THE THERAPIST (Journal of Therapies & Rehabilitation Sciences)

Stuttering’s Effect on Job Efficacy in Five Participants

Sehar Rafique — 2023-03-31

Stuttering also known as stammering is a speech disorder, in which the flow of speech is disrupted by involuntary repetitions and prolongations. Adults who stutter suffers with many problems at workplace due to speech disfluencies. To evaluate the effect of stuttering on job efficacy. A population both male and female between the age of 30 to 40 years were selected. Data for the stuttering patients were collected from different job places of Lahore. All these stutters were given the consent form. It confirmed their willingness to participate in interview. Interview guide was designed as per the criteria of research questions. Interview guide was evaluated and reviewed by two external members. Interviews were conducted on WhatsApp audio or video call, zoom meetings and face to face, according to the availability and willingness of participants. Interviews were recorded for further analysis. Recorded interviews were transcribed which were further coded, and subthemes were extracted. On the basis of subthemes, themes of the research were decided. Results shows that only those individuals who stutter doing their own business or running their own NGO’s (Non-Governmental organizations) are satisfied with their jobs/works. Individuals doing any kind of job in a private company are not satisfied with their jobs because of stuttering. Case Summary: Stuttering has a negative impact on their job performance and employment. Stuttering made them lose their confidence in front of any stranger, senior or boss. People usually mock them because of stuttering. These issues lead them towards anxiety, complexity and frustration.

Frequency of Non-Specific Low Back Pain Among School Going Adolescents in Peshawar

Naeem Ur Rahman — 2023-03-31

Nonspecific low back pain is a state which is characterized by discomfort and inflexibility in the lumbo-sacral area without any underlying pathology. NSLBP is taken as non-specific when any mechanical and structural impairment cause is excluded. Initial symptom starts when a person is in the phase of adolescence and further continuous. Objective: To evaluate the frequency of non-specific low back pain in school going adolescents. Methods: Cross sectional study design was used. Total 202 samples were taken through consecutive sampling technique. Study duration was six months. The study setting was different private schools of Hayatabad Peshawar. Students of age 10- to 19-year-old were included in the study. The results were analyzed by using SPSS version 23. Results were shown in the form of tables and graphs. Results: According to the results 108 (53.5%) students reported to have NSLBP. Total 202 subjects were added in study, in which 150 were males and 52 were females. Total 106 participants were between the ages of 10 to 15 years. The remaining 96 students were between the ages of 15 to 19 years. According to Wong-bakers faces pain rating scale 84 participants reported to have non-specific low back pain while 64 participants reported pain for 12 to 24 hours. Students from frontier student’s academy reported to have repeated NSLBP. Conclusion: Nonspecific low back pain is a familiar condition that occurs in school going children and adolescents. Due to heavy back packs, poor posture and prolong setting

Effect of Posteroanterior Lumber Spine Mobilization Versus McKenzie Prone Push Ups on Pain and Functional Disability in Subjects with Non-Specific Low Back Pain

Saman Ali — 2023-03-31

85% of the population has non-specific back pain. Posteroanterior (PA) lumbar mobilization and Push-up exercises are primarily used in physical therapy for back pain. Objective: To know the outcomes of posteroanterior spinal mobilization and prone push-ups on nonspecific lower back pain. Methods: The randomized clinical trial was done with 30 subjects meeting inclusion criteria and were randomly selected by non-probability/purposive sampling technique from the Department of Physical Therapy, Mayo Hospital Lahore. The 4 weeks study was conducted in which 2 groups with 15 in each group were formed. Group I was treated with PA lumbar glide while group II was treated with prone Push-ups. VAS and functional disability index were used to evaluate pre-treatment and post-treatment. Results: A significant decrease in mean pain score was noted in both groups. Results did not show any statistically significant differences between groups for any parameter. The study has given evidence that supports the use of posteroanterior mobilization and prone push-ups to reduce pain, improve range of movement, and disability reduction in patients with nonspecific low back pain. It also showed that posteroanterior mobilization was more beneficial than prone Push-ups. Conclusion: Both PA mobilization and Push-ups can be used as effective maneuvers for the treant of non-specific low back pain

Psychological Well-Being and Care Giver Burden of Parents Having Child with Leukemia

