Study aim: To compare the effects of dry needling and conventional physical therapy patients with piriformis syndrome Design: Two arm parallel group randomized trails with blinded outcome assesor and with sample size of 86 enrolled Settings and conduct: Participants were referred by the orthopedic physician of Nishtar hospital to the Physical Therapy Department Participants/Inclusion and exclusion criteria: Inclusion criteria was as follows: • Aged between 30-50 years • Both Male and females • Patients with positive FAIR & Lasegue test • Having atleast 4 score of Numeric Pain Rating Scale Exclusion Criteria: • Patients with any abnormality in spine column • Patients with any systemic inflammatory disease (rheumatologic Conditions) • Recent fracture/dislocation in and around the Hip Joint • Patient with psychological impairment (Parkinson's disease) • Pregnancy Intervention groups: All the screened and willing participants were randomly allocated to two groups (Group A: Experimental group / Dry needling group, Group B: Comparative Group / Conventional therapy group) by lottery method. Main outcome variables: 1. Pain (Numeric Pain Rating Scale) 2. Lower extremity Functional Scale (LEFS) 3. Range of Motion (Goniometry)

Study aim: Compare the effects of positional release technique and myofascial release technique with foam roller on Pain, Range of motion, Functional Mobility and Quality of Life in patients with piriformis syndrome. Design: Parallel group randomized clinical trial and Randomization will be achieved through computer generated random allocation software. Settings and conduct: Government General Hospital Faisalabad, National Hospital and Mujahid Hospital. Patients and outcome assessor will be blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Both male and female patients, Age group 25-40 years, A score of 8 or more out of 12 scoring system according to Clinical scoring system for the diagnosis of piriformis muscle syndrome Exclusion criteria: Mentally retarded, Any pathology or recent injury near the hip, sacroiliac joint, or lumbar spine, Limb length discrepancy, Recent buttock trauma and bladder/bowel dysfunction, Ischiogluteal/ischiofemoral bursitis or impingement, Referred pain from gastrointestinal or pelvic source Intervention groups: Group A: They will receive Positional release technique and conventional treatment in the form of TENS and hot pack for 15 minutes then piriformis muscle and hamstring/calf muscle stretching will be performed (3 repetitions) for 5 minutes after the PRT. Session duration will be 30-35 minutes, twice a week and with 8 sessions over 4 weeks. Group B: They will receive Myofascial release technique with foam roller and conventional treatment in the form of TENS and hot pack for 15 minutes then piriformis muscle and hamstring/calf muscle stretching will be performed (3 repetitions) for a duration of 5 minutes after the MRT. Session duration will be 30-35 minutes twice a week and with 8 sessions over 4 weeks. Main outcome variables: Pain, range of motion, functional mobility and quality of life

, and Chaudhary Hospital Gujranwala, Pakistan Participants/Inclusion and exclusion criteria: Inclusion

Study aim: Primary purpose of this research to evaluate the efficacy of Positional Release Therapy versus Post Isometric Relaxation in treating Plantar fasciitis symptoms such pain, ROM , and cadence. Design: A randomized double blinded clinical trial and parallel-group design of 36 patients. Settings and conduct: Study 'll be conduct in Different Government schools. Participants/Inclusion and exclusion criteria: Inclusion Criteria: School teachers,Male and female both , with unilateral PF & pain that persist more than 3 weeks .Windlass test positive , Age between 30 to 60 Exclusion Criteria: Patient with traumatic , nerve related issue ,NSAIDS user ,with any other musculoskeletal disorder of hip knee foot or fracture , with congenital deformities & using assistive devices Intervention groups: Both group 'll receive protocol along theragun on baseline. Group A PIR subject in supine position keeping knee extended and therapist on affected side in walking position. The subject's ankle joint will be dorsiflexed until a resistance feel and will ask to hold this position and exert 20% of force towards plantar flexion for a period of 5 to 7 seconds. Resistance will be released and relaxation of 5 seconds will be given during which the ankle will passively dorsiflexed to a new barrier. 5 repetitions. Group B PRT: Therapist places thumb on tender point at plantar fascia insertion while patient in supine position with ipsilateral knee flexed. Plantar flex the toes and ankle while monitoring sore site with thumb, curling around tender point until monitoring thumb feels relief. Supination/pronation of foot will be added if necessary. position of ease is maintained for 90 sec until the tissues soften. After returning the foot to a neutral position the tender spot is re-evaluated. process is repeated three times with 30-sec resting intervals between each repetition. Main outcome variables: Pain ROM Cadence

