ELDOA is a revolutionary technique for improvement of health and longevity of the spine which is introduced by French osteopath; Guy Voyer. The primary goal of ELDOA is to apply focused internal tension and load to decrease pressure on the discs of spine, increase blood flow and to reduce pain at cervical spine. There is little high-quality evidence on best no operative therapy for cervical radiculopathy. Objective: To determine the effects of Modified ELDOA technique in patients with cervical radiculopathy in terms of pain, nerve tension and disability. Methods: Thirty patients were randomly assigned either to a group that performed modified ELDOA along with conventional treatment aimed at decreasing the effects of pain, nerve tension and disability or to a group that performed ELDOA and received conventional treatment having the same goal as the former. Randomized controlled trial was selected as the design of study. Treatment protocol of control group included hot pack, TENS, PIR(MET) 4 reps with 6 sec hold, Maitland oscillations (20 reps in 3 sets), ELDOA at cervical spine, Neurodynamic stretching of involved nerve. Treatment protocol of experimental group included hot pack, TENS, PIR(MET)4 reps with 6 seconds hold, Maitland oscillations (20 reps in 3 sets), modified ELDOA at cervical spine, Neurodynamic stretching of involved nerve. Each patient received 8 sessions on alternate days covered in a total span of 16 days. Assessments were done at 1st 8thsession.The tools used were NDI, NPRS and ROM through goniometer. IBMSPSS-21 was used to analyze data. Results: The results demonstrated that treatment protocols of both the control and experimental groups have significant effects on reducing pain, tension and disability and improving mobility of cervical spine. Whereas, for difference in effectiveness of modified ELDOA and ELDOA, the overall p-values came out to be >0.05 while comparing the end values of both groups, showing that there is a non-significant difference in the effects of ELDOA and modified ELDOA. Conclusion: Modified ELDOA works effectively in posture correction hence improving the functional status of patient. Modified ELDOA and ELDOA postures help in treatment of cervical radiculopathy. The effectiveness of ELDOA and modified ELDOA has a non-significant difference.

Background: The occurrence of shoulder pain among competitive swimmers is bizarre, but no strategy exists to diminish shoulder injuries in swimmers. Objective: To assess the disability associated with shoulder pain across the lifespan of competitive swimmers. Methods: A cross-sectional study including 58 swimmers who were selected based on inclusion criteria for this study from different swimming centers in Lahore, Pakistan. The questionnaire consisted of a total of 28 questions, 24 questions on Penn shoulder score and 4 questions on disability of arm, shoulder and hand questionnaire score and a diagnostic side bridge test was assessed 2 times by each participant to check endurance. Manual muscle testing was performed bilaterally on the serratus anterior, middle trapezius and lower trapezius muscles. Means and standard deviations were calculated for quantitative variables while frequency and percentages were used for qualitative variables. Chi-square was estimated to find the association between disability and shoulder pain. Results: There were 21 (36.2%) males and 37 (63.2%) females participated in the study. This showed that hand dominance affects the ability of competitive swimmers. For the side bridge average time, left and right hand, the p-value was <0.001 which was statistically significant. Conclusion: This study concludes that disabilities are associated with shoulder pain across the lifespan of competitive swimmers. Pain and discomfort in the shoulder is the main risk factor among competitive swimmers that can ultimately lead to the disability of the extremity.  As only a few participants were fully satisfied with the current level of their shoulder functioning.