Robina Ghaffar — 2023-03-31

Leukemia is one of most prevalent type of cancer among the children with age less than 15 years. Worldwide, Leukemia represents 32.5% of all types of cancer among the children. In Pakistan, 46.5% child with cancer diagnosed with leukemia. Both the mother and father are involved in the direct and indirect care of their child with leukemia Direct care is the tasks with the care of the child with leukemia and indirect care is the financial support and the facilities provided to the patients. Objective: To determine the psychological wellbeing and Care burden among parents having Children with Leukemia. Methods: A cross-sectional study designed was used. A sample of n=81 participants was recruited from Sadiq Abbasi Hospital Bahawalpur, through convenient sampling. The psychological wellbeing and care burden questionnaires were used to measure care burden and psychological wellbeing among parents having children with leukemia. Filled questionnaires were entered and analyzed through SPSS version-21. Results: Findings revealed that 71.60% participants had poor psychological wellbeing, 18.51% had fair and only 38.27% had good wellbeing during their children leukemia care. Similarly, 12.34% had low care burden, 38.27% had moderate and majority 49.38% were having high care burden. Conclusions: Majority of the parents of children with leukemia in this study were having high care burden and poor psychological wellbeing while taking care of their children

Challenges Faced by Speech Language Pathologists as Entrepreneurs: A Thematic Analysis

Elaha Jamali — 2023-03-31

Speech language pathology is a new profession in Pakistan. With cultural & linguistic variations, SLP entrepreneurship in Pakistan needs to be augmented to reach the needy as well as economic growth of the country, hence challenges need to be identified. Objectives: To determine the challenges faced by Speech Language Pathologists in becoming entrepreneur. Methods: This qualitative exploratory study was conducted at Riphah International University, Islamabad from April 2019 to Sept. 2019. Study recruited N=15 speech language pathologists of both genders, aged 25-50 years, running their own private clinics using purposive sampling. Individual interviews were conducted using interview guide with 11 structured interview questions. Audio recording and note taking methods were used for data collection. Data was transcribed and thematic analysis done manually & verified. Results: Study with a sample of N=15 Speech Language Pathologists mostly 11(73.33%) highly qualified females with most 14(93.33%) with master’s degree & 10(66.67%) with < 10 years’ experience came up with an array of rich data. Thematic analysis revealed the outcome themes in descending order with a frequency 45 for Infrastructure, 32 for Professionalism, 27 for Recruit, 26 for Inclination, 23 for Unity, 22 for Legislation, 21 for Self-regulation, 20 for Wealth, 17 for Determination, 11 for Optimism & Matriarchy each, 10 for Expertise, 8 for Customers, 8 for Obstacles and 2 for Ethics. Conclusion: The five most common and eminent issues/ themes faced by Speech therapists as an entrepreneur in descending order of their frequency include infrastructure, professionalism, recruit, inclination, & unity.

Virtual Reality Training Improves Upper Limb Functions in Stroke Survivors

Namal Shahzadi — 2023-03-31

Stroke survivors with upper extremity functional limitation are particularly susceptible to problems in performing independent ADLs. Virtual Reality training has a significant contribution to enhancing the independence of stroke survivors. Objective: To determine the effect of additional VR training on upper limb gross motor function, gross manual dexterity, and functional activities in hemiplegic stroke survivors. Methods: It was a single-group experimental study in which 20 participants were recruited through non-probability convenient sampling. Participants were included in the study if they had any sort of stroke (hemorrhagic or infarct), were between the ages of 30 and 70, had at least one score on the box and block test, and did not have any cognitive deficits or uncontrolled high blood pressure. The intervention was provided three days a week for a total of six weeks. Gross motor function, gross manual dexterity, and functional capacities of the upper limb were measured at baseline, 2^nd, 4^th and at 6^th week of intervention through Fugl-Meyer Assessment, Box and Block Test, and Wolf Motor Assessment Scale respectively. Data were analyzed through within-group inferential analysis using SPSS-21 software. Results: The mean age of patients was 49.45 ± 11.02 years. The scores of the Fugl-Mayer Assessment Scale, Box and Block Test and Wolf Motor Assessment Scale were significantly improved from baseline to six weeks (p<0.05). Conclusion: This study concluded that the hemiplegic stroke survivors who received additional Virtual Reality training using Xbox Kinect showed significant improvement in Gross motor Function, Gross Manual Dexterity and Functional Abilities of the Upper Limb.