Study aim: To determine the effect of Proprioceptive Neuromuscular Facilitation exercises in improving knee ROM, functional activity and balance in total knee arthroplasty patients. Design: two arm parallel group randomized trial with patients and data analyzer blinded Settings and conduct: The study will be conducted at Physiotherapy department of Rehman Medical Institute, Peshawar. The participants will be blinded by not informing them what group they are in, similarly the statistician will be blinded by keeping the allocation of participants concealed. Participants/Inclusion and exclusion criteria: Participants who had unilateral total knee replacement surgery 1 week ago and were able to walk for 10 meters on ground at a comfortable speed, and having MMSE score of 24 or more were included in the study while the participants who had total knee replacement previously, re-operation for total knee replacment (revision arthroplasty or manipulation under anesthesia), past surgical history of any orthopedic procedure at lower limbs, history of fractures at lower limbs, multiple medical comorbidities such as metabolic disorders, cancers, cardiovascular conditions, Cognitive and neurological disorders i.e. stroke, neuropathy, neuromuscular disorders and individuals on Beta Blockers and uncontrolled Hypertension were excluded. Intervention groups: Participants in the control group will receive traditional stretching and exercises using isotonic contractions while those in experimental group will be engaged in stretching using PNF techniques such as Rhythmic Initiation, Combination of isotonic and Hold Relax, along with the exercises given to the control group, each for 30 minutes, conducted 5 times a week for 2 weeks. Main outcome variables: Knee Range of Motion, Functional activity and Balance are the outcome variables, which are to be assesed via goniometer, time up & go test, and mini berg balance scale.

Study aim: the aim of the study is to check the effectiveness of the treadmil trainng alone versus treadmil training with external clues in improving gait and functional ability in parkinsion patient Design: Randomized control trial Settings and conduct: this trial will be conducted at Physicaltherapy and rehablitation ward of Chauhary akram teaching hospital (Teaching hospital associated with Azra Naheed Medical College ,THe superior University ,Lahore) Participants/Inclusion and exclusion criteria: Inclusion Criteria: (1) Age 50 to 65 years (2) Male and female both (3) idiopathic Parkinson’s disease (4) disease severity of II to V on the Hoehn and Yahr Scale and with minimum assistance and support required (5) ability to stand independently and to walk on a treadmill (with body weight support, if required) (6) sufficient visual capacity to see the cues Exclusion Criteria: (1) Patient with Parkinson disease wheel-chair bond and bed-ridden (2) any other neurologic or orthopedic disorder affecting gait and postural stability; (3) change in medication for the treatment of Parkinson’s disease during the study period (4) cognitive impairment (5) severe cardiovascular disorders (6) vestibular dysfunctions Intervention groups: Interventions: Group 1 (Control group) Group 1 in training session will receive the treadmill training session over 30 minutes. Patients in 1 receive the same treatment protocol in 5 days per week and the this treatment protocol must be continue for 6 weeks. Group 2 (Experimental Group): Group 2 in training session received the treadmill training session over 30 minutes along with the external clues like visual, auditory,etc.In 5 days per week and this treatment protocol must be continuing for 6 weeks Main outcome variables: Gait it will be assesed by usiing wisconsin gait scale and Functional ability wil be assesd by Motor Aspects of Experiences of Daily Living (M-EDL)

Study aim: our study aim to compare the effects of mobilization and strength training on pain and quality of life in patient with forward head posture Design: A concealed ,randomized ,assesor blind clinical trial with a parallel group design of 34 patient enrolled between from may,2022 to july 2022 for two month, Settings and conduct: its will conduct in chaduhary akram teaching hospital and this trial is assesor blind Participants/Inclusion and exclusion criteria: inclusion criteria: Patient with chronic neck pain for more than 3 month Patient with neck disability index less than 24 Patient with prolong sitting workspace enviourment Patient with chronic headache age between 23 to 57 Exclusion criteria En Patient with congenital/acquired postural deformities like scoliosis patient undergone the neck surgeries patient with spinal diseases like compression,tumors,neurological deficits patient with neck fracture and inflammatory disease Intervention groups: Group A Intervention group: Subjects will told to perform head nodding action to gradually target and hold the 5 pressure levels for 10 seconds between 22 mmHg and 30 mmHg. The minimum satisfactory performance requirements were 26 mmHg. Each session of consisted of 3 sets, with each set having 10 repetitions. Sessions were performed for a total of 6 weeks with 4 days in a week under the supervision of the therapist for total 8 weeks of the total trial Group B Intervention group: will given the mobilization exercises total of three sets will conducted, with one set consisting of repeating the motion that will maintained for 10 s up to 10 times. A break of 5 s will provided per one movement and 30 s per one set. Therefore, the total exercise time will be less <10 min.this treatment will continue for 8 weeks. Main outcome variables: Pain will be assessed by using Visual analog scale and quality of life will be calculated with Sf36 quality of life scale

