Pakistan Sports Board, Lahore. The study population will be consisted of patients with non specific pain

Study aim: To compare the effects of modified Otago exercises and Vestibular rehabilitation therapy on balance, postural stability, and risk of fall in sub-acute stroke. Design: Randomized Clinical Trial, a single blinded study, sample size 42, computer generated randomization Settings and conduct: Data is being collected from General Hospital, Lahore. Participants/Inclusion and exclusion criteria: Inclusion criteria: Diagnosed cases of ischemic stroke. Age between 40-70 years Both males and females. Stroke with unilateral hemiplegia in less than 6 months. Participants are able to walk 10 meters with or without assistive device. Participants should be able to understand and follow simple verbal instructions, Mini-Mental Status Examination (MMSE ≥24). Exclusion criteria: Participants with spasticity (modified Ashworth scale grade ≥3) or flaccidity in lower limbs and upper limbs. Individuals suffering from unstable angina, symptomatic heart failure or uncontrolled hypertension. Balance or gait impairments prior to the stroke. Visual field defects Severe unilateral spatial neglect. Neurological and orthopedic comorbidities like significant osteoarthritis, particularly in the lower limbs. Intervention groups: Group A will be treated by Vestibular Rehabilitation Therapy (25 minutes) and Conventional physical therapy (30 minutes). Group B will be treated by Modified Otago Exercises (25 minutes) and Conventional physical therapy (30 minutes). Main outcome variables: Balance, postural stability and risk of fall.

Study aim: To compare the effects of calisthenic exercises and sensory-motor training on pain, range of motion, balance and functional disability in patients with knee osteoarthritis. Design: Randomized clinical trial, single blinded study, two parallel groups with 108 patients from Gosha e Shifa and Riaz Mansoor trust hospital. Settings and conduct: Gosha-e-Shifa trust hospital and Riaz Mansoor trust hospital. Participants/Inclusion and exclusion criteria: Inclusion criteria Both male and female patients Age 40 to 65 years Exclusion criteria Patients with any systemic disease Patients who had any neurologic deficit Patients with any mental illness Intervention groups: Group A: Calisthenic exercises will be given to group A. Group B: Sensory-motor training will be given to group B. Main outcome variables: Pain, range of motion, balance and functional disability

and conduct: The study will be conducted at Pakistan Ordinance Factories (POFs) Hospital and Wah (...) ) Rawalpindi Pakistan, Participants/Inclusion and exclusion criteria: Inclusion criteria: Pakistani

Study aim: To compare the effectiveness of Cervical-Thoracic Spine Stabilization Exercises and Dynamic Cervical Exercises in reducing pain intensity and improving functional disability among patients with cervical spondylosis. Design: Single-centre, single-blind, parallel-group quasi-experimental pretest-posttest study with 40 participants. Allocation was based on clinical availability. Outcomes were assessed at baseline, two weeks, and four weeks. Settings and conduct: The study was conducted at the Department of Physiotherapy, DHQ Hospital, Okara, after ethical approval (Ref No. LIMIT/DPT/2025/15). Written informed consent was obtained. Participants were allocated by an independent researcher, and the outcome assessor was blinded to group allocation. Participants/Inclusion and exclusion criteria: Forty adults (30–55 years) with radiologically confirmed cervical spondylosis, chronic neck pain (>3 months), and mild-to-moderate disability were included. Patients with cervical surgery, trauma, radiculopathy, myelopathy, other major musculoskeletal disorders, pregnancy, or lactation were excluded. Intervention groups: All participants received conventional physiotherapy consisting of a 15-minute hot pack and cervical stretching exercises before the exercise intervention. Group A received Cervical-Thoracic Spine Stabilization Exercises, while Group B received Dynamic Cervical Exercises. Both interventions were supervised, performed five days per week for four weeks, with three sets of ten repetitions per session and progression according to patient tolerance. Main outcome variables: Visual Analogue Scale (VAS) and Neck Disability Index (NDI)