Knowledge and Care Among Mothers Having Children with Cerebral Palsy

Saima Perveen — 2023-03-31

Cerebral palsy (CP) is a chronic, non-progressive, and incurable disorder that affects mobility and posture. Objective: To assess the Knowledge and Care among mothers having Children with Cerebral Palsy at Nishter hospital Multan. Methods: A cross sectional study designed was used. A sample of n=85 participants was recruited from Nishtar Hospital Multan Pakistan, through purposive sampling. The knowledge and care questionnaire were used for measurement of knowledge and care among mothers having children with cerebral palsy (CP). Filled questionnaires were entered and analyzed through SPSS version 21. Results: Findings revealed that 71.8% participants had poor knowledge regarding CP, 21.2% had fair knowledge and only 7% of participants had good knowledge regarding CP. Similarly, it was revealed that 50.6% participants had poor care, 41.2% had satisfactory care and only 8.2% were having good care for cerebral palsy children. Conclusions: Majority of the mothers of children with cerebral palsy in this study are unaware of the condition and show no concern for it. Support groups may be developed further to increase care giving' awareness of and concern with CP, which may aid them in finding the most suitable and timely interventions for their charges.

Efficacy of Arthroscopic Debridement with Proximal Fibular Osteotomy in Early Medial Joint Osteoarthritis of the Knee

Faizan Ali Janjua — 2023-03-31

In the USA alone, osteoarthritis affects > 3 billion people, making it the most predominant type of joint disorder. It costs the US more than $185 billion a year and is the primary cause of persistent disability in older persons. The results of our cases will help encourage local health researchers to continue this procedure and review the available resources thereof. Objective: To determine efficacy of arthroscopic debridement with proximal fibular osteotomy in early medial joint osteoarthritis of the knee in patients presented to tertiary care hospital. Methods: This descriptive Case Series was held in the Orthopedic Surgery department, MTI-Hayatabad Medical Complex, Peshawar from 30 Dec, 2020 to 30 Jun, 2021. Patients with medial knee osteoarthritis were treated by proximal fibular osteotomy combined with arthroscopic debridement. The efficacy of the knee function was evaluated by VAS score, AKSS, and ML ratio at 1 week and 3 months after operation. Results: As per frequencies and percentages for efficacy, 114 (69.1%) patients showed effective results of arthroscopic debridement. Conclusion: This study demonstrated that arthroscopic debridement with proximal fibular osteotomy is an effective procedure in the management of early medial joint osteoarthritis of the knee in terms of improved knee function.

Prevalence of Trapezius Trigger Points in Young Healthy Individuals

Maria Khalid — 2023-03-31

MTrPs are labelled as hard, discrete, and palpable nodules in a taut band of skeletal muscle. It can be further divided into 2 forms, if it is spontaneously painful (i.e., active trigger points) or painful only on compression (i.e., latent trigger points). Objectives: To determine the frequency of active and latent trigger points of trapezius in healthy individuals and to find out its association with gender. Methods: A cross sectional survey was conducted from April 2018-August 2018 after getting approval from the ethical committee of Riphah College of Rehabilitation Sciences. The sample size was 323 which were selected by non-probability (convenient sampling) technique. Data were collected through self-structured questionnaire which also included trigger points assessment form. The data were analyzed using SPSS 24. Results: The mean age of participants was 23.60±4.6years with 60(19.8%) males and 243(80.2%) females. The trapezius trigger point 2 was found more active on right side (TT2Rt side) in 91(30%) and left side (TT2Lt side) 57(18.8%). While the same was more latent in 75(24.8%) on right side (TT2Rt side) and 86(28.4%) on left side (TT2Rt side) among the participants. There was no significant association between active trigger points and gender (p>0.245), as well as the association between latent trigger point and gender was not significant (p>0.740). Conclusions: The frequency of trapezius trigger point is less in healthy individuals whereas the majority of the young individuals have at least one or two active or latent trigger points. There was no significant association of both active and latent trigger points with gender.

Relationship of Resilience and Anxiety with injury prevention programs in Pakistani Footballers

Esa Khan — 2023-03-31

Resilience is a one of the major psychological qualities that enhance an individual’s strength and shield individuals from the adverse effects of diverse situations. Objective: To find out resilience and anxiety in footballers following or not following an injury prevention program. Methods: The study design used for this study was comparative cross-sectional survey, and data were collected from 35 football players. Players who were following or not following an injury prevention program were divided into two groups. Data for the resilience and anxiety was collected with help of strait trait anxiety questionnaire and Conner-Davidson resilience scale. Results: There was significant difference (p≤0.05) between the two groups for state anxiety in players not following any injury prevention program (44.15±4.71) and players following injury prevention program (39.00±3.77). Between groups comparison for trait anxiety also showed significant difference (p≤0.05) for players not following any injury prevention program (45.30±5.56) and following injury prevention program (40.20±4.21). Between groups comparison also showed that there was significant difference (p<0.05) in CDRS scores for players not following any injury prevention program (81.65±1.42) and players following injury prevention programs (92.20±1.97). Conclusions: The present study concluded that those players who had less anxiety levels had increased resilience levels while those players who were having increased anxiety had decreased resilience. There was a significant difference between anxiety and resilience levels and the players who were following injury prevention programs had less state and trait anxiety and better resilience

