Non-steroidal anti-inflammatory drugs (NSAIDs) continue to be amongst the most frequently used pharmaceutical treatments for mild to moderate musculoskeletal pain globally. In this short communication, we continue to expand the growing field of environmental physiotherapy by tracing NSAIDs journey through aquatic ecosystems, and the potential of physiotherapy to mitigate these negative environmental impacts and so contribute to achieving a range of UN Agenda 2030 Sustainable Development Goals and the aspirations of One Health. Through metabolic excretion into waterways, NSAIDs negatively impact the health and survival of various aquatic lifeforms, which, in turn, has consequences for human health. By reducing and delaying the need for pharmacotherapy for mild to moderate musculoskeletal pain, physiotherapy presents an important sustainable healthcare solution. Beyond this, however, the ecological persistence of NSAIDs also underscores the need for transformative change in healthcare and physiotherapy, towards the full recognition of the interconnected nature of human, animal, and ecosystems health and the complex questions and responsibilities this raises. For this, we need to increase our understanding of the entangled nature of health and its negotiation with human and non-human others and develop approaches to include them in our thinking, pursuit, and practice of health and care.

Background and purpose: Amongst all of the bi-articular muscles of the human body hamstring have a greater tendency to shorten. Tightness of hamstrings produces decreased range of motion and reduce flexibility of the pelvis, hip and knee joints which can lead to musculoskeletal injuries. Muscle energy technique (MET) also known as active muscular relaxation technique is effective for lengthening a shortened muscles and increasing the range of motion. It is found that neuro dynamic tension technique also affects muscle flexibility and stretch tolerance. The purpose of this study is to evaluate the immediate effect of muscle energy technique verses non ballistic active knee extension in neural slump position on hamstring flexibility in young adults. Materials and Method: 60 healthy individuals between the age group of 18-35 years with bilateral hamstring tightness without any previous musculoskeletal injuries were allocated into 2 groups by means of quasi random sampling. Hamstring tightness was measured using active knee extension (AKE) test. Group A was given neural slump stretch and group B was given muscle energy technique.Results: For within group data analysis Wilcoxon test was applied where Group A and Group B showed statistically significant difference (p<0.001) in pre and post hamstring flexibility. Mann Whitney U test was used for between group analysis in which Group A(mean rank 35.22) showed a greater improvement than Group B (mean rank 25.78). Conclusion:Both the techniques showed statistical as well as clinical significance in improving hamstring flexibility, however non ballistic active knee extension in neural slump position showed greater improvement than MET.

Background: Post stoke hemiparesis limit the upper extremity function due to development of spasticity and synergy patterns, therefore rendering the patient impaired in activities of daily living. Transcutaneous electrical nerve stimulation (TENS) has recently been used to reduce spasticity. The purpose of this study was to evaluate the effects of TENS on spasticity and upper extremity function following chronic middle cerebral artery stroke (MCA). Study design and setting: interventional study conducted on patients from clinical and hospital setting in Ahmedabad. Methods: A total of 30 patients between the age group of 35-75 years of age. Group A received TENS for 30 minutes in addition to conventional exercise therapy regime where as group B received only exercise therapy regime. The intervention was given for 5 days a week for 4 weeks. The outcome measures were Modified Ashworth scale (MAS) and Fugl Meyer assessment for upper extremity (FMA-UE). The data collected was statistically analysed by using Wilcoxon’s signed rank test for within group analysis and Mann Whitney U test for between the group analysis. Results and conclusion: Group A showed a statically (P <0.05) as well as clinically significant improvement in both the outcome measures. There-fore it was concluded that TENS prove to be effective in reducing spasticity and improving upper extremity function in chronic MCA stroke. KEY WORDS: Stroke, Spasticity, TENS, Modified Ashworth scale (MAS), Fugl Meyer assessment for upper extremity (FMA-UE).

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