Study aim: our study aims to compare the patients pre-treated with oral duloxetine planned for elective modified radical mastectomy to placebo for quality of recovery, pain scores and reduced rescue analgesia requirements post-operatively. Design: Quasi-experimental comparative study Settings and conduct: Department of Anesthesia, Combined Military Hospital, Rawalpindi for at least 3 months or till completion of minimum sample size Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: • Will include all ASA II and III female patients aged 18-60 years of age, diagnosed with non-metastatic breast cancer planned for an elective modified radical mastectomy and referred to the anesthesia clinic for pre-anesthesia assessment EXCLUSION CRITERIA: • Will include patients with metastatic disease, already on anti-depressants or anti-psychotic treatment, patients with severe depression, patients with debilitating hypertension and/or uncontrolled diabetes. Intervention groups: They will be divided into Group A (n=40) to receive oral duloxetine and Group B (n=40) to receive placebo tablet not containing any active drug but used to ensure blinding and prevent bias. Main outcome variables: After the surgical procedure, patients will be kept in the high dependency unit (HDU) for observation. Primary variable would be patient recovery assessed at 3,6,12 and 24 hours after the procedure using the QoR-40 scoring system which will include assessment of patient support, comfort, emotions, physical independence, and pain with a total score ranging from 40-200 with higher scores associated with better patient recovery. Secondary variables will be pain scores assessed using 10-point Visual Analog Scale (VAS) assessed at 3,6,12 and 24 hours post-surgery and total dose of IV Morphine used in 24 hours as rescue analgesia once pain scores will be above 6 on the VAS.

of Anesthesia, Combined Military Hospital, Rawalpindi, Pakistan Participants/Inclusion and exclusion

Study aim: To evaluate effects of upper thoracic spine mobilization with mobility exercises and upper cervical spine mobilization with stabilization exercises in reducing pain, improving cervical ROM and function in treating patients with mechanical neck pain. Design: Single Blinded Randomized Clinical Design Settings and conduct: Faisal Hospital Faisalabad Mujahid Hospital Faisalabad Bin Inam Physical Therapy & Chiropractic Rehab Clinic Faisalabad Pro Health Wellness Center Faisalabad Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Male and female both genders • Age ranging from 20-40 years • Primary complaint of neck pain from past 12 weeks • Pain rating of more than 2 on NPRS • Reduced cervical ROM in extension, rotation and side bending • Neck Disability Index score of 20% or more i.e. 10 points or more on 0 to 50 scale Exclusion Criteria: • Previous history of trauma or surgery to cervical or thoracic spine, whiplash injury • Presence of neurological deficits • Presence of bilateral upper extremity symptoms • Cervical myelopathy or nerve root pathology • Patients with positive Lhermitte’s sign • Vascular diseases of head and neck • Presence of any red flags e.g. fracture, tumor • Any symptoms of CNS involvement • Patients with psychological disorders or those who can’t comprehend given instructions. Intervention groups: Treatment will be provided for 2 times a week for 4 weeks for both groups. Group A will perform upper thoracic mobilization and mobility exercise. Main outcome variables: Numerical Pain Rating Scale Universal Goniometer Neck Disability Index

Pakistan Sports Board, Lahore. Outcome assessor will be blinded to treatment groups Participants/Inclusion

Study aim: To compare the immediate effects of diaphragmatic breathing (DB) and pursed lip breathing exercise (PLBE) on blood pressure, pulse rate and oxygen saturation in hypertensive people Design: Community based, parallel group design, single blinded, randomized clinical trial Settings and conduct: Settings: Government girls high school Arriyan and Punjab workers welfare fund office, Lahore. Conduct: Trial will be completed in a period of 5 months by three physiotherapists. Single blinded study with blinding of outcome measure assessor who will be called from other place to record outcome measures without knowing about patient's group. Participants/Inclusion and exclusion criteria: Inclusion: Patients with hypertension (stage 1 and stage 2) with Systolic Blood Pressure ≥ 140mmHg and Diastolic Blood Pressure ≥ 90 mmHg will be recruited. ✓ 40 to 60 years of age people will be included. ✓ Both males and females. ✓ Patients either who would have taken any anti hypertensive medicines ( ACE inhibitors, calcium channel blockers, thiazide diuretics, ACE receptor inhibitors, beta blockers) at least 6 hours ago or no medicine at all to be certain that results are purely because of mentioned techniques. Exclusion: Participants who are unwilling to participate. Patients who are critically terminally ill e.g. patients with mental illness, psychosocial factors, cancer, infectious diseases, and comatose patients. Intervention groups: There will be 2 groups 1 will receive PLBE and other will receive DBE. For PLBE, patients will be asked to inhale through nose with mouth closed for 2 seconds and then exhale with pursed lips for four seconds. DBE group will be asked to assume a relaxed position with back and head supported. Start with breathing in slowly through the nose such as abdomen is filling first and then exhale slowly through the mouth. Main outcome variables: Blood Pressure, Oxygen saturation, Pulse Rate.