Efficacy of Compassion Focused Therapy for Managing Skin Shaming of Acne in Young Women

Adeela Khan — 2023-03-31

People are socially evaluated from face as ugly/beautiful. So person with acne isolate themselves from social gathering because of fear of stigmatized as unattractive. This social rejection leads them towards skin shaming of acne. Previous studies were not giving much importance to psychological impact of acne; just dermatological treatment was focus of attention. Objectives: To find a short duration but effective therapy to manage skin shaming of acne in young women. To test the efficacy of Compassion Focused Therapy on managing skin shaming of acne in young women. Methods: The research was an experimental study with sample of 64 young women of 18-25 years. 32 young women are allocated to therapy group and 32 women are allocated to control group. Data were collected at three time intervals of pre-therapy, post-therapy and follow-up. SPSS 21.0 version was used for data analysis. Results: Results clearly indicated significant reduction of skin shaming due to acne of young women from pre-therapy to post-therapy and also from pre-therapy to follow up. When therapy group women data compared with control group women data, conforms our objectives of study that that compassion focused therapy is effective and efficient therapy to manage skin shaming of acne in young women. Conclusion: Compassion Focused Therapy is successful therapy to manage skin shaming of acne in young women.

Association of Low Back Pain with Body Mass Index and Stress Among House Officers in Different Rotational Placements

Tamjeed Ghaffar — 2023-03-31

Low back pain (LBP) is the most common disorder affecting the back's muscles, nerves, and bones and affecting the quality of life. Objective: To find the association of LBP with body mass index and stress among house officers in different rotational placements. Methods: In this cross-sectional study, a sample of 170 participants were recruited. Oswestry disability index was used to assess the LBP and perceived stress scale was used to assess the stress. Inclusion Criteria includes house officers, both male and female and physical therapy internes. Exclusion Criteria includes disability, trauma and congenital disorder. Data were analyzed by IBM SPSS statistics version-25. Results: Out of 170 participants 10(5.9%) were underweight, 60(35.3%) were normal weight, 66(38.8%) were overweight and 34(20%) were obese. p value was .694 which showed that there is no association between LBP and body mass index. The p value for LBP and stress was .458 which showed there is no association. The p-value for LBP and different rotational placement was .000 which shows there is association present. Conclusions: There was no association found between LBP and body mass index, LBP and stress. There is association found between LBP and different rotational placements.

Correlation of Burnout Syndrome with Musculoskeletal Disordersand Its Prevalence Among Medical Students

Minahil Tanveer — 2023-03-31

Burnout is common exhaustion in students especially among medical students due to their increased study hours, increased demands according to the education sector and less tolerance. Objective: To determine the prevalence and correlation of burnout syndrome and musculoskeletal problems among university students in Lahore. Methods: The analytical cross-sectional study was conducted by including 181 medical students by using, a convenience sampling technique according to the predefined selection criteria. The Copenhagen Burnout Inventory (CBI) and Nordic Questionnaire were used for assessing the outcomes of the patient. The data were analyzed by using SPSS in which frequency, percentage, and Correlation analysis were used to determine the relationship that exists between burnout syndrome and musculoskeletal pain. Results: The study showed that Musculoskeletal pain and burnout syndrome exist a strong correlation among students of universities with a p-value <0.05. Conclusions: The study concluded that burnout syndrome had a statistically significant relationship with students’ study years and musculoskeletal problems that ultimately affect their normal activities of daily life

