Study aim: The objective of this study was to assess the synergistic effects of curcumin with and without strengthening exercises in rheumatoid arthritis patients. Design: Pragmatic,community bases,parallel group,Double blinded,Randomised control trial. There were 100 patients were enrolled.Study was done form June-december 2021.Out of 100 patients 90 were selected. Settings and conduct: Study was conducted at Muhammad Institute of Medical and Allied Sciences Multan after approval from institutional ethical comittee. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients of all ages, diagnosed RA, of both gender, and patients with swelling in joints and pain. Exclusion criteria: Patients with vascular neoplasia, fibromyalgia, radiculopathy, neuropathy, tumor, joint fractures, and vestibular problems were excluded. Intervention groups: Treatment group A was treated with Curcumin and strengthening exercises, and control group B was treated with Curcumin only. Dosage of 180 mg/day of Curcumin The strengthening exercises given to group A were upper extremity resistive exercises, resistive hand training with the medicine ball, elbow, and shoulder resistive training by dumbbells. Lower extremity resistive exercises i-e resistive knee training by pressing soft rollers and ankle weights—upper extremity theraband strengthening exercises and lower extremity theraband strengthening exercises. Main outcome variables: By using WOMAC and NPRS,pain,stiffness and physical activities were measured.And at the end patient dependency and range of motion were also assessed.By using WOMAC and NPRS scale,pain stiffness and ADLs were the variables to be assessed. Morover,Xray finding were also done for the assessment.

Study aim: Muscle energy technique is an emerging type of manual therapy. It is not common in clinical setups. Nowadays, clients and patients want results of a treatment on the spot. So, the scholar want to find out immediate effects of MET on cervical pain and range of motion Design: This study will have 2 groups. A will be experimental group and B control . Sample size: 50 Randomization: will be done using lottery method Center: Single center Settings and conduct: (Hayatabad medical complex, MTI, Peshawar) Participants/Inclusion and exclusion criteria: Inclusion criteria: Male and female, Age 18-50 years, Subjects having neck pain from previous 3 or more than 3 months Exclusion criteria: Cervical radiculopathy or disc prolapse, trauma, bone fractures, joint dislocation or cervical instability, dermatitis, abnormal sensations, active bleeding and open wounds, History of the neck surgery in the past 12 months, Diagnosed cases of serious pathologies like infection, inflammation or malignancy Intervention groups: Experimental Group (Group A): This group will be same as control group (as in having conventional physical therapy) but with addition of the intervention which will be muscle energy techniques (MET). Therapist will give resistance to produce isometric contraction in the muscles just short of the barrier. The patient strength of muscle contraction will be less than the therapist counter force of resistance. Therapist will hold the position for 7-10 seconds. Then a 30 seconds stretch will be given and the process will be repeated three times. Control Group (Group B): This group will comprise of conventional therapy for the participants. Conventional therapy will include heating pad for 15-20 minutes and soft tissue release for 5 minutes. Main outcome variables: Outcome will be measured on the basis of means of NPRS score and neck ROMs.

Pakistan. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA 1. Age 20-40 years Male. 2

Study aim: To determine the comparative effects of high and low intensity resistance training on balance and fatigue perception in patients with Parkinson's disease. Design: Parallel group, single-blind, randomized controlled trial on 44 individuals Settings and conduct: A study was conducted in Physiotherapy Department at District Headquarter Hospital (DHQ) Sheikhupura. A single blinded study and participants were blinded through chit method. Participants/Inclusion and exclusion criteria: Inclusion criteria: both male and female; 50-65 years old people; Parkinson's disease. Exclusion criteria: cognitive impairments; diagnosed by any other neurological conditions. Intervention groups: Patients allocated to Group A performed a low-intensity exercise program that included breathing, stretching, and relaxation in a sitting position twice a week for 12 consecutive weeks. In contrast, Participants located in Group B went through high-intensity exercises with Thera-bands twice a week for 12 consecutive weeks with individualized progression. Each session ended up in 60 min. The standard training program included a 5-10 min warm-up session, core activities, and a 5-min cool-down. Outcomes were measured by two scales, Mini-Bestest and Revised Piper Fatigue Scale. Main outcome variables: Dynamic balance (sensory orientation; dynamic gate; postural instability; anticipatory transitions); Fatigue perception (behavioral/severity; affective meaning; sensory; cognitive/mood).