Study aim: The aim of this study is to compare the effect of spinal manipulation therapy, general exercise therapy and motor control exercises in chronic low back pain patients. Design: Randomize control clinical trial, three parallel groups with single blinded study Settings and conduct: Sample size is 36. Randomized clinical trial will be conducted and the data will be collected from Kannan physiotherapy and spinal clinic,Lahore. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA:Non-specific low back pain for at least 3 months,Age between 18 and 35 years EXCLUSION CRITERIA:Neurological signs, Specific spinal pathology ,Back surgery. Serious low back pathology Intervention groups: Three interventional groups named as general exercises, motor control exercises and spinal manipulation therapy are formed. First two groups participants will attend eight sessions of one hour, twice a week, for four weeks.The first group class will be modeled on the ‘Back to Fitness’ program described by(Klaber Moffett and Frost, 2000). The classes will start with Warm-up and Stretching. After about seven to ten minutes, stretching exercises are started then Warm-down and Relaxation. Secong group will be teached how to contract the transversus abdominis and multifidus muscles in isolation from the more superficial trunk muscles, but in conjunction with the pelvic floor muscles. Spinal manipulative group participants will be given joint mobilization or manipulation techniques applying to the lumber spine (Maitland et al.,2001). Participants in this group will not get exercises or a home exercise program, and they will get advice to avoid pain-aggravating activities. Manipulative therapy will discontinue if the participant completely recover before the 8 sessions are complete. Main outcome variables: Two primary outcomes. • Function •Pain.

Study aim: Comparison of Prophylactic and therapeutic effects of active isolated stretching, myofascial release and olive oil phonophoresis in exercise induced muscle damage Design: The current study investigated the prophylactic and therapeutic effects of myofascial release (MFR), Active isolated stretching (AIS) and Olive oil phonophoresis protocol versus control over a period of seven days in experimentally induced muscle soreness. The study design was a single blinded, 4 X 2 X 9 factorial design with repeated measures, the three factors were intervention (s), limb (s) and time. The repeated measures involved the time factor Settings and conduct: The study was carried out in Healthy, untrained and sedentary college/university students age ranging between 18-30 years without any upper arm injury or musculoskeletal disease at university of Sargodha. After screening, Randomization was carried out by stratified block randomization scheme. The subjects was allocated to one of the interventional group or control group. The outcome measures was recorded by a trained physical therapist of the department who was blinded about treatment and time status. Participants/Inclusion and exclusion criteria: Healthy, untrained and sedentary adults age ranging between 18-30 years, without any upper arm injury or musculoskeletal disease Intervention groups: The study constitutes Active isolated stretching , Myofacial release, olive oil Phonophoresis, and a control group. We had used limb to limb comparison model in each group, randomly one limb was allocated to prophylactic intervention limb (PIL) and the other to therapeutic intervention limb (TIL) Main outcome variables: 1. Muscle pain intensity by VAS 2 Muscle Soreness Score by VAS 3. Pain pressure Threshold by Algometer 4. Passive Range of motion by univeral goniometer 5.Grip strength by dynamometer