Methods: This study was a Randomized Controlled Trial conducted at The University of Lahore Teaching Hospital, University Institute of Physical Therapy, Lahore. n= 84 patients with Cervical Dystonia were recruited in this study using non- probability convenient sampling technique. Patients suffering with Cervical Dystonia who aged between 30 till 50 years were randomly assigned into two groups, 42 patients in each group. First Group A which was the control group which was treated with Functional Electrical Stimulation and routine physical therapy only while Group B was the Experimental group which was treated with Functional Electrical Stimulation also with kinesiotherapy and routine physical therapy. Both the groups were evaluated and assessed using the Toronto Western Spasmodic Torticollis Rating Scale, the Pain Numerating Scale, the 36- item short form health survey( SF-36), Neck Disability index and range of motion of neck flexion, neck extension and neck rotation was measured using universal goniometer. Results: Functional Electrical Stimulation combined with kinesiotherapy given to the experimental group showed more improvement in range of motion, quality of life , functional disability and the symptom of the pain also was reduced in the experimental group as compared to the control group. The mean values showed that there was a statistically significant difference in different variables between both the groups. When the scores( scores at baseline and at 16th week) for Toronto Western Spasmodic Torticollis Rating Scale for both the groups were compared it showed statistical difference between both the groups(p<0.05). Conclusion: Despite the fact that cervical dystonia has central neurological etiology, this study concludes that multimodal kinesiotherapy program which included stretching and relaxation, active exercises in addition to Functional Electrical Stimulation and Routine Physical Therapy tempts to have beneficial effects on a patient suffering from Cervical Dystonia. It showed beneficial effects on pain, quality of life, functional disability and range of motion of patients with cervical dystonia. Key Words: Functional Electrical Stimulation, Kinesiotherapy, Cervical Dystonia, Pain, Rang of Motion, Quality of life

Background: Diastasis recti abdominis is an impairment that is characterized by the separation of the rectus abdominis muscles along the linea alba. There is an increased distance between the two recti muscles which is termed “inter-recti distance”, that might exist congenitally, but usually develops during pregnancy and in the initial postpartum period. Objective: To determine the association between diastasis rectus abdominis and lumbopelvic pain in postpartum females. Methods: In this cross-sectional study, the data was collected from various public and private hospitals in Lahore, Pakistan in six-month duration. Convenient sampling was used to include 97 postpartum females aged between 25 and 35 years. Those postpartum females were excluded who had any history of auto-immune disease, cerebral disease or any spinal issue. After getting their consent, the postpartum females were asked about their age and mode of delivery and they filled self-structured assessment questionnaire The body mass index of patients was calculated and Pearson’s correlation was applied to find out the association between lumbopelvic pain and diastasis recti abdominis. Results: The occurrence of diastasis recti abdominis was 81(83.5%) out of 97 postpartum females and their inter-rectus distance was greater than 16mm at 2cm below the umbilicus. A significant association was found between lumbopelvic pain and diastasis recti abdominis in postpartum females (p<0.05). Conclusion: This study concluded that diastasis recti abdominis is significantly associated with lumbopelvic pain in postpartum females. Out of 97 postpartum females who were included in this study 81 were reported to have diastasis recti abdominis and out of these 81 postpartum females 47 were reported to have lumbopelvic pain in their postpartum period.

Background: Pain in the medial side of elbow in taxi drivers is a work-related problem that normally comprises repetitive movement and occurs commonly in wrist flexion with pronation of the forearm. Objective: To determine the prevalence of medial elbow pain in taxi drivers in Lahore. Methods: This cross-sectional study comprised of 268 taxi drivers from Lahore. Questionnaires were given to taxi drivers who were recruited through convenient sampling. Consent forms, both in Urdu and English were explained before data collection. Professional participants who had taxi driving as an occupation and who were working for two years were involved in this study. To fulfill the criteria of a sample size that was 268 the record of taxi drivers was also gathered from the e-record of Uber and Careem, Lahore. Taxi drivers of age 20 to 55 years, both gender and those who had working hours of 5 to 8 or more hours were included in this study. Drivers who had any recent traumatic injury or had been in a recent road traffic accident, undergone surgery were excluded from this study. The visual analogue scale was used as an outcome measuring tool to assess the medial elbow pain in taxi drivers. The taxi drivers were asked to fill out questionnaires, which consisted of questions focusing on pain, daily activities, difficulties in function and personal care. Data was analyzed by SPSS version 23, qualitative data was presented as frequency and percentages. Results: The prevalence of medial pain elbow pain came out to be 38.8% (103 participants), 30 (11.2%) were having mild pain, 64 (23.9%) moderate, 9 (3.4%) severe while 165 (61.5%) were free from medial elbow pain. Conclusion: This study showed that the prevalence of medial elbow pain in professional taxi drivers was 38.4% and affected the activities of daily living of drivers. Most drivers reported the pain within mild to moderate range. Pain in the medial aspect of the elbow can arise in taxi drivers due to the nature of their work and factors such as long working hours, prolonged sitting, whole body vibration and poor ergonomic design of taxi.