Study aim: Literature has reported beneficial effects of prone positioning but in our region the use of this positioning is dependent on patients’ will. Currently to the investigator’s knowledge, no such trial has been documented comparing prone positioning and prone positioning combined with ACBTs, studies only showed that prone positioning is feasible and effective for COVID-19 patients. so the aim of this study is to determine the effectiveness of prone positioning combined with ACBT techniques in non-intubated COVID-19 patients at HAYATABAD MEDICAL COMPLEX, PESHAWAR. Design: Randomized controlled trial Settings and conduct: The data will be collected from 97 patients admitted in Hayatabad Medical complex Peshawar. Participants and assessor will be blinded Participants/Inclusion and exclusion criteria: Inclusion Criteria: i. Admitted patients ii. Laboratory confirmed SARS-COV-2 having PCR or pharyngeal swab positive. iii. Both male and female gender. iv. Age ≥18 years. v. Noninvasive ventilation Exclusion Criteria: i. Intubated patients ii. Pregnancy iii. Patient inability to tolerate prone positioning iv. Hemodynamically unstable (SBP<90mmhg) or arrhythmias v. Pressure sores vi. Seizures vii. Recent abdominal surgery1) Intervention groups: This control group will comprise of prone positioning for 1 hour session, five sessions per day each spaced 2 hours for 1 week. The interventional group will be same as control group but with addition of ACBT technique. The technique comprises breathing Control in which patient will breathe in and out gently through nose then deep Breath through nose hold for 2-3 sec before breath out 3-5 times then huffing or Forced Expiratory Technique to remove secretions for 15-20 minutes for 1 week Main outcome variables: 1. heart rate 2. respiratory rate 3 blood pressure 4 oxygen saturation

Study aim: To find out Effects of Inspiratory Muscles training in improving Dyspnea and quality of life in moderate COPD patients during Pulmonary Rehabilitation. Design: Two parallel group , single blinded, randomized control trial with pre and post assessment Settings and conduct: Pulmonology Ward/Intensive Care unit Nishtar Medical University and Hospital Multan Participants/Inclusion and exclusion criteria: Inclusion criteria, •Moderate cases of COPD as per Gold Criteria •Moderate cases FEV1 =50–79 •Participants routinely visiting the OPD •Participants with significant history of smoking •Well controlled DM or HTN, if they have •Age 20 to 40 years. Exclusion criteria, •Pregnancy • History Of Recent Trauma/Fall Or Fracture •Red Flags Like: Fever, Night Sweats, Malaise Etc. • Patients Having History Of Pneumonectomy • Lobectomy In Previous 6 Months • Risk Of Pneumothorax/Presence Of Bulla • Rib Fracture • Acute Exacerbation Of COPD • Having History Of Drug Abuse • Unstable Cardiovascular Diseases • Unstable Orthopedic Problems Intervention groups: Standardized pulmonary rehabilitation program along with Inspiratory muscle training Main outcome variables: Multidimensional Dyspnoea Profile (MDP) •Assessment of quality of life using the SGRQ (Saint George Respiratory Questionnaire) • Pulmonary function changes by Inspiratory capacity at rest and inspiratory capacity at the end of the 6MWT using a portable spirometer.

Study aim: the aim of study is to compare the effects of mobilization and manipulation on pain and functional disability in female patients with Sacroiliac joint dysfunction and to check whether or not one technique is more effective than other. Design: two arm parallel group randomized trial with blinded outcome assessment Settings and conduct: study will be conducted in Islam central hospital Sialkot. it will be double blinded study as the care giver and assessor will be unaware of treatment given Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: (1)Females from age 25 to 50 (2)Patients with confirmed clinical diagnosis of sacroiliac joint dysfunction (3)Patients presenting with acute pain from last four weeks in low back or Sacroiliac joint of iliac origin (4)Patients with the complain of hypomobility of sacroiliac joint. EXCLUSION CRITERIA: (1)Patients with vertebral bone pathology,radiculopathy,sciatica, recent fracture (2)Patients with history of recent surgery in lumbosacral or pelvic area (3)Pregnant women, or those who had recent infection (4)Females with history of osteoporosis or cancer Intervention groups: experimental group 1 will receive mobilization along with routine physical therapy experiental group 2 will receive manipulation along with routine physical therapy Main outcome variables: Pain Functional Disability