Study aim: The purpose of this study was to compare the short- and long-term effects on the Shoulder Pain and Disability Index (SPADI) of axillary nerve block (ANB) and intra-articular injection (IAI) vs suprascapular nerve block (SSNB) guided by ultrasonography as well as to find out how they affect the patients' quality of life who have AC. Design: A Randomized Control Trial (RCT) with two group interventions, each group have 40 participants. Settings and conduct: Ghurki Trust Teaching Hospital, Lahore. Participants and data collector will be blinded. Participants/Inclusion and exclusion criteria: 6.1 Inclusion Criteria: • Stage 2-3 AC unilateral • No shoulder injuries in the previous three months • Absence of shoulder injections • Absence of bleeding disorders • no prior history of cancer • absence of inflammatory illness history • Ages Eligible for Study: 30 Years to 70 Years (Adult, Older Adult) • Sexes Eligible for Study: All 6.2 Exlusion Criteria: • Malignancy • Inflammatory disease Intervention groups: Participants will be randomly assigned to two treatment groups: suprascapular and axillary nerve blocks or intra-articular shoulder injection. The nerve block group receives ultrasound-guided blocks with a 10 mL solution of 40 mg Prednisolone, 0.125% bupivacaine, and 0.125% lidocaine. Group II receives an intra-articular injection into the glenohumeral joint, also guided by ultrasound, using a similar anesthetic and corticosteroid mix for pain relief. Main outcome variables: Shoulder Pain and Disability Index (SPADI), Pain, Range of Motion ROM, assessing quality of life.

Study aim: To find the effectiveness of facilitated electric stimulation of two alternating patterns (abdominals cross hamstrings and lower back muscles cross quadriceps) on lower extremity in stroke patients. Design: Randomized Clinical Trial Settings and conduct: Allied hospital Faisalabad, Sahil hospital Faisalabad, Aziz Fatima hospital Faisalabad, Maqsooda Zia hospital Faisalabad Participants/Inclusion and exclusion criteria: 24 hemiplegic stroke patients 6 months post stroke aging between forty five to sixty years old Inclusion criteria • All men and women • Hemiplegic stroke patients • Age between forty five to sixty years old • Patient with static and dynamic sitting balance • Patients with static standing balance Exclusion criteria • All patients had imaging tests to rule out their diagnosis for stroke during the acute stage. • People who frequently have strokes. • Patients with peripheral or orthopedic neuropathy, substantial vision field defects, or hemi neglect issues were not included. • Poorly controlled epilepsy • Pregnancy • Heart pacemaker. • Patients with malignant tumors • Exposed metal • Suspected, recognized, or uncontrolled cardiovascular conditions • Neurological problems other than ischemic brain injury or hemorrhage that can result in hemiplegic stroke. Fracture Intervention groups: Group A Abdominals cross Hamstrings and additional exercises 3 days per week with 30 minutes. Additional exercises will include lower limb joint mobilizations, stretching of lower extremity, and ROMS. Group B Lower back cross Quads and additional exercises 3 days per week with 30 minutes stimulation each session. Additional exercises will include ,lower limb joint mobilizations (including hips, knees, ankles and feet) stretching of lower extremity, and ROMS. Main outcome variables: Pelvic tilt, Functional gait analysis, modified Ashworth scale, ranges of motion and cadence

current study was multi-centered study that included centers of Faisalabad, Punjab, Pakistan. Allied

Study aim: Evaluate the effects of muscle energy technique and strain counterstrain on pain, cadance, stride length, ankle dorsiflexion and planterflexion of fast bowlers with gastrocemius trigger points. Design: Randomized clinical trial, Non-probability simple random sampling technique was used in this study. Settings and conduct: Saeed Ajmal International Cricket Academy Borannwalla Ground Jinnah Bagh Faisalabad Jawad Sports and Cultural Complex Participants/Inclusion and exclusion criteria: Inclusion Criteria • Fast bowlers willing to participate in the age group of 20-30 years • Fast bowlers having at least one hypersensitive tender nodule within a palpable taut band in the gastrocnemius muscle • Fast bowlers having ankle dorsiflexion range of motion less than 20 degrees • Pain intensity of more than 4 on numeric pain rating scale • Subjects running for 3 days per week for more than 6-months will be recruited Exclusion Criteria • Participants having Fibromyalgia syndrome • Congenital deformity of the foot and ankle • Tumors of the lower back and lower limb • Lower limb fractures • Diabetic neuropathy • Peripheral vascular disease • 3-month recent injuries to legs, foot or ankle will be excluded from the study Intervention groups: Patients were divided into two group i.e., group A (muscle energy technique group) and group B (strain counterstrain group). Main outcome variables: Pain Cadence Stride length Ankle dorsiflexion/plantarflexion Sprinting

