Aim: To determine the effects of Hand-arm Bimanual Intensive Training on fine motor skills of chronic stroke patients. Methods: A randomized control trail was conducted at District Head Quarter Hospital Sargodha. Twenty-eight stroke patients were randomized into 2 groups. All patients were examined by using Questionnaire of Disabilities of Arm, Shoulder, and Hand (DASH), Action Research Arm Test (ARAT) and Wolf Motor Function Test (WMFT). Control group was treated with Conventional Physical Therapy and experimental group with Hand Arm Bimanual Intensive Training. There were 3 sessions every week for a total of 12 sessions over the course of 4 weeks. At the beginning of the intervention, two weeks later, and four weeks later, all outcomes were evaluated. Data analysis was done with SPSS version 21. Results: Intra group analysis showed statistically significant results (p<0.001) in each group after 4 weeks of treatment indicating improvement in Disabilities of Arm, Shoulder, and Hand (DASH), Action Research Arm Test (ARAT) and Wolf Motor Function Test (WMFT) of both groups. However, based on their mean differences, experimental group demonstrated greater progress across all outcome measures which is indicated through Inter group analysis that statistically significant difference was present between two groups in DASH, ARAT and WMFT with p-values 0.045, 0.046 and 0.043 respectively at end of treatment. Practical implications: HABIT pays attention to bimanual training which is highly related to most ADL tasks so there is need to evaluate the effectiveness of HABIT-related interventions. This will help to promote improvements in upper extremity functions and to enhance the level of independence among stroke patients. Conclusion: Study concluded that both conventional physical therapy and hand arm bimanual intensive training (HABIT) are helpful in improving upper extremity fine motor abilities in chronic stroke patients, but HABIT is more beneficial as compared to usual conventional and routine rehab treatments. Keywords: HABIT, fine motor skills, physical therapy, upper extremity, stroke.

Objectives: This study aims to find and compare the effects of primal reflex release technique and stretching exercises on pain intensity, functional performance, and pain-free sitting duration in patients with coccydynia. Methods: This is a randomized clinical trial. A total of 46 individuals were chosen for the sample based on the inclusion criteria, and they were divided into groups A and B. Pre-treatment values of patients for pain assessment were taken by the Numerical Pain Rating Scale (NPRS), Dallas Pain Questionnaire (DPQ), and pain-free sitting duration (PFSD). Group A received treatment with a hot pack and primal reflex release technique. Group B received treatment with a hot pack and stretching exercises. Each patient received a total of 12 sessions over the course of 4 weeks, 3 sessions per week. After 4 weeks of therapy, both groups were evaluated again. The obtained data were analyzed using SPSS 21. Results: Findings revealed that within-group differences were statistically significant (P<0.05) for all variables. In the primal reflex release technique group, the average NPRS value reduced from 5.565±1.4086 to 1.7391±1.09617, the average DPQ value from 129.967±33.102 to 38.000±26.691 and the average PFSD duration increased from 43.043±20.323 to 368.478±160.464. In the stretching group, NPRS reduced from 6.087±1.345 to 3.695±1.490, DPQ from 116.032±35.054 to 60.608±22.186 and PFSD increased from 28.260±11.928 to 94.130±102.154. The between-group analysis also indicated statistically significant differences in NPRS, DPQ, and pain-free sitting duration with P values ≤0.001, 0.003, and ≤0.001, respectively Discussion: The study concluded that both the primal reflex release technique and stretching exercises were effective in reducing pain and improving functional status with a marked increase in pain-free sitting duration. However, the primal reflex release technique was found to be more useful than stretching exercises in terms of mentioned outcome measures on basis of their mean differences.

Background: Plantar fasciitis (PF), an inflammation of the plantar fascia. This study compared the effects of the extracorporeal shockwave and high-intensity laser in reducing pain and enhancing function in chronic plantar fasciitis patients, who have failed to achieve results by the conservative treatment. Aim: To explore the best non-invasive treatment option for chronic PF within the scope of physical therapy. Method: After registry of trial the data collection was started.A total of45 chronic PF patientswere divided, randomly into three groups. Group 1 received BTL-6000 Shockwave therapy (ESWT) , group 2 received Diowave 60W Class IV hot Laser (HILT) and group 3 (the control group) was not given any electrotherapy treatment. All groups were given some exercises for the home plan. The groups were assessed with the Visual Analogue scale (VAS) and foot functional index (FFI) at baseline, post-treatment, and follow-up of 2 months. Result: The mean age of participants was 39.66±10.05,38.06 ±12.64 and 37.40±13.18 for ESWT, HILT group and control groups respectively. There was significant difference in VAS and FFI score p=<0.001 across the time. Pre-treatment and post-treatment scores were significantly different but post treatment and follow-up scores were not significantly different for both VAS and FFI score (p=1.00). Practical implication: This study will help us to find out chronic Plantar fasciitis treatment within physical therapy and electrotherapy domain. As both these modalities are non-invasive, cost effective and proved as effective treatment for reduction of pain and improvement of pain in chronic plantar fasciitis patients. Conclusion: Extracorporeal shockwave have been promising treatment for chronic plantar fasciitis but High intensity LASER therapy effectiveness was not explored a lot in previous literature. The study concluded that both ESWT and HILT are effective in reducing pain and improving function on VAS and FFI, though the ESWT group was found better than both groups in FFI score and VAS across time on the basis of the mean differences across time. Keywords: Exercise, Extra-corporeal shockwave therapy, heel pain, High-intensity Laser therapy, Plantar fasciitis

Aim: To determine the effects of Muscle energy technique with and without Bowen therapy on pain, function, range of movement, and posture in Text neck syndrome. Methods: A randomized clinical trial was conducted in Fatima Hospital Sargodha. A total of 22 patients with text neck syndrome were included and randomly allocated to two groups. Assessment of pain, function, Cervical ROM, Craniovertebral angle, and Rounded shoulder angle was taken using a Numeric pain rating scale (NPRS), Neck disability index (NDI), Goniometer, and photogrammetry. Group A received treatment with hot packs and METs. Group B received a hot pack, Muscle energy technique (METs) and Bowen therapy. A total of 18 sessions were given in 6 weeks with 3 sessions per week. Both groups were reassessed after 3 weeks and 6 weeks of treatment with follow-up after 3 weeks of treatment completion. Data were analyzed by using SPSS 21. Results: Findings revealed that a statistically significant difference (p<0.05) was observed for both within a group and between-group analysis in NPRS, NDI, cervical range of motion (CROM), Craniovertebral angle (CVA), and Rounded shoulder angle (RSA). However, the Bowen group showed more improvement in terms of all outcome measures based on their mean differences. Conclusion: The combination of METs and Bowen therapy was more effective in decreasing pain, improving movement, regaining functional status, and correcting posture in individuals with Text neck syndrome rather than using METs alone. Keywords: Text neck, Muscle energy technique, Bowen technique, Pain, Range of motion