Study aim: To evaluate the effects of cervical manipulation on posture related cervicogenic headache. Design: single blind, parallel assigned, multi-centered, randomized clinical trials will be conducted on 36 participants (two groups with 18 participants each) with history of posture related cervicogenic headache. Settings and conduct: DHQ Gujranwala / Med care international hospital Gujranwala participant kept anonymous for conducting the single blind trial. Participants/Inclusion and exclusion criteria: Male and female participants of age 20 to 40 years with primary complaint of headache. Frequency of at least once a week from minimum of last 3 months and Minimum Neck Disability Index (NDI) disability score of 20 % or greater. joint tenderness exhibited in at least one of the three upper cervical joints (C0-C3) on assessing through manual palpation, non-throbbing and non-lancinating pain of moderate to severe intensity were included into the study. Excluded Having any other primary headaches e.g. migraine or tension headaches, presence of contraindications to cervical spinal manipulation, metabolic diseases, infection, dislocation, osteoporosis, anticoagulant user, chronic corticosteroid user, previous 3 months history of head or neck surgery, previous history of a whiplash injury within six weeks, bilateral headaches, cervical spine stenosis bilateral upper limb symptoms, exhibiting “5 D’s” & “3 N’s” signs and positive and cervical instability tests were excluded from the study. Patient using analgesic drugs. Intervention groups: Group A:The baseline treatment will be 20 minutes of hot pack application and neck isometrics with additional treatment of cervical manipulation. Group B: only received baseline treatment 20 minutes of hot pack + neck isometrics will be performed. Main outcome variables: cervicogenic headache ( pain) Functional disability Quality of life

Study aim: To evaluate the comparative effectiveness of ischemic compression and muscle energy technique on chronic shoulder pain and range of motion. Design: Single blind,Parallel assigned,multicentred, randomized clinical trial on 34 participants (With 17 participants in each) with the history of rotator cuff as assessed by pain and limited range of motion and randomization is being accomplished using simple random sampling by lottery method. Settings and conduct: District head quatar hospital faisalabad. Nustrat Abdul Rauf centre for enablement. Participants/Inclusion and exclusion criteria: Both gender with age 25 to 45 years with shoulder pain from at least 3 months,pain and Jump sign which is distinguished by patient expression,at least 3 to 7 no. of pain on visual analogue scale,unilateral or bilateral pain, subjects must be able to raise the arm above head, MRI, showing any rotator cuff tear.patient test positive for Hawkins-Kennedy test and Empty can test, no radiographic signs of bone fracture were included. Subjects having a history of past surgery , trauma history , injection, having open wounds, skin or vascular disease and sensory disturbance on shoulder,patient taking any medication from 1 month, Patient having any radiculopathy or myelopathy and fibromyalgia, infection, bursitis, capsulitis, rheumatoid arthritis, tumor, or any systemic illness of shoulder and pregnancy were excluded. Intervention groups: Group A:The subjects will recieve Ultrsaonic at baseline and Muscle energy technique on bicep,supraspinatus,deltoid and infraspinatus. Group B:The subjects will recieve Ultrsaonic at baseline and Ischemic compression on bicep,supraspinatus,deltoid and infraspinatus. Main outcome variables: Pain Range of motion Shoulder pain and disability index

