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Abstract Objective: To determine the association of musculoskeletal discomfort with the high heeled shoes related variables in females who use such footwear frequently. Methods: A cross sectional study was conducted on 174 female residents of Islamabad and Rawalpindi, for a time period stretching from July 1, 2018 to December 31, 2018. The participants aged between 18 and 55 years appeared as the frequent users of high heeled shoes. The Nordic Musculoskeletal Questionnaire (NMQ) and Numeric Pain Rating Scale (NPRS) were used as outcome measures to assess the musculoskeletal discomfort and a self-structured questionnaire was used to obtain information related to the high heeled shoes e.g. duration and frequency of high heeled shoe use. Data was analyzed using SPSS version 21. Results: The data analysis showed a positive association of shoulders’ discomfort with length of high heeled shoes used by women (p value= 0.03<0.05). Moreover, a positive association was also found between an occurrence of upper back discomfort and length of the heeled shoes (p value= 0.01<0.05). However, no significant association was found between pain intensity and length of the shoe’ heel, frequency and duration of high heeled shoe use. Conclusion: The shoulders’ and upper back discomfort in females who frequently used high heeled shoes was determined to be associated with the length of the heels in shoes. Keywords: Female, Heel, Musculoskeletal System, Pain, Shoes. Continuous...

ObjectiveTo determine the effects of augmented reality (AR) interventions on the function of the upper extremity (UE) and balance in children with spastic hemiplegic cerebral palsy (SHCP).MethodsIn total, 30 children with SHCP, aged 6 to 12 years, were randomly divided into three interventional groups. Each group received an AR game, i.e., Balance It, Bubble Pop, or Scoop'd (WonderTree, Pakistan). The UE function and balance were assessed at the baseline and after 8 weeks of intervention through the Disability of Arm, Shoulder, and Hand (DASH) questionnaire and Pediatric Balance Scale (PBS), respectively. The mixed ANOVA was used to determine the combined with-in and between-the-groups differences in the function of the upper extremity. The Wilcoxon sign ranked test was used for with-in group changes, while the Kruskal Wallis test with the bonferroni correction post-hoc analysis was used to compare the groups in terms of balance. The data were analyzed by using SPSS version 21 and the level of significance was set at p &lt; 0.05. Paired sample t-test and Wilcoxon signed-rank test was used for analyzing the changes in the total DASH and PBS scores within the groups, respectively. One-way ANOVA was used to determine the differences between the groups in the total DASH and PBS scores, while the Kruskal Wallis test was used for the differences between the groups in the PBS items. The data were analyzed by using SPSS version 21.ResultsAll the groups improved significantly in the total DASH and PBS scores post-intervention. A significant difference was determined in standing with one foot in front between Bubble Pop and Balance It groups (p = 0.03). The total score of PBS also showed a significant difference between Bubble Pop and Balance It groups (p = 0.02).ConclusionThe AR interventions used in this study were found to be effective in improving the UE function and balance of children with SHCP. The Balance It game showed more promising results in improving the balance as compared with the other games, however, no significant difference was determined between the three AR games in terms of the UE function of the participants.

Background: Tension neck syndrome (TNS) is a prevalent condition worldwide. Soft tissue mobilization and strengthening exercises are used in physiotherapeutic rehabilitation of the musculoskeletal disorders. Objective: To compare the effects of strengthening exercises with and without soft tissue mobilization (STM) for pain and disability reduction in females with TNS. Methods: A single-blinded, parallel-group randomized controlled trial was conducted at the National Institute of Rehabilitation Medicine, Pakistan, from April to July 2016. A total of n=30 females, aged 30-70 years, were recruited through non-probability convenient sampling technique and randomly allocated to the experimental and control group. The experimental group received STM and neck isometric strengthening exercises, whereas the control group received neck isometric strengthening exercises only. The Numeric Pain Rating Scale (NPRS) was used to assess the pain intensity, while Neck Disability Index (NDI) was used for the neck-related disability. The data was collected at the baseline, after the 4th session and after the 8th session. The repeated measure analysis of variance (RM ANOVA) was used to analyse within the group changes, while the independent t-test was used to analyse the differences between the groups. The data was analysed by using SPSS version 21.Results: The mean age of the study participants was 47.9 ± 8.95 years. Within groups’ changes showed that pain intensity, individual items of NDI and its total score showed significant improvement in both the groups from the baseline to the 8th session (p £ 0.05). After the 8th session, the experimental group showed more significant reduction (p £ 0.05) in pain intensity and neck disability as compared to the control group. Conclusions: Soft tissue mobilization when combined with neck isometric strengthening exercises was more effective than exercises alone for reducing the pain intensity and disability in females with tension neck syndrome. Keywords: Management, neck pain, physical therapy, soft tissue mobilization, strength training