Study aim: The purpose of this study is to compare incentive spirometry and peak expiratory flow meters to evaluate the cardiorespiratory parameter following valvular surgery and determine which has a better impact on cardiopulmonary problems after valvular surgery experience Design: A concealed, randomized, single blinded study with two group/parallel design of 60 patients enrolled. And then allocated their respective groups. The treatment duration will be about 3 weeks. Settings and conduct: Data will be collected from ICU of Ch. Pervaiz Elahi Institute of Cardiology Hospital, Multan Participants/Inclusion and exclusion criteria: Inclusion criteria Both male and female Patients with age ranges of (35-65) Patients who had recently undergone extubated heart valve surgery and who will be able to comply with the instructions and sign the consent form. Patients who undergone median sternotomy-based valvular surgery. Patients with stable hemodynamics Exclusion criteria Patients who needed to be intubated for more than 48 hours following surgery. Re-intubation throughout the healing process. Patients who within the previous three months had a history of a respiratory infection. Patients undergo CABAG surgery. Patients with any neuromuscular disease, renal disease, smokers, alcohol, anemia, and pregnant females. Intervention groups: The total patient population will be split into two groups, one of which will use a peak expiratory flow meter and the other incentive spirometry Main outcome variables: Cardiorespiratory parameters Blood Pressure Heart rate Oxygen saturation Respiratory rate ABGs (Atrial Blood Gasses)

Study aim: To evaluate the effects of instrument-assisted soft tissue mobilization on trigger points of the cervical and lumbar region among sedentary individuals 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: Data will be collected from department of Physical and Rehabilitative Medicine of Memon Medical Institute Hospital Karachi Participants/Inclusion and exclusion criteria: Inclusion Criteria: • 18 – 40 years of age male and female both • Cervical and lumbar pain more than 6 months • Pain intensity of at least 3 in the numeric pain scale Exclusion Criteria: • Any type of trauma related to pain area • Acute Fractures • Tuberculosis of spine • Who has history of whiplash injury • History of head, neck, cervical spinal surgery • History of cervical radiculopathy • Diagnosed fibromyalgia and myopathy • History of cancer in relevant area • Myofascial therapy within the past month • Who has taking any medicine for psychiatric disorder Intervention groups: Intervention group: 25 participants will be received instrument-assisted soft tissue mobilization treatment technique using ergon tool. Along with ergon technique conventional treatment including hot pack 15 minutes, strengthening exercises of all weak cervical and lumbar muscles with 10-12 repetitions of each muscle would be performed. Stretching exercises of all tight cervical and lumbar muscles 3-6 repetition with 10 seconds hold Control Group: 25 participants will be received only conventional treatment same as included in intervention group Main outcome variables: Neck Disability Index, Pain Sensitivity Questionnaire, Modified Somatic Perception Questionnaire

Study aim: The aim of this study is to compare the effects of calisthenic exercises and isometric exercises on pain, balance and functional ability in diabetic patients with Knee Osteoarthritis Design: Randomised, parallel group trial with blinded outcome assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site. That external site will be Research Randomizer software (https://www.randomizer.org/). Settings and conduct: Study will be conducted at Allied Hospital Faisalabad and Outcome assessor, who was a serving physiotherapist in hospital, will be blinded Participants/Inclusion and exclusion criteria: Inclusion Criteria: Both male and female Age between 35 to 60 Inter-articular knee joint pathology Diagnosed osteoarthritis Grade 1 to 4 osteoarthritis Exclusion Criteria: History of lower extremity traumatic injury Any neurological deficits of the lower extremity History of any fracture or surgery on the lower extremity. Intervention groups: Intervention group 1: will receive callisthenic exercises. Callisthenic exercises, also known as bodyweight exercises, are a form of physical activity that uses the own body's weight to provide resistance and build strength, flexibility, and endurance. These exercises can be performed without the need for equipment or weights, making them accessible and convenient for individuals of all fitness levels. Intervention group 2: will receive the hold relax technique. The "hold relax" technique, also known as proprioceptive neuromuscular facilitation (PNF) stretching, is a method used to increase flexibility and improve the range of motion in specific muscle groups. It involves a combination of stretching and muscle contraction to achieve greater gains in flexibility compared to traditional static stretching. Main outcome variables: Knee joint pain; Knee joint range of motion