randomized clinical trial was conducted at a school sports complex in Gujranwala, Pakistan (June–September

Study aim: The study aims to find out the effects of Voodoo floss band with Proprioception neuromuscular facilitation(Hold-Relax) stretching in improving Hamstring Flexibility and pain reduction in low back and lumbar flexion ROM in patients with Non-specific Chronic low back pain. Design: Quasi-Experimental study Settings and conduct: Clinics and Hospitals will be the settings and the research will be conducted as follows : a screening performas will be distributed to those who are willing to participate those who fulfill the screening and inclusion exclusion criteria will be selected and then will be evaluated using ODI questionnaire, by checking SLR ,By measuring MMST and then pain on NPRS. Participants/Inclusion and exclusion criteria: Inclusion Criteria: age 18-45 years, Both Genders, Persons who sit for more than 3 hours, During SLR having pain at >70 degrees, Patients with Past three months of NSCLBP Exclusion Criteria: Malignancy, Pregnancy, Disc Herniation, Fracture, Surgery in past 6 months Intervention groups: After the evaluation and recruitment of participants , the participants will be equally distributed to two groups. Two Groups , Group 1 :PNF (Hold-Relax) stretching with Voodoo Floss band, Group 2:PNF (Hold-Relax) stretching. Both groups will have equal participants with base line treatment using TENS and Ultrasound on low back and the voodoo floss band will then be wrapped around thigh and the PNF technique will be performed in Three sessions per week for four weeks and the recordings will be taken at baseline week(2) and then at week(4) in clinic and hospital settings Main outcome variables: SLR(Straight leg Raise test), NPRS(Numeric Pain Rating Scale), ODI(Oswestry Disability Index), MMST(Modified-Modified Schober's Test)

Study aim: study aims to compare the effects of routine physical therapy with and without kinesiotaping for treatment of patients with dequervains tenosynovtis. Design: single blinded , randomized controlled trial Settings and conduct: District headquarter hospital Jhang, Punjab, Pakistan. Participants

Study aim: The aim of study is to compare the effects of scapulothoracic joint mobilization and acromioclavicular joint mobilization on pain among adhesive capsulitis patients. Design: Quasi-Experimental research design, where participants with unilateral adhesive capsulitis was divided into 2 groups and both groups received the group wise interventions. Non-probability Purposive Sampling was used to recruit participants for study which was allocated to groups using computer generated number by random allocation. Settings and conduct: This study will be conducted at physiotherapy departments of Allied Hospital and DHQ Hospital Faisalabad Participants/Inclusion and exclusion criteria: Inclusion criteria: Male and female participants of age between 40-60 years old; Participants having idiopathic Adhesive capsulitis (phase I & II); Participants with a complain of pain score of minimum 3 or more on NPRS and minimum 30 percent disability scores on SPADI questionnaire. Exclusion criteria: Patients suffering with shoulder pain from a severe trauma; Participants with rotator cuff pathologies, calcification tendinitis; Participants with history of osteoarthritis.Any inflammatory or infective diseases, skin disorders, Patients having cardiac issues. Intervention groups: Intervention group 1; Acromioclavicular joint mobilization was performed three times per week for four weeks, for a total of 12 sessions. Acromioclavicular joint mobilization and baseline treatment was take 40 minutes in total Intervention group 2; Scapulothoracic mobilization was performed three times per week for four weeks, for a total of 12 sessions. Scapulothoracic mobilization and baseline treatment was take 40 minutes in total. Main outcome variables: Range Of Motion (ROM); Shoulder Pain