Frequency of Work-Related Neck Pain in Freelancers

Tamjeed Ghaffar — 2023-03-31

The use of electronic devices like tablets, smartphones, desktop and laptop users has been increased to a lot of extent from past few years. So, the workers are more prone to be affected by neck pain, shoulder pain and other forms of musculoskeletal problems, due to lack of awareness about bad posture and ergonomics about workstation in their environment. Objectives: To find out the frequency of work-related neck pain in freelancers. Methods: It was a cross-sectional study containing of questionnaire based online survey in which the data were collected by asking the participants to fill the form online. There were 100 participants who were actively working in this field from last 6 months and all of them were having neck related problems. The data was analyzed using statistical packages of social sciences and different tests were performed including Chi-square and standard deviation and square tab. Results: Statistics show that 27% of freelancers were suffered from neck and shoulder pain, 43% suffered from neck pain along with other symptoms and followed by headache in which 34% rarely suffered from headache, 38% suffered from moderate headache and 28% from severe headache. Emotional findings show that 44% faced frustration, anger and sadness to some extent. Conclusions: The neck discomfort due to working online increases with sitting still for more than 1 hour, making physical activity difficult as well as making lifestyle change. A significant Association was found between lifestyle changes due to neck pain, neck pain intensity with online working.

The Prevalence of Coccydynia among Postpartum Females in Allama Iqbal Memorial Teaching Hospital, Sialkot

Saman Shah — 2023-03-31

The coccydynia refers to the pain in the coccyx. Its incidence is increasing due to sedentary lifestyles. The problem is commonly seen in postpartum females caused due to prolong sitting, poor breast feeding position or due to internal and external trauma during labor. Objective: To evaluate the prevalence of coccydynia and its association with postpartum females in Allama Iqbal Memorial Teaching Hospital, Sialkot. This is an observational study and convenient sampling technique is used in it. Methods: This study includes 90 postpartum females of age between 20 to 44. Data were collected by using a questionnaire containing 16 questions. Results: Out of 90 postpartum females, the total number of patients having tailbone pain were 86.7% whereas, 8.2% participants had no pain after delivery. Conclusion: The study concludes that the prevalence rate of coccyx pain is very high in postpartum females, due to several reasons. The study mainly focus on providing guidance to the females about the correct positioning, exercises and postural guidance in order to maintain the active lifestyle.

Effect of Whole-Body Vibration During Chemotherapy in Improving Functional Outcomes of Patients with Malignancies

Wajiha Shahid — 2023-03-31

The use of functional outcome scales to see the effect of whole-body vibration on the patients having malignancies and going through chemotherapy. Objective: To perform a systematic review to see the effects of whole-body vibration on patients having chemotherapy. Methods: Using the specified keywords, a search was conducted in the TRIP, PEDro and PubMed databases. The studies were picked based on their eligibility for evaluation. The articles having full length were included which specified the effect of whole-body vibration technique in the patients having malignancies and going through chemotherapy. Results: According to the exclusion criteria, three publications were included, all related to patients having chemotherapy. Reported were the effects of WBV both in sensory and motor symptoms. Conclusions: It was concluded that by using the whole-body vibrator the debilitating effects of the chemotherapy can be controlled or minimized such as fatigue, weakness and bone loss. It is comparative to high intensity exercises which account behavioral barriers and certain risks

Targeted Therapies in Chronic Kidney Disease

Fahad Tanveer — 2023-03-31

About a millions of glomeruli, or filtration units, found in the kidney linked to the tubules where water and solutes from the primary urine are selectively reabsorbed. Both the glomerular and tubular compartments are eventually affected by acute and chronic kidney diseases, but circulating substances like antibodies or cytokines frequently target the glomeruli first. A minimum of three months must pass before there are any abnormalities in renal function in order for the patient to be diagnosed with chronic kidney disease (CKD). Twenty million people in the US have CKD. Despite being a major global health burden, chronic and acute kidney illness still lack effective treatments. Current treatments, like anti-inflammatory steroids, have systemic side effects and cannot halt the disease's development. Although efforts have been made to create renally pursued treatments, no such strategy exhibits yet entered the clinic. At this time, we provide a critical overview of the state of drugs and delivery methods that specifically target the kidneys [1].

Functional results fall into two categories: (i) Targeting the kidney causes the renal-to-liver ratio to rise. This is referred to as explicit targeting; (ii) the medication accumulates more in the kidneys while the kidney verses liver proportion stays the same, which allows the carrier to boost uptake generally. Overall, targeting that was focused on receptors and transporters was the most successful. The biggest task for nanoparticulate formulations is to reach glomerular cells and prevent liver accumulation [2].

Long-term contact with a carrier may be necessary to treat chronic kidney illnesses. Evidence on frequency, quantity, and application as well as the kinetics of degradation must be converted crazy about kinetic models of degradation and uptake in order to determine whether possibly lethal accumulation is to be predictable for decomposable polymers.