Background: Achilles tendinopathy is highly prevalent and caused by intrinsic or extrinsic factors. The multiple minor traumas can lead to achilles tendinopathy. Physical therapy treatment includes soft tissue mobilization and exercises. Objective: To compare ultrasound and transverse friction massage in chronic Achilles tendinopathy. Methodology: The study was a randomized control trial from 1st March 2019 to 15th August 2019. The non-probability convenient sampling technique was used to include n=76 patients having pain and activity limitation of Achilles tendon and randomly allocated into groups A and B by lottery method. The outcome measuring tools were numeric pain rating scale (NPRS) for pain, the Victorian Institute of Sports Assessment- Achilles questionnaire (VISA-A) for severity and goniometry for ROM. The Group A was treated with transverse friction massage and the group B was treated with ultrasound therapy. Both groups also performed eccentric exercises. The assessment was done at the baseline on the 1st session, at end of the 9th and 18th session. The data was analysed by SPSS 23 using independent t-test and repeated measures ANOVA. Results: The results of RM-ANOVA with pairwise comparison showed that both groups improve significantly (p<0.05) throughout the treatment duration with large effect size for all variables. While comparing the groups with independent t-test, TFM group showed more improvement in all variables as compared to UST group (p<0.05) after 3rd week as well as after 6th week of intervention. Conclusion: The Transverse friction massage (TFM) was more effective than ultrasound therapy (UST) when combined with eccentric exercises in improving pain severity of tendinopathy and ROM of ankle. Keywords: Achilles tendon, eccentric exercises, pain stretching, myofascial release, ultrasonic therapy, tendinopathy.

Background: Quality of life is a key feature to measure the progress in children with disability. Motor disability is major problem and it affect quality of life of cerebral palsy children. Methods: The objective of the study was to determine the psychometric properties of Urdu version of cerebral palsy quality of life children (CP QOL-Child) primary caregiver questionnaire. Forward and backward translation for English version of CP QOL-child primary caregivers was performed following cross-cultural adaptation guidelines. Psychometric properties assessed include test-retest reliability, internal consistency, construct validity. The Urdu CP QOL-Child was completed by 100 caregivers. Results: 100 primary caregivers of CP children were included. internal consistency ranged from 0.607 ­- 0.916, intra-class correlation coefficient (ICC)) ranged from 0.865to 0.974. there was negative correlation between all domains of CP-QOL primary caregivers version and GMFCS except feeling about function domain. Conclusion: The result of this study indicates that the Urdu CP QOL-Child primary caregivers questionnaire appears to be valid for use in Urdu speaking primary caregivers of children with cerebral palsy.

Background and Purpose: The hamstring muscle shortening occurs in normal person which can lead to movement dysfunction. There is a link between limited flexibility and the development of neuromusculoskeletal symptoms. The Bowen technique is used in connective tissue flexibility. This study aimed to determine the effects of the Bowen technique and sustained stretching on improving flexibility of the hamstring muscle in asymptomatic females. Methods: A randomized clinical trial study was conducted, from November 2020 to April 2021 in Mubarak Hospital Sargodha, Pakistan. 44 healthy females were allotted into group A and group B. Group A received Bowen therapy and Group B received sustained stretching technique for three weeks, both groups received these interventions three times per week. The readings were taken at baseline, after the 9th session, and at follow-up. Subjects were asked to come for follow-up after 1 week of the 9th session. Outcome measures included an active knee extension test and sit and reach test.Results: Out of 44 females, 22 were in each of the two groups. The mean age in our study was 28.66±2.787, height was 1.53±0.08, and weight was 54.43±4.88, also 29% of subjects were overweight, and 61% were normal weight based on body mass index. Findings revealed that a statistically significant difference was observed within-group analysis (P<0.001) and in Between-group analyses, no significant difference was observed (P>0.05) with respect to active knee extension and sit and reach test. Conclusion: Both Bowen and sustained stretching techniques were equally effective in improving hamstring flexibility in asymptomatic females. Physiotherapists can use either sustain stretching or Bowen techniques to improve hamstring flexibility.

Depending on the cause, neck pain can persist anywhere from a few days to several years; Osteoarthritis, spinal stenosis, ruptured disc, pinched nerves, emotional and physical stress, strain, bad posture, tumor, and other disorders are among the most common causes acupressure on local and distal acupuncture sites may provide drowsiness and relaxation, which may help to relieve chronic neck discomfort. Objective: To compare the effects of therapeutic massage and acupressure on neck pain. Methods: ISRA University Hospital Karachi conducted a randomized clinical trial. A total of n=30 individuals were between the ages of 20 and 35, with neck discomfort ranging from 3-6 on the VAS scale. The n=30 participants were separated into two groups: therapeutic massage (n=14) and acupressure (n=15). The data was analyzed using the SPSS version 22.0. Results: Mean age of study participants was 24.34± 4.3 years. A total of n=12 were female, and the remaining n=18 were male. The analysis showed that pain and neck disability significantly improved in both groups (p<0.05). When compared in both groups, the intensity of pain was not significantly different in both groups, but neck disability was significantly improved in the acupressure group as compared to the massage group after six weeks of intervention. Conclusion: The study concluded that both techniques benefit neck pain and disability and found significant results. But results show that acupressure was found to be more beneficial and significant than the therapeutic massage.

BACKGROUND AND AIM Quadratus lumborum trigger points developed in low back pain. The aim of this study was to compare Reciprocal Inhibition with Ischemic Pressure on the Trigger Point of Quadratus Lumborum muscle in Low Back Pain. METHODOLOGY A 6 month randomized controlled trial was conducted. Non probability Convenience sampling was used to select a sample 50 participants having low back pain with Quadratus lamborum trigger points placed into group1 and group 2 by lottery method. Group 1 was treated with reciprocal inhibition and ischemic pressure along with conventional therapy and group 2 was treated with ischemic pressure along with conventional therapy. The data collection tools were Numeric pain rating scale and Goniometer. Data was analyzed by statistical package for social science 21. Independent t-test used for between comparison analysis and Paired t-test was used for within analysis. RESULTS The numeric pain rating scale mean difference in group 1 and group 2 was 4.72±0.12, 5.13±0.13 respectively. The Quadratus lamborum muscle length mean difference in group 1 and group 2 was 8.95±1.67, 5.34±1.25 respectively. CONCLUSION The addition of reciprocal inhibition with ischemic pressure showed significant results. KEY WORDS reciprocal Inhibition, ischemic pressure, quadratus lumborum, Back Pain, Myofascial Trigger Point Pain, Articular Goniometry, range of motion