Study aim: To determine the effectiveness of gaze stability with and without vestibular rehabilitation on gait, balance, and kinesiophobia in elderly people. Design: A concealed, randomized, single-blinded, controlled trialS with a group design of 96 participants. Settings and conduct: In Sofia old age home Multan and Nova old age home Multan study will be conducted. Group-A will be treated with gaze stability exercises and Group B will be treated with gaze stability with vestibular rehabilitation exercises. The data analyzer will be kept blind. Participants/Inclusion and exclusion criteria: In inclusion criteria both gender aged 50-79 years with at least 50% of Activities-specific Balance Confidence Scale score included. In exclusion criteria were people with serious mobility issues, people with the neoplastic disorder, and coronary artery disease patients. Intervention groups: Group A received gaze stability exercises and group B received gaze stability with vestibular rehabilitation exercises. Main outcome variables: Tampa scale for kinesiophobia (TSK) Time up and go test for balance (TUG) Dynamic gait index for gait (DGI)

Study aim: To compare the effects of rib cage mobilization and diaphragmatic breathing on lung function in patients with COPD. Design: Randomize clinical trial, not blind trial, 2 group. Settings and conduct: Idrees teaching hospital Sialkot Cantt, Allama Iqbal memorial hospital Sialkot, Chest and gynae hospital Sialkot. The study was conducted within 6 months after the approval of synopsis. Participants/Inclusion and exclusion criteria: Inclusion criteria: •Age 40 to 70 years, at least history of chronic obstructive pulmonary disease from 1 year •Altered dyspnea index •Decrease FEV1/FVC •chronic obstructive pulmonary disease Grade II and III Exclusion criteria: •Acute exacerbation of chronic obstructive pulmonary disease •Grade IV chronic obstructive pulmonary disease patients. •Patients with comorbidities •Patient in any life-threatening condition. Intervention groups: Group A: Rib cage mobilization, postural drainage, breathing exercises(expiratory) Group B: diaphragmatic breathing, postural drainage, breathing exercises(expiratory) Pre interventional readings will be taken at baseline & post interventional readings at 6 weeks Main outcome variables: level of dyspnea(Dyspnea index) and FEV1/FVC ratio (Spirometer)

Study aim: To determine the comparative effectiveness of cervical translatoric mobilizations with cervical stability training on pain and mobility in female patients with cervicogenic headache. Design: Randomized controlled trial Settings and conduct: SETTING: Orthopedic Department, Mayo Hospital, Lahore. Neurology Department, Mayo Hospital, Lahore. Physiotherapy Department, Mayo Hospital, Lahore. DURATION OF STUDY: Six months after the approval of synopsis Participants/Inclusion and exclusion criteria: Inclusion Criteria: Female patients aged 20-40 years Diagnosis of cervicogenic headache Positive cervical flexion-rotation test (FRT) Exclusion Criteria: Patients previously receiving treatment for underlying pathology. Patients presented with red flag signs for headache. Patients presented with migraine. Patients in whom manual therapy is contraindicated. Patients who are diagnosed with radiculopathy. Patients who are taking analgesics. Intervention groups: GROUP-A: Cervical Translatoric Mobilization This group will receive a 10-minute treatment consisting of 30-second series of translatoric mobilizations of the upper cervical spine with 10-second rest periods between sets. GROUP-B: Cervical Stability Training The Cervical Stability Training consists of three application phases. The first phase will improve muscular coordination and proprioception. The second phase will improve muscular endurance and strength. The final phase will improve muscular strength as well. The intensity of exercise in the third phase will be slightly higher than in the second phase. Based on the exercise tolerance of the patients, all exercises will be repeated 7–10 times during the first week and 10–15 times during the second week of each phase. Main outcome variables: Pain reduction Increasing range of motion Reduced disability

randomly. 1. Pakistan Sports Board and coaching center. 2. K21 Sports Academy, Model town. Participants

performed in the institute of physical medicine and rehabilitation Khyber Medical University Pakistan after