Study aim: To determine the effectiveness of resisted exercises and electrical muscle stimulation in upper limbs muscle strength and bulk development in paraplegic patients. Design: The study was conducted on a total sample of 52 participants divided into two groups; the control and the experimental. Randomized, superiority, parallel-group trial with blinded outcome assessment. Randomization was centralized and computerized with concealed randomization sequence carried out at an external site Settings and conduct: Paraplegic Center Peshawar Participants/Inclusion and exclusion criteria: Inclusion criteria: If participants have a sustained spinal cord injury for four weeks and their primary rehabilitation is completed. Aged between 18-30 years Being able to give consent. labeled by their physician as fit and can undertake exercise training program Ischemic stroke of MCA subjects suffering from stroke for at least 6 months. Exclusion criteria: If patients will have Brachial plexus, peripheral nerve injury or current surgery of upper limb since last 2 months. According to the National Pressure Ulcer Advisory Panel classification have stage 3 or 4 sacral ulcer. Have any bone disorder e.g. such as Paget’s disease, senile osteoporosis etc. Have a long-term history of fracture in the upper limb. Intervention groups: Group 1: This group was provided with electrical muscle stimulation intervention. Participants undergone the overall treatment session for two months (8 weeks) and 3 days per week.The total electrical stimulation time was 10 minutes for each Muscle. Group 2: This group were underwent resisted exercises for 8 weeks. During each training session 3 sets were performed. Every training session were started and ended at heart rate of 100 beats per minutes whereas stretching time of 5 minutes. Main outcome variables: muscle strength and muscle bulk

Study aim: To determine the Comparision of the effectiveness of Mulligan (NAGs & SNAGs) and McKenzie (self-stretching) on improving pain and functional ability in patients with Chronic Neck pain. Design: A concealed, experimental, blinded, randomized clinical trial with a control group design of 26 patients enrolled between September 2022 and October 2022 and followed for 2 months Settings and conduct: This trial will be conducted at the Physical Therapy & Rehabilitation Ward of Chaudhary Akram Teaching Hospital.This Trial is assessor blind trial in which the outcome assessor was unaware of the treatment protocol Participants/Inclusion and exclusion criteria: The ages of patients were around 20-55 years old. The entire patient has mechanical neck pain and pain due to postural abnormality. All the patients that were Included in the study should be based on Biondi questionnaire. All the patients should have a greater than 20% neck disability index score and the score of Numeric pain rating will be more than 2-3 points. All participants were excluded from this study if they had any hearing problems, vision disorders, smell issues, or any kind of taste-related problem. All participants were having systematic problems, like tension headaches, Rheumatic arthritis. Intervention groups: Group A: In group A we applied the mulligan technique of manual therapy treatment that included the Natural Apophyseal Glides & Natural Sustained Apophyseal Glides in sitting Group B: The second group of 13 patients with chronic neck pain was given the following treatment strategies in which we applied the Mackenzie exercises in seven motions 4 movements of neck extension,2 movements in lateral flexion and rotation, and one movement in flexion direction. Main outcome variables: Pain will be measured by a Numeric pain rating scale and the Functional ability of the neck will be measured by the Neck disability scale

Study aim: The study's main objective is to perform randomized control trial to determine the effect of iron supplementations on the neurocognitive development of infants. Design: A concealed, randomized, single blinded, clinical trial with a parallel group design of 204 patients, enrolled between April 2023 and October 2023, and followed up after one year post conceptional age. Settings and conduct: The study will be conducted one year after approval of the synopsis from the research and ethics committee (REC) of Sheikh Zaid Hospital Rahim Yar Khan and UHS Lahore. Participants/Inclusion and exclusion criteria: Inclusion criteria: 1. Patients born between 34 and 36weeks gestational age. 2. Infants older than 1 month of age and tolerating enteral feeds. 3. Parental permission was obtained prior to the start of the study. Exclusion criteria: 1. Significant intrauterine growth limitation, birth weight less than 2000 g, or tiny for maternal age (<3° centile) 2. Congenital illnesses, presumed disorders, or severe congenital malformation. 3. Birth asphyxia 4. Neurological and neuro-sensory disorders, cerebral anomalies, or hematologic disorders. 5. Infants having a history of any blood transfusion will be excluded. 6. Parents gave no consent, 7. Unable to return for follow-up evaluation at 1 year of age. Intervention groups: Using a computer-generated randomization process, the infants will be randomly allocated into two groups (Group 1: iron group; Group 2: Placebo). Main outcome variables: Primary Outcome: 1. Neurodevelopmental outcome in infants at twelve months of age using scale “Portage guide to early education (PGEE)." Secondary Outcome: 1. Iron deficiency: 2. Weight: 3. Length:

