Study aim: To compare effects of virtual reality and routine physical therapy on balance and postural control in adulthood population having risk of fall Design: Randomized clinical Trial. single-blinded, 64 samples, parallel groups, randomized by computer-generated method and further concealed envelop method used for allocation in the group. In the envelope, 1 will be code for the control group and 2 will be code for the experimental group. Settings and conduct: The study will be conducted at the Department of Physiotherapy Al-Noor Hospital Pasrur, Sialkot with the approval of UIPT UOL. The study will be single-blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Age 40-65 years. • Both gender • Capable of walking with and without any assistance • Having normal and corrected visual and auditory acuity • Having Berg Balance Scale Score from 21-40. • Can understand instructions. • Individuals with disease, diabetes mellitus, knee osteoarthritis grade 1 on Kellgren and Lawrence scale will also be included. Exclusion Criteria: • Any comorbidity. • A history of other neurological, cardiovascular, or orthopedic diseases affecting postural stability • All patients having a pacemaker or a history of serious cardiac event or of cardiorespiratory dysfunction • Severe cognitive impairment or aphasia leading to difficulty in communication Intervention groups: INTERVENTION GROUP (Virtual Reality Exercise) The intervention group will be receiving simulated balance exercises in the form of 30–60-min sessions on a weekly basis (5 days) for 6 weeks. For simulated balance exercises, Xbox Kinect will be applied, which is a game console simulating balance exercise in the game environment and allows a person to move freely and have diverse positions. Main outcome variables: Balance and Postural control.

Study aim: This study aims to find out synergistic effect Berberis aristata and metformin in lowering blood glucose level in diabetic patients.Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels Design: Lottery method, community bases,parallel group, double blinded, randomized control trial. Settings and conduct: Study will be conducted at Muhammad Institute of Medical and Allied Sciences Multan after approval from Institutional ethical committee. Participants/Inclusion and exclusion criteria: Inclusion criteria: Age group of 25-70 years Both Genders (Male, Female) Hypertensive patients Married and unmarried Educated and uneducated Diabetic patients Exclusion criteria: Any type of mental disability Lactating females Having any type of physical disability History of chest pain, bronchitis, asthma, angina, MI Chronic illness related to cardiorespiratory ailments Any type of major surgery• Pregnant females Intervention groups: Patients will be recruited by using the lottery method into three groups. Informed consent will be taken from patient. Group A will be treated with Berberis aristata (550 mg twice a day) orally. Group B will be given metformin orally (500 mg). Group C will be given both Berberis aristata and metformin (550/250 mg once). The treatment regimen will be 6 weeks. Blood glucose, blood pressure, blood cholesterol, respiration rate, heart rate, ketone bodies, HbA1c, DDS score and oxygen saturation of all the patients with diabetes type-2 at baseline and after 6 weeks. Main outcome variables: Cardiometabolic and cardiorespiratory parameters including Blood glucose, blood pressure, blood cholesterol, respiration rate, heart rate, ketone bodies, HbA1c, DDS score and oxygen saturation

Study aim: To find out what is better in reducing neuropathic pain and increasing balance and functional reach between plantar massage and reflexology foot massage among patients with peripheral neuropathy Design: A randomized clinical trial with two parallel intervention groups, a study of phase 3 with 18 people in each group, 36 in total. Settings and conduct: Allied hospital Faisalabad General hospital Samanabad Participants/Inclusion and exclusion criteria: Both genders are between 35 and 60 years old. Diagnosed patients with grade II peripheral neuropathy. Ability to stand on both feet. Can perform the given instructions. There was no cardiac problem. No fracture, injury, or amputation of the lower or upper limb. Any neurological problem. No foot or toe ulcer. There is no peripheral thrombosis. Ambulation difficulties or using any walking devices were excluded. No vision impairment. Intervention groups: Group A: Plantar massage group Group B: Reflexology foot massage group Main outcome variables: Pain Balance Functional reach

Study aim: This study investigates the f Comparative Effects Of Neural Slider Technique And Neural Tensioner Technique On Wrist Pain, Function, And Grip Strength In Pregnant Women With Carpel Tunnel Syndrome Design: Simple Random Sampling technique Settings and conduct: Allied Hospital Faisalabad Madinah Teaching Hospital Participants/Inclusion and exclusion criteria: INCLUSION Age 22-35 years Unilateral CTS females in third trimester of pregnancy Discomfort, tingling, or sensations of paraesthesia in the thumb, the index, the middle, and the radial half of ring finger VAS score (24-hour maximum pain): 4–7 cm at 10 cm VAS scale Positive Tinel’s sign Positive Phalen’s test EXCLUSION Undergone any form of conservative treatment within the last month Prior neurovascular surgery within the last six months pertaining to the same area of the body CTS as a result of a fracture of the upper extremity or trauma to the median nerve Undergone previous surgery for CTS Exhibit severe thenar muscle atrophy Psychosocial problems Intervention groups: Using the inclusion criteria as a guide, patients will be evaluated for symptoms of carpal tunnel syndrome. A diagnosis will then be made after confirmation using phalen's test and tinel sign. Subjects who fulfil the requirements will be asked to sign a consent form. Participants will be randomly assigned to either Group A or Group B once they complete the consent form. In Group A neurodynamic slider technique will be given with tendon gliding exercises, while group B will receive neurodynamic tensioner technique with tendon gliding exercises for 3 weeks. Treatment sessions will be 9 sessions, 3 sessions per week on alternative days. Outcome measures will pain, assessment of functional status and hand grip. Main outcome variables: • Wrist Pain • Functional status • Grip strength