Study aim: To find out the effect of median and ulnar nerve neurodynamics to improve motor hand function in carpal tunnel syndrome patients Design: Single blinded, parallel assigned, multi center, randomized clinical trial that will be conducted on 30 participants with diagnosed carpal tunnel syndrome. purposive sampling technique will be used and randomization would be done by sealed and identical slips of paper which will contain their group numbers. Settings and conduct: Allied hospital and district head quarter hospital Faisalabad. Participants will be kept anonymous for conducting single blinded trial. Participants/Inclusion and exclusion criteria: 30 to 50 years age both male and female patients, Work related and unilaterally diagnosed carpal tunnel syndrome, Mild (only sensory symptoms pain, paresthesias and numbness) and moderate carpal tunnel syndrome (motor weakness and symptoms) symptoms from less than one year, Without any conseravtive treatment before, Willing to participate will be included. Participants with pain due to severe carpal tunnel syndrome , Trauma to affected hand from last 12 months, Cervical radiculopathy, Brachial plexopathy, Previously use of any steroid injection, Current pregnancy ,Thorasic outlet syndrome, Inflammatory joint diseases, Rheumatoid arthritis and osteoarthritis, Central nervous system disorder, Guyon tunnel syndrome, Neoplasm, Language and cognitive disorder patients, Drug abusers will be excluded. Intervention groups: Active control group A: Participants will first receive common treatment (ultrasound and tendon gliding exercises) then median nerve neurodynamics. Intervention group B: participants will receive common treatment then median nerve neurodynamics and ulnar nerve neurodynamics. Main outcome variables: Boston carpal tunnel questionnaire: symptoms severity and functional status scale and quick disabilities of arm shoulder and hand questionnaire

slow learners institutes of Dera Ghazi khan division Multan, Pakistan, and each session would be of

Study aim: study aim was how tension type headache was improved by METS and myofascial release Design: A single blinded randomized control trial with sample size of 48 patients Settings and conduct: setting of study was in Rehabilitation and Injury Management Department of Medcare International Hospital Gujranwala Participants/Inclusion and exclusion criteria: Patients of both gender of age 18-40 years with diagnosis of tension type headache and chronic tension type headache were included. Other inclusion criteria regarding tension type headache were at least 10 episodes occurring on ≥1 day per month for at least 3 months. Headache episodes lasting from 30 minutes to 7 days Intervention groups: Muscle energy technique along with myofascial release technique on upper trapezius and sternocleidomastoid was applied on patients of experimental group . Only myofascial release technique was used on upper trapezius and sternocleidomastoid muscle to control group Main outcome variables: Outcome variables of pain, range of motion and functional level of patients

Study aim: To determine the effects of spinal segmental exercises versus conventional treatment to improve trunk stability in sub acute stroke. Design: RCT Settings and conduct: Trial conduct in private clinics, Laraib physiotherapy clinic and perfect physio care clinic D.G.Khan. It was a single blind study in which participants are blind Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: a) Patients within 1 year after onset of stroke. b) Age 35 to 60 years. c) Patients with positive sharpened Romberg test (static balance). d) Patients with Modified Functional reach test (Dynamic balance) specific for sub acute. EXCLUSION CRITERIA a) Patients of pusher syndrome (defined as inclination to the hemi paretic side and giving resistance to any attempt at passive correction). b) Any incurable illness. c) Pain, limitation in the non-paretic lower extremity or restricted motion. d) Patient with cognitive disorders. Intervention groups: INTERVENTIONAL PROTOCOL Group A: In conventional group total 11 patients was recruited by giving conventional therapy for the period of 12 week, consisting of 1 hour of treatment per day, 3 times a week for 12 weeks. Conventional exercises include Exercise 1: supine lying – Leg lifts. Exercise 2: Abdominal crunches in crook lying position. Exercise 3.Back Isometrics. Main outcome variables: Two outcome measuring tools was used TIS (Trunk impairment scale) and Posture Zone mobile app.