Study aim: Therapeutic deep tissue foot massage with jasmine oil in diabetes and hypertensive patients and their effects on blood pressure, heart rate, oxygen saturation, insulin level, temperature, respiration rate, lipid profile. Design: Lottery method, community based, parallel group, double blinded, randomized control trial and 290 patients will be enrolled. 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: Incision criteria : Age group of 23-70 years ,Both Genders (Male, Female), Educated and uneducated Diabetic patient, Hypertensive patients,Married and unmarried.Exclusion criteria: Any type of mental disability,Lactating females,Having any type of physical disability,Pregnant females,Any type of major surgery. Intervention groups: The three treatment groups will be treated with therapeutic deep tissue massage with three ways: first group will be treated with jasmine oil manually massage, second group will be treated electric palm massage with jasmine oil massage and third group will be treated with electric palm massager with-out jasmine oil. The deep tissue foot massage will be applied by three ways on the feet of diabetics and hypertensive patients for 20 consecutive days. Each session will be 40 minutes per day. Massage will be applied for 20 minutes on each foot. After 20 days we will compare per and post blood pressure and glucose level in hypertensive and diabetics patients. We will measure objective data heart rate, respiration rate, blood pressure, and glucose level and oxygen saturation. Main outcome variables: Increasing insulin and blood circulation in diabetic patients and will help in reducing mean of arterial pressure (MAP), heart rate, respiratory rate, and increases oxygen saturation in hypertensive patients.

Study aim: To determine the effect of task oriented functional and balance training for achieving unsupported sitting balance in paraplegic patients with fire arm injury Design: Randomized Control Trial (RCT) Single blind study. Study groups: (task oriented) and (conventional exercises) group Phase: N.A Sample size : 30 Randomization: In this study simple random sampling technique is used by sealed envelop method through 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: Paraplegic Centre Peshawar. Physiotherapy 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: Age 17-60 Years, ASIA scoring A & B, Both Genders, Fire arm injury paraplegic patients (thoracic level), <6 months, able to sit supported on wheelchair for at least 30 minutes. Exclusion Criteria: External bracing or injuries affecting their ability to lift their arms above their head, existing stage 3 or 4 sacral pressure ulcer, chronic systemic diseases, Pregnant patients, extensive fixed contractures in the upper limbs. Intervention groups: Two groups A and B. Group A experimental group (task oriented) and Group B control group (conventional exercises) Main outcome variables: Sitting Balance Measure (SBM), Trunk control test, Goal Attainment scale (GAS) , Maximal lean test, Modified Functional Reach (mFR), Spinal cord injury falls efficacy scale (SCI-FES),SF-36

Study aim: 1.To determine the effect of hand functional recovery through robotic hand training. 2.To compare the effects of robotic hand training and mirror therapy in regaining hand mobility. Design: Randomized Control Trial (RCT) Single blind study. Study groups: (Mirror Therapy) and (Robotic Hand Therapy) group Phase: N.A Sample size : 34 Randomization: In this study simple random sampling technique is used by sealed envelop method through 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: National Institute of Rehabilitation Medicine Islamabad. Physiotherapy 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: All participants age 40-85 years suffered from a single right hemisphere ischemic or hemorrhagic stroke and were at least 6 months post stroke at time of their enrollment into study. All participants demonstrated mild to moderate upper extremity impairment as defined by Upper extremity fugl-meyer score (range 34-62) and mild to severe hand impairments as defined by the box and block test (range of 1-55).Exclusion criteria will include previous cerebrovascular disease, cognitive dysfunction to an extent that would interfere with therapy participation and any contracture formation in affected extremity. Intervention groups: There are 2 experimental group 1. Experimental group (A) Robotic Hand Therapy group and 2) Experimental group (B) Mirror Therapy group. Main outcome variables: Motor Assessment Scale, Upper extremity fugl-meyer Scale, Box and Block Test, Self structured Questionnaire

