data will be collected at 3 intervals i.e: 0 week (baseline), 2nd week and 4th week (after completion of treatment) from both groups. Participants will be allocated to the groups randomly by using lottery method to minimize bias. It is a single blinded study, accessor is blinded. Study is conducted at Physiotherapy department of University of Lahore Teaching Hospital Lahore. Settings and conduct: University of Lahore Teaching Hospital Physiotherapy department. It is a single blinded study, assessor will be blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 20-45 years old, Both males and females are included, diagnosed patients of non-specific neck pain, NDI score equal to or more than 24 Exclusion Criteria: The presence of neurological signs and symptoms, previous surgical history related to spine or neck, Currently undergoing any injection treatment to reduce pain, Neurological issues, Pregnancy, Cardiac disease , Active infection Intervention groups: Group A: sling-based thoracic active exercises with thoracic mobilization and cervical manual therapy Group B: thoracic mobilization and cervical manual therapy Main outcome variables: Pain Function Quality of life

Study aim: The main aim of the study is to compare the effects of phonophoresis with and without diclofenac diethylamine phonophoresis with routine physical therapy in patients who are diagnosed with cervical spondylosis. Design: It will be single blinded study, in which the accessor will be unaware of the treatment group. Settings and conduct: The data will be collected from the University of Lahore Teaching Hospital. The study population will be consisted of patients with cervical spondylosis. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Patients with cervical spondylosis. • Aged from 30 to 60 years of patient with cervical spondylosis. • Pre-diagnosed cases of cervical spondylosis. • Both the genders. • Patients referred by orthopedic surgeons. • Patients who are willing to participate in this study. • Patients who are diagnosed with cervical spondylosis by other professionals/doctors. Exclusion Criteria: • Patients with cervical fracture. • Patients with vertebrobasilar insufficiency. • Presence of other significant rheumatic disease variants. • Patients who have history of any cervical spine surgery. • Patients who have active infection. • Pregnant Females. • Ankylosing Spondylitis. Intervention groups: Intervention Group A: Diclofenac diethylamine phonophoresis will be done on the participants along with routine physical therapy to check the effectiveness of diclofenac diethylamine phonophoresis and how it influence the range of motion, pain and quality of life. Group B: Phonophoresis with only aqua gel and routine physical therapy will be provided to the patients. Main outcome variables: Visual Analogue Scale and Neck Disability Index for Pain and Cervical Disability respectively and Universal goniometer will be used for Range of motion and Short Form -36 for Quality of Life.

Study aim: To find the effects of Chest Expansion exercises on pulmonary function, chest expansion, trunk control ability and quality of life among stroke patients. Design: Two parallel groups, double blinded, randomized controlled trial with pre and post assessment Settings and conduct: Physiotherapy department of Jinnah Memorial Trust Hospital Gujranwala Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Patients between age group of 40-55 years • Both genders • Chronic stroke from at least last 6 months-2 years of both forms (ischemic and hemorrhage). • Hemiplegic patients caused by stroke • Patients are able to sit independently • Patients who are able to walk independently with or without walking aid Exclusion Criteria: • Patients with any pulmonary disease before onset of stroke • Patients with thoracic deformity or rib fracture • Patients who received respiratory rehabilitation for stroke • Patients with any neurological disorder other than stroke Intervention groups: Conventional neurorehabilitation program along with Chest expansion exercises Main outcome variables: Pulmonary function test by using Diagnostic Spirometry, Assessment of quality of life using SS-QOL (Stroke Specific Quality Of Life) questionnaire, Trunk Impairment Scale used to assess trunk control (TIS), Measurement of Chest Expansion using measuring tape.