Study aim: To compare the effectiveness static stretch technique and bent leg raise technique to increase the flexibility of hamstrings. Design: It was an experimental Randomized Clinical Trial, pretest/post-test study. Settings and conduct: study was conducted at Syed Medical Complex, Sialkot Pakistan

Study aim: To compare the effects of Lumbar Sustained Natural Appophyseal Glide and Muscle energy techniques on pain, Range of Motion and function in chronic nonspecific low back pain. Design: Two parallel group , double blinded, randomized clinical trial with pre and post assessment Settings and conduct: Riphah Rehab clinic. Participants and outcome Assessor blind: Data safety will be ensured by assigning Specific Identity numbers and all consent, readings forms will be placed in locker to blind assessors Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: 1. Subject between the ages 25 to 60. 2. Both male and female patients with low back pain. 3. Subject with history of 3 months continues or intermittent symptoms of low back pain. 4. The flexion of trunk at least 40-degree ROM. EXCLUSION CRITERIA: 1. Patient with history of pathology of spine (spine tumors,spinal infections, spondylosis, neurological deficit, pregnant women). 2. Patient pain will radiate down to the knee. 3. History of spinal surgery. Intervention groups: Intervention group A: lumber sustained natural appophyseal glide and conventional treatment. Intervention group B:Muscle Energy Technique (METs) of Quadratus Lumborum and conventional treatment. Main outcome variables: Numeric Pain Rating scale (NPRS),Modified Oswestry disability index (MODI),Lumber inclinometer

Centre, Lahore Pakistan Participants/Inclusion and exclusion criteria: Inclusion Criteria:  Patients

Department of Multan Institute of Kidney Diseases, Multan, Pakistan. Study was completed in 6 months. Sample

Study aim: To compare the effects of Same Arm Movement Therapy (SAME) Vs Constraint Induced Movement Therapy (CIMT) to improve upper-limb function in chronic Stroke. Design: Randomized clinical trial. Settings and conduct: Riphah Rehabilitation Center, Spine & Physiotherapy Rehab Centre Participants/Inclusion and exclusion criteria: Inclusion Criteria: Confirmed infract or Hemorrhage by a neurologist using either MRI or CT scan. Age between 30-65. History of stroke 1–6 months prior to participation in the project. Patients who provided consents to participate in the study. Proper balance and safety while wearing the restraint Exclusion Criteria: Patients were not considered for participation in the trial if: They were discharged from hospital within 1 week. Patients with implants such as Neuro stimulator containing electric circurity and implants generating electric sign. Patients with anxiety and claustrophobia with diagnosed psychological disorder. Patients undergoing chemotherapy. Alcohol dependency or evidence of substance abuse. Patients without any visual-perceptual problems. Patients without any communication barriers/language issue. Patients with no significant cognitive impairments Intervention groups: Group A: SAME Therapy treatment protocol consists of 8 weeks of mental rehearsal of upper limb movements during 45-min supervised sessions three times a week and structured independent sessions twice a week. Group B: CIMT treatment protocol consists of 8 weeks of daily intensive training of the affected extremity for 2 hours per day, 5 days per week, and 8 weeks in association with restriction of the non-affected extremity for 10 hours a day. Main outcome variables: Wolf motor function test, Action Research Arm test

Study aim: To Find The Effects Of Shoulder Joint Mobilization With Movement With And Without Scapular Mobilization On Pain,Range Of Motion And Function In Adhesive Capsulitis. Design: Two parallel groups ,Double blinded ,Randomized Controlled Trial. Settings and conduct: DHQ TEACHING HOSPITAL SARGODHA, Outcome assessor and participant will be blinded. Participants/Inclusion and exclusion criteria: Inclusion criteria: • Age 40-65 yrs with complaint of shoulder pain for last 3 months. • both genders. • NPRS score ≤ 6 screened written informed consent. • Diabetes and hypertension. • unilateral shoulder must have not move more then 90 degrees of abduction and 50% decreased external rotation as compared to normal side/normal ROMS values. Exclusion criteria: • Inflammatory Pathologies such as Rotator cuff tendinitis,rheumatoid arthritis. • Trauma. • Shoulder Surgeries,Malignancy . • Neurological disorders of upper extremity • Cervical or thoracic problem having cervical rib. • Intra articular injection in glenohumeral joint during last 03 months. Intervention groups: Intervention Group A:Shoulder Joint Mobilization With Movement. Intervention Group B:Shoulder Joint Mobilization With Movement With Scapular Mobilization. Main outcome variables: Pain intensity will be measured by NPRS. ROM of shoulder measured by universal Goniometer. Functional Disability by Shoulder Pain And Disability Index (SPADI).