Study aim: To compare the effect of Mirror Visual feedback therapy combined with a home dexterity program and home dexterity program in improving hand function of patients with Parkinson's Disease Design: Two arms Parallel group, single-blind, randomized controlled trial Settings and conduct: • The study will be conducted in Neurology department Fauji Foundation Hospital. • Patient will be included in study after taking full informed consent. • Participants will be screened thoroughly for any exclusion, before getting enrolled. • Severity of disease will be determined by means of the MDS Unified Parkinson Disease Rating Scale, Part III: Motor (MDS-UPDRS III). Participants/Inclusion and exclusion criteria: Inclusion Criteria: All patients with stages 1to 3 in Hoehn and Yahr and who would be on a stable medication regimen. Patients with impaired hand dexterity Exclusion Criteria: 1. Patients with history of other neurological conditions, 2. deep brain stimulation, 3. Patients cognitive status < 24, 4. Patients with visual field defects, which will prevent the patient to see their reflection of hand 5. Patients with severe orthopedic conditions of upper limb Intervention groups: The intervention group (Mirror visual feedback therapy combined with home dexterity program group) will receive Mirror visual feedback therapy combined with home based dexterity Program for 1 hour 3 times a week for 6 weeks. A patient will have to perform six various types of exercises, either bi-manually or unimanually, Both hands will have to be trained equally. The control group (Home dexterity program group) will receive only home dexterity program for 1 hour 3 times a week for 6 weeks Main outcome variables: Independent Variable: • Mirror Therapy combined with Home based dexterity program • Home dexterity program Dependent Variables: • Hand function

Study aim: To determine the effects of virtual reality on burden, quality of life and satisfaction and to find out the association between caregiver burden and quality of life in informal caregivers of stroke survivors Design: Randomized, parallel groups Settings and conduct: Rawal General Hospital Participants/Inclusion and exclusion criteria: Inclusion Criteria: Both Genders of 20 to 40 years Taking care of a stroke patient ≥ 3 months. Exclusion Criteria: Caregivers taking care of more than one patient Caregivers who are suffering from a Neurological or Orthopedic disease. Included caregiver was no longer the primary caregiver. Intervention groups: Group A: Virtual reality therapy applied, every subject will be treated individually. Before the intervention, there will be a 5-minute warm-up time, and after the session there will also a 5-minute cool-down time. The virtual reality time will be 25 to 30 minutes periods, 3 days per week for 4 weeks. Group B: Undergo the psychotherapy using Cognitive Behavioral therapy. The therapy will be 25 to 30 minutes periods per day, 3 days per week, for 4 weeks. Group C: Provided with both cognitive behavioral therapy and virtual therapy training for 25 to 30minutes per day, 3 days per week for 4 consecutive weeks. Main outcome variables: 1. Caregiver Strain Index 2. 36-Item Short Form Health Survey 3. Adult Carer- Quality of Life

Study aim: To compare the effect of modified constraint induced movement therapy with mirror therapy in addition to neuromuscular electrical stimulation on upper extremity of chronic stroke patients Design: Randomized Control Trial (RCT) Single blind study Study groups: mCIMT group and MT+NMES group Phase: N.A Sample size : 20 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: Smart Medical & Diagnostic Center Islamabad. Physiotherapy 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: age 40 to 65 years; both gender; Hemiplegic stroke patients past 6 months; minimal function of hand includes 10° wrist extension, 10° thumb extension, 10° finger extension; absence of severe attentive deficit; will able to understand and follow simple verbal instructions; have no severe cognitive disorder that interferes with the study. Exclusion criteria: upper limb fracture; peripheral nerve injury; Apraxia; visual field defect; serious cardiac disease ( arrhythmias and pacemakers); skin or peripheral circulation disorder; those who participate in other studies or rehabilitation program; chronic synergies. Intervention groups: There are 2 groups A and B. Group A : modified CIMT group; Group B: Mirror therapy MT group Main outcome variables: 1. Modified Barthel Index 2. Wolf Motor Function test 3. Upper Limb Motor assessment Scale

