OBJECTIVE This systematic review is to evaluate the impact of visceral mobilization or manipulation in improving low back pain via standard protocols. MATERIALS AND METHODS Literature was searched electronically on various databases such as PEDro, PubMed Central, Google Scholar, BioMed Central, MEDLINE, EMBASE and Science Direct considering duration of 2011 to 2019. Randomized Controlled Trials investigating effectiveness of visceral manipulation or mobilization, either, in the comparison with different modalities or with sham/placebo were included. Data was extracted and studies were reviewed on standardized qualitative assessment criteria. Cochrane guidelines were followed to find out the risk of bias among the included studies. RESULTS All the studies provided moderate to high quality evidence in favor of visceral mobilization or manipulation being effective on low back pain in terms of risk of bias and quality assessment with significant results (p-value <0.05). CONCLUSION The available studies provided the significant and strong effectiveness of visceral manipulation and mobilization. However, scarcity of literature in domain raises an inevitable need for further studies to be conducted in future.

Bell’s palsy is a prevalent type of Facial nerve Palsy, estimated up to 75% of the cases. A 58 year old male patient presented with right sided Bell’s palsy. Thorough examination revealed the weakness of facial musculature and synkinesis associated with drooping and asymmetry. Reportedly, he had difficulty in eye closure, chewing and drinking. Assessment was conducted using Sunny Brook Facial Grading Scale. After assessment a comprehensive strategy combining of different modalities including electrical stimulation with Russian Current, gentle soft tissue mobilization, resistance exercises and taping. Symptomatically, after 3 weeks there was a significant improvement in the facial symmetry, strength and function of facial musculature as well as score of Sunny Brook Facial Grading Scale. Experimentally, this indicates effectiveness of this treatment regime, however; further randomized control trials should be conducted to further investigate efficacy and validity of this combination approach.

BACKGROUND AND AIM Early mobilization practices in critical care settings are safe, efficacious and evidently proven treatment to reduce morbidity as well as mortality. Inactivity adversely affects pulmonary and cardiovascular systems. Despite of widely available evidences, barriers to early mobilization still exist in critical care settings. Hence the present study aims to identify the barriers related to early mobilization perceived by physiotherapist in critical care settings. METHOD A cross-sectional survey among 99 physiotherapists working in a critical care setting of different tertiary care hospitals of Karachi, Pakistan was conducted in which a self-administered questionnaire related to perceived barriers for early mobilization was introduced. RESULTS The descriptive statistics revealed that 87% of physician requisition is required for mobilization, 74% response rate was received by PT for unawareness to identify the suitable patient for early mobilization, and 68% showed lack of staffing resources. 56% response rate was received regarding requirement of adequate training to facilitate early mobilization. Moreover, lack of decision making and safety concerns were 68% respectively.

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