Study aim: To determine the effects of mobilization with movement and Maitland grade III mobilization on pain and physical function in plantar fasciitis. Design: Randomised, superiority, parallel group trial with blinded outcome assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site Settings and conduct: This study will be conducted at Riphah Rehab Clinic.The treatment will be given for a total of 4 weeks.2 sessions given in each week. The outcome measure will be measured at baseline and after 4 weeks.Outcome assessor will be blinded. After taking informed written consent. Allot a distinct identification number and placed all written consent forms in locker to blind assessor. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: 1. Age: 30-60 years 2. Both male and female patients with chronic plantar fasciitis 3. Tender medial side of the calcaneus on palpation 4. Pain occur on insertion of the plantar fascia by palpation 5. Pain occur in weight-bearing activities 6. Positive results of windlass test 7. Negative results of tarsal tunnel test EXCLUSION CRITERIA: 1. Patient having any arthritis such as rheumatoid arthritis, reactive arthritis 2. Tumor 3. Fracture of tarsals and metatarsals 4. Tarsal tunnel syndrome 5. Any recent surgery of ankle and foot Intervention groups: Intervention of group A=Mobilization with movement, Gastrocnemius stretching, Stretching of Plantar fascia, Ultrasound Therapy. Intervention of group B=Maitland grade III mobilization, Gastrocnemius stretching, Stretching of Plantar fascia,Ultrasound Therapy Main outcome variables: Numeric pain rating scale, Foot and ankle ability measure

Study aim: To compare the effectiveness of mirror therapy and motor relearning program in stroke. This study will compare the effects of both techniques on the motor function after stroke. The document which states that mirror therapy has therapeutic effect is. Jan, Shafqatullah, et al. "A randomized control trial comparing the effects of motor relearning program and mirror therapy for improving upper limb motor functions in stroke patients." JPMA 69.1242 (2019). Design: Randomised control trial with blinded outcome assessment.Randomisation was computerised with concealed allocation sequence carried out at an external site. Settings and conduct: The study will be conducted in the Sheikh Zayed Hospital and Al Noor Hospital of Rahim Yar Khan city.The outcome assessor will be blind. Participants/Inclusion and exclusion criteria: Inclusion Criteria Age between 40 to 65 years, both ischemic and hemorrhagic stroke, both male and female will be included, Must have intact/unaffected extremity Exclusion Criteria Patients who are not medically stable, Patients who have dementia, Other musculoskeletal, vascular related conditions, impaired cognitive functions, Rare cardiac diseases, Progressive Neurological disorder, Orthopedic disorder involving any joint of limbs Intervention groups: Group A.Motor relearning program(Experimental Group) Group B.Mirror therapy(Control Group) Main outcome variables: Motor function of upper and lower limb (Fugl meyer assessment scale)

Study aim: To compare the effects of breathing reeducation on clinical outcomes in non specific chronic neck pain. Design: A Randomised controlled trial,Double blinded,sample size of 80 patients single centre Settings and conduct: Trial will be conducted at district Headquarter Hospital Faisalabad,patient and therapist are blinded by sealed envelop method Participants/Inclusion and exclusion criteria: Inclusion criteria • Patients having non specific neck pain for more than 3 months • Patients having no history of respiratory disease • Patients having FEV1/FVC ratio=0.7 or 70% of the predicted • Age between 25-50 years Exclusion criteria • Smokers • Patients with upper cervical signs and symptoms • Prolong sitting Intervention groups: Intervention group will receive supervised breathing exercises focusing on proper inhalation, exhalation and chest expansion for 15 minutes in addition to routine physical therapy treatment. Patients will undergo the intervention twice a week for consecutive 8 weeks. Main outcome variables: Pain, ROM,Disability, Strength of neck muscles, Endurance, Quality of life, Vital capacity FET values