Study aim: The purpose of this study is find the comparison of effects of ankle position on isometric quadriceps strengthening in osteoarthritis of knee joint Design: Randomized control trial Settings and conduct: Shaikh Zayed Hospital lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria o X-ray findings of primary osteoarthritis patients with grade ≥ 2 according to Kellgren Lawrence scale o Male and female both were included o Age from 40-60 years old patients were included o Unilateral and bilateral involvement, in case of bilateral involvement more symptomatic knee was included; pain in and around the knee Exclusion Criteria Participants were excluded if they exhibited. o less ankle ROM o History with any injury either soft tissue or bony o Pain radiating into leg in patients with lowback pain o Any neurological signs o History with NSAID past three months o Any inflammatory disease such as Gout o History with RA, ankylosing spondylitis, o History with metal implants, noncooperative patient, patient with mental disorders, o Patients with BMI ≥40 kg/m2 (morbid obesity) Intervention groups: Group 1 will perform quadriceps exercise with ankle in planterflexion position + shortwave diathermy , Group 2 will perform quadriceps exercise with ankle in dorsiflexion position + shortwave diathermy and Group 3 will perform quadriceps exercise with ankle in neutral position + shortwave diathermy. Main outcome variables: pain , strength and functional activity

Study aim: To improve balance and functional mobility in children with spastic diplegia by applying proprioceptive training and partial bodyweight supported treadmill training. Design: Randomized controlled trial Settings and conduct: Randomized controlled study was conducted in children hospital Faisalabad. Assessor was blinded. Participants/Inclusion and exclusion criteria: Spastic diplegic cerebral palsy, Both gender, 11-13 years old, Spasticity of grade <2 according to the Modified Ashworth Scale, Level 2-3 (GMFCS), Intact cognitive status, Normal Vision and hearing status were included whereas patients with, Seizures, any surgical procedure 6 months ago, fixed Joint contractures, Bony deformity i.e. Scoliosis, windswept deformity, crouch knee deformity, Rocker Bottom deformity etc. Multiple medical concerns i.e. Any Cardiac issue and Asthma etc. Medicines to reduce spasticity were excluded. Intervention groups: In Control Group patients practiced proprioceptive training in form special seven exercises. All the proprioceptive exercises was performed for 30 minutes per session with 5 minutes rest period in between for 3 days a week and continued for 12 weeks. whereas in Experimental group Patients were treated with proprioceptive exercises in addition of treadmill training program which was conducted 3 times/week for 12 successive weeks. Patients practiced one hour session of treatment including 30 minutes of Proprioceptive training and 30 minutes of treadmill training. A specialized Harness was used with treadmill training to ensure safety of a patient. Treadmill speed started at 0.5 km/h~1.0 km/h and increased gradually according to children’s adaptability by 0.1 km/ h progressively to suit the child’s speed. Main outcome variables: Balance and Functional mobility was the main outcomes measure

Study aim: To compare the effects of the Mulligan two-leg rotation technique and the Muscle Energy Technique on pain, hamstring flexibility, and functional disability in patients with chronic non-specific low back pain. Design: The double-blinded, parallel-assigned, bi-center, randomized clinical trial was done on 108 patients with a history of pain for more than 12 weeks. Patients were assigned by using the lottery method of simple random sampling. Settings and conduct: The study was conducted at the physiotherapy department of Bakhtawar Amin Hospital, Multan. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 1. Both gender, 2. Age group of 18-35years. 3. Non-specific low back pain for more than 3 months. 4. Patients with hamstrings tightness measured by Active Knee Extension (AKE) test. Exclusion Criteria: 1. History of fracture or surgery. 2. Low back pain with active systemic or spine pathology. 3. Upper motor neuron or lower motor neuron lesion 4. Pregnancy, psychological risk factor, or subjects apprehensive for the stretching techniques. Intervention groups: After taking written informed consent, patients meeting the inclusion and exclusion criteria were screened for hamstring tightness by a trained physiotherapist, having greater than 30-degree loss of knee extension.108 patients were randomly allocated into two groups (54 patients each) by a computer-generated random number table. Group A received Mulligan’s two-leg rotation technique with routine physiotherapy and group B received the muscle energy technique with routine physiotherapy. Total 12 sessions were given to both groups, 3 sessions per week. Data was calculated at baseline and after every 6th session. Main outcome variables: 1. Pain measured by Numeric pain rating scale. 2. Hamstring tightness measured by Active knee extension angle. 3. Functional Disability measured by Modified Oswestry Disability Index scale.

