Aim: To determine effects of Kinect- based games on neurocognitive functions in older adults with mild cognitive impairment. Methodology: A quasi experimental pre-post trail was conducted on 18 mild cognitive impairment (MCI) older adults. The subjects were recruited to access cognitive impairment through purposive sampling technique. The inclusion criteria were elderly aged ≥ 50 years, both genders, able to read and write, whereas older adults with severe cognitive impairments, neurological disorders and un controlled comorbidities were excluded. Brain training was provided for 30 minutes with 5-minute warm-up time and 5-minute cool-down time for 6 weeks. Blind assessor measured readings at baseline and after six weeks. The outcome measures were Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MOCA), Trail making test A & B and verbal fluency test (Semantic &Phonemic). The data was analyzed at baseline and after six weeks of intervention Results: Significant improvements were observed in post-test measurements (p <0.05) in MMSE, MoCA, TMT A & B and verbal fluency (Semantic &Phonemic) tests after 6 weeks of treatment. Conclusion: Kinect-based virtual reality games are beneficial in improving cognitive abilities of older adults with mild cognitive impairment. Keywords: Cognitive training, Mild cognitive impairment, Montreal Cognitive Assessment

Aim: This study was conducted to determine the prevalence of musculoskeletal pain disorders and related factors among female school teachers of Peshawar. Methodology: A descriptive cross-sectional survey was conducted from February 2019 to July 2019 among primary and secondary female school teachers (n=289) in Peshawar. Data was collected from using semi-structured questionnaire. Outcome measures were based on modified version of Nordic musculoskeletal questionnaire (NMQ) and Numeric Pain Rating Scale (NPRS). Descriptive statistics was used to summarize qualitative variables in the form of frequencies and percentages. Mean and standard deviation was calculated for quantitative variables. Chi-square test was used to find association. The significant P value was <0.05. Results: Prevalence of musculoskeletal pain disorders was 82.7%. The overall mean age of sample was 37.5±8.47. Most common sites of pain were low back 60.2% followed by neck pain 50.2%, ankle pain 48.4% and shoulder pain 44.3%. Factors that showed significant relationship were long time standing (p=0.001), long time sitting (p=0.039), checking copy/paper marking (p value 0.023) and uncomfortable work chair/table (p = 0.012). Conclusion: Female school teachers showed high prevalence of musculoskeletal pain disorders, low back was the most common site for pain followed by ankle and shoulder. Risk factors associated with pain were long time standing, long time sitting, checking copy/paper marking and uncomfortable work chair/table. Keywords: Musculoskeletal disorder, ergonomics, Nordic musculoskeletal questionnaire, low back pain, neck pain.

Aim: To determine the prevalence of fall among geriatric population and to find out risk factors associated with fall. Method: A cross-sectional study was conducted with a sample of 223, raised through non-probability convenient sampling technique. The inclusion criteria were older adults both genders, aged 60 years and above. The exclusion criteria were older persons with severe and uncontrolled co morbidities that include diabetes, hypertension, memory impairment, stroke, psychiatric disorders, and use of any walking aid. Data was collected through semi structured questionnaire. Fall risk assessment scale was used to categorize fall risk status in older persons. Data was analyzed using SPSS 24. Descriptive statistics and Chi-square test were applied. Results: The overall mean age of participants was 67.61±5.64 years. Out of 223 participants, females were 134(60.1%) and 89(39.9%) were males. The prevalence of falls reported in elderly was 42.6%. Most prevalent fall were reported under category of 1-2 falls, out of which females had 43(32.1 %) and males had 29 (32.6%) falls. Among study participants 87 (39.0%) were in high-risk group while 136(61.0%) participants were in low-risk group. Furthermore, weak eyesight, use of medications, vertigo/imbalance, and chronic medical conditions (p<0.05) were considered as most significant risk factors with fall. Conclusion: The study showed significant number of older adults who had fall. Female were at high risk of fall. Weak eyesight, use of medications, vertigo/imbalance, and chronic medical conditions were found to be most prevalent risk factors associated with fall. Keywords: Fall, geriatrics, aging, fall risk, prevalence, old age

Introduction: Lumbar disc surgery is a common procedure for patients with lower back pain associated with lumbar disc herniation. This study aims to evaluate the impact of active physiotherapeutic rehabilitation on global/functional improvement and subjective pain score reduction among patients 1–2 months following lumbar disc surgery. The outcomes of this study are to assess the impact of active physiotherapeutic rehabilitation on functional improvement and subjective improvement in pain behavior post active rehabilitation. The outcomes are measured as pain assessed using the visual analog scale, global measurement of improvement, back pain functional status, and return to work. Methods: Databases, including MEDLINE/PubMed (10 June 1996, 2022), Web of Science (10 June 1997, 2022), Scopus (15 March, 10 June 2004, 2022), CINAHL Plus (10 June 1961, 2022), and Cochrane (10 June 1993, 2022) were reviewed without any language restrictions. All studies were systematically screened; however, only randomized controlled trials were eligible against the inclusion/exclusion criteria. All statistical tests were conducted in Review Manager (RevMan) 5.4. The quality of studies was appraised using the grading of recommendations assessment, development, and evaluation (GRADE) approach and the risk-of-bias 2 (RoB 2) tool. Results: Fifteen articles were identified, enrolling a total of 2188 patients, where the majority of active rehabilitation interventions continued for 3 months. All these interventions began 1–2 months postoperatively, and quantitative findings were presented as mean scores. The subjective pain scores were significantly lower in the interventional group, with a mean difference (MD) of −7.01 (p = 0.004). The pain disability score was considerably lower in the interventional group, with an MD of −3.94 (p = 0.002). Global improvement was higher in the interventional group (OR = 1.94, p = 0.0001). Conclusions: This study presents significant improvement in all parameters concerning pain and functionality. Postoperative rehabilitation requires optimization concerning timing, duration, intensity, and associated components to benefit patients post lumbar disc surgery.

Objective: One of the frequent causes of disability in stroke patients is balance impairment. Balance training is integral part of rehabilitation for stroke patients. Exergame is innovative technology which provides benefit of exercise in entertaining way. The objective was to compare the effects of exergames versus traditional balance exercise to improve balance and reduce risk of fall in chronic stroke patients. Method: A randomized control trial was conducted on 40 chronic stroke patients. Patients were randomly divided into exergaming group (n=20) and control group (n=20), using coin and toss method. Patients in control group performed traditional balance exercises while exergaming group performed supervised exergames along with traditional balance exercises. The treatment duration for both groups was 35-40 minutes/3 times a week for 6 weeks, with 5 minutes of warm up and cool down before and after intervention. The demographics were recorded, and assessment was done using Berg balance scale, Time Up and Go test and Dynamic gait index at baseline and after 6 weeks of intervention.  Data was analyzed using SPSS 24. Results: Of the 46 patients assessed, 40 (86.9%) were included in the study. The overall mean age was 57.78±5.38 years, there were 20 (54.1 %) males and 17 (45.9 %) females. Significant improvements were seen between the groups for Berg balance scale, Time Up Go test and Dynamic gait index after six weeks of intervention (p<0.05). Conclusion: Exergame is found to be effective in improving balance and reducing risk of fall in chronic stroke patients.