Study aim: To compare the effects of walking exercises and swiss ball exercises along-with walking exercises in reducing pain and improving lumbar extensors endurance and physical activity in non-specific low back pain among sedentary women. Design: Randomized Controlled trial, parallel group with participants and outcome assessors double blinded. A list was generated using computer generated table and concealment of allocation was made using sealed envelopes Settings and conduct: Gujrat Hospital Gujrat, participants and outcome assessors are blinded Participants/Inclusion and exclusion criteria: Inclusion criteria: 1. Age 18 to 40 years old; 2. Females with sedentary lifestyle or occupations; 3. Pain duration more than 6 weeks; 4. Not taken any previous exercise session for lumbar pain within last two months Exclusion criteria: 1. Presence of spinal deformity (scoliosis with cobb’s angle exceeding 10*); 2. History of recent lumbar or abdominal surgery; 3. Presence of systemic or inflammatory disease; 4. Severe knee or hip arthritis as it will affect walking; 5. Prolapsed intervertebral disc; 6. Fracture, tumors, ankylosing spondylitis Intervention groups: Group A: Perform fast walking on flat ground for 30 minutes with abdominal bracing. Group B: Perform fast walking on flat ground for 30 minutes with abdominal bracing alongwith swiss ball exercises ( swiss ball straight arm crunch, alternate arm and leg extension, wall squat, shoulder bridge, back extension, hamstring curl and leg raises) Main outcome variables: Pain and endurance of lumbar extensors using NPRS and Trunk extensors endurance test are primary outcomes. Secondary outcome is function measured by Modified Oswestry Disability Index.

Study aim: To compare the effect of cervical mobilization and thoracic manipulation on pain and function in myofascial temporomandibular joint dysfunction patients Design: Randomized Clinical trial. (RCT) Settings and conduct: • Life Line Hospital Lahore. • Fatima Memorial Hospital Shadman Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria: 1 Myofascial pain in region of TMJ. 2. Reduced mouth opening measured by using 3fingers and 2 knuckles. 3. Age group in range of 20-40 years. 4. Females only. 5. Presence of any taut band and trigger point in surrounding area. 6. Reproduction of referred pain pattern of trigger point in response to palpation. 6.8 Exclusion criteria: 1. Degenerative TMJ arthritis 2. Malignant tumor of face and jaw. 3. History of fracture and dislocation of TMJ. 4. History of previous surgery of jaw or TMJ. 5. Neurological disorders includes stroke, bell’s palsy and spinal cord injury 6. Hypermobile TMJ. 7. Osteoporotic patient Intervention groups: Group A : Cervical Mobilization Group B : Thoracic Manipulation Main outcome variables: 1. Pain 2. Function

Study aim: To identify the effects of sustained natural Apophyseal gilde versus Cervical Manipulation in treatment of Mechanical neck pain Design: Randomized Clinical Trial,50 subjects (25 in each group) will be randomly allocated,single blinded study Settings and conduct: study conducted at KKT Orthopedic Spine Center and Royal Institute of Medical Sciences,Multan ,Sample size will be 50 individuals (25 each group) conducted in time duration of 6 months.group 1 patients got sustained natural Apophyseal glide and group 2 got cervical manipulation. Participants/Inclusion and exclusion criteria: inclusion criteria-1.- 50 patients both males and females with mechanical neck pain aged between 22 to 65 will be included.2-• hypo-mobility of the cervical range of motion.3-• Non -discogenic neck pain, stiffness, muscle tension, headache and migraine. exclusion criteria-1-• Any contraindication to systemic manifestation (e.g. inflammation, infection, advanced degeneration, congenital malformation, trauma, cerebrovascular abnormalities).2-• Positive neurological examination e.g. presence of positive motor reflex, or sensory abnormalities indicating spinal root compression.3-• cervical spine surgery or stenosis ,metabolic or systemic disorders or cancer.-. Intervention groups: Group A Subjects will be treated with Sustained Natural Apophyseal Glide (SNAG) which included two sessions per week. Patients in this group will receive a baseline treatment that is heating pad for 15 minutes before the treatment. Procedure will be repeat in sets of 5 to 10. Group B Subjects will be treated with Cervical Manipulation after baseline treatment that is heating pad for 15 minutes which included two sessions per week. Main outcome variables: pain,disability and cervical range of motion