Study aim: To compare the effects of backward walking training and standing balance training in improving the walking speed & balance of the patients in the sub-acute phase of stroke rehabilitation. Design: Single Blind, Randomized Controlled Clinical Trial Settings and conduct: Madinah Teaching Hospital Faisalabad Participants/Inclusion and exclusion criteria: Inclusion Criteria 1. Diagnosis of first stroke in previous 45 days, 2. Patients older than 20 years and less than 50 years, 3. Able to maintain upright standing posture with moderate assistance, 4. Anticipated inpatient rehabilitation length of stay 2 to 3 weeks, Exclusion Criteria 1. Absence of significant balance impairment, defined by Berg Balance Scale (BBS) score greater than 45/56, 2. Lower extremity joint or weight-bearing pain, 3. Inability to follow 2-step command, 4. History of Contraversive pushing syndrome Intervention groups: Group A: Group A participants received the task-oriented training (grasping objects and CIMT) combined with backward walking training. The participants were treated 60 minutes, 3 times per week for 4 weeks. Group B: Group B participants received the task-oriented training (grasping objects and CIMT) combined with standing balance training. The participants were treated 60 minutes, 3 times per week for 4 weeks. Main outcome variables: • 6-Meter walk test • 3-meter backward walk test • Berg balance scale

Study aim: The aim of this study is to compare the effects of instrument-assisted soft tissue mobilization with routine physical therapy and isolated treatment of routine physical therapy on the function of the lumbar spine and pain during the achievement of daily life in patients with chronic low back pain. Design: Parallel group, single-blind, randomized control trial Settings and conduct: 38 subjects will be studied at TABA Medical Complex, Lahore. Participants and assessors will be blinded. During the first visit, the researcher will complete thorough case history and lumbar regional assessment. Patients will be assessed using the Rolland Morris Questionnaire and Modified Oswestry Disability Index score for function and Numeric Pain Rating Scale for pain. Treatment will be then continued according to the allotted group intervention. All participants will receive a total of 12 treatment sessions over a 4-week period, which will consist of 3 treatment sessions per week. The researcher will take a follow-up value after 12 sessions. A follow-up assessment will be done at the end of 12 sessions as the post-treatment reading. Participants/Inclusion and exclusion criteria: Inclusion criteria: Age between 40 and 60 years, Not make use of continuous drugs for low back pain, Previous spine surgeries, Do not present medical restriction to practice physical exercise or if they presented any limitations in lower limbs that physical exercises Exclusion Criteria: neurological signs, specific spinal pathology (e.g. malignancy, or inflammatory joint or bone disease), Patients who will be reported osteoarthritis or disc lesions (prolapse, protrusion, or herniation without neurological compromise) with or without leg pain, Pregnant women Intervention groups: Group A: Instrument assisted soft tissue mobilization with routine physical therapy Group B: Routine physical therapy. Main outcome variables: Pain and function

Study aim: Primary aim of this study is to evaluate effectiveness of core stability exercises with and without routine physical therapy (RPT) on pain and functional mobility in patients with iliotibial band (ITB) syndrome. Secondary aim, evaluate effectiveness of core stability exercises on quality of life in iliotibial band syndrome (ITBS) Design: Single center, parallel group, concealed, double blind, randomized controlled trial of 40 participants Settings and conduct: University Physical Therapy and Rehabilitation Clinic, University of Lahore. Participants and outcome assessor blinded. Participants/Inclusion and exclusion criteria: Participants were included if age between 18-50 years in both the gender, presence of local tenderness over the lateral epicondyle, positive noble compression test and modified ober’s test. Participants with systemic illness, peripheral nerve involvement and any type of Arthritis in lower limb, Tumor and history of previous knee trauma and surgery were excluded. Intervention groups: In control group participants follows RPT that includes 1- Specific stretching exercises of ITB, tensor fascia latae, and gluteus medius 2- Soft tissue and medial patella mobilizations 3- Active release soft-tissue mobilization and myofascial release 5- Strengthening exercises for ITBS 6- Cryotherapy, Phonophoresis, While interventional group participants follow RPT and core stability exercise , which includes: Transversus abdominus (30 reps with 8s hold) Bracing with heel slides, Abdominal bracing, bridging, standing, standing row, walking, leg lifts. Paraspinals/multifidi (30 reps with 8s hold). Quadruped legs lifts and arm lifts with bracing, Quadruped alternate legs and arms lifts with bracing. Quadratus lumborum and obliques (30 reps with 8s hold). Side plank with knees flexed and extended Trunk curl Main outcome variables: Numeric Pain Rating Scale and Lower Extremity Functional Scale