Study aim: The aim of the study is to comprehensively compare the efficacy of breathing exercises and low-intensity circuit training as therapeutic interventions for asthma patients. This will help patients of asthma to become more independent. Design: Pragmatic,community based,parallel group,double blinded, randomised control trial. There will be 357 patients that we will enroll.Study will be done form April-July 2024. Settings and conduct: 1. Azeem Hospital Multan 2. Sughran Wazeer Child Clinic Hospital Multan 3. South Punjab Hospital Multan 4. Muhammad Rehabilitation Clinic (Muhammad Institute of Medical and Allied Sciences Multan) after approval from institutional ethical comittee Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients of 18-40 years, diagnosed asthmatic patients, both genders. Exclusion criteria: Patients with vascular neoplasia, fibromyalgia, radiculopathy, neuropathy, tumor, joint fractures, and vestibular problems, heart problems, not willing to participate, pschycological unfit patients, pregnant/lactating ladies were excluded. Intervention groups: Group-A will be given breathing exercises and group-B will be given low-intensity circuit exercises for 12 weeks. Breathing exercises for group-A includes pursed lip breathing, diaphragmatic breathing and breath holding exercises. For group-B low intensity circuit exercises includes walking, running and abdominal crunches. Main outcome variables: Lung capacity, forced expiratory volume, exercise capacity and quality of life.

Study aim: To find the effects of Dynamic Hug Exercise and Serratus Punch on Chest wall mobility, Dyspnea, Pulmonary function test and Strength of scapulothoracic muscle in COPD patients. Design: Two parallel groups, single-blinded, Randomized Controlled Trial with pre and post-assessment. Settings and conduct: Gulab Devi Hospital Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Stable mild to moderate COPD according to GOLD guidelines, • 40-60 years of age will be included. • Both genders will be included. • Stable hemodynamics (heart rate, blood pressure, temperature) • FEV1≥50 Exclusion Criteria: • Subjects having any kind of Infective pulmonary conditions. • The subjects with acute exacerbation. • Uncontrolled hypertension • Fracture at the clavicle, scapula, humerus, sternum or spine within previous 2 months • Patients with any diagnosed neurological, orthopedic and cardiovascular disease Intervention groups: Group A: it will be treated by pursed lip breathing, upper trapezius stretching. Group B: it will be treated by pursed lip breathing, upper trapezius stretching as well as dynamic hug and serratus punch. Main outcome variables: Dyspnea: Medical Research Council (MRC) Dyspnea Scale Pulmonary function test: Spirometry Cest wall expansion : measuring tape Pectoralis muscles, Lower trapezius and Serratus anterior strength: Handheld dynamometer

Study aim: To compare the combined effects of Retro walking exercises and Clamshell exercises on pain, strength and balance among Osteoarthritic patients. Design: Single blinded, Parallel, Randomized clinical trial Settings and conduct: This study will be conducted at Arif Memorial Teaching Hospital Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients who will above 40 years old and diagnosed with osteoarthritis or have previous knee pain will be included in this study. Exclusion criteria: Patients diagnosed with rheumatoid arthritis, having history of ankle or knee surgery or intra-articular injection in knee joint in past 1 year or having dizziness or balance problems and pregnant women will excluded from this study Intervention groups: There will be two intervention groups. Group A will be treated with clamshell exercise and group B will be treated with retro walking exercises and clamshell exercises Main outcome variables: 1. Numeric Pain Rating Scale will be used for knee pain intensity 2. Berg Balance Scale will be used to check balance while 3. Sit To Stand Test will be used to measure glutei strength

Study aim: To evaluate the effectiveness of the primal reflex release technique on calf tightness Design: Design of the study was randomized clinical trial, sample size was 32, parallel groups, single blind Settings and conduct: Madina teaching Hospital, Faisalabad and The University of Faisalabad Participants/Inclusion and exclusion criteria: Inclusion Criteria: Adult Age 20 to 30 years Both gender (male, female) Prolong standing for more than six hours from more than two months. Reduced ROM (ankle dorsiflexion<15). Tender nodules or tender points in calf muscles on deep palpation. NPRS showing more than 3(3-10). Exclusion Criteria: Lower limb surgery (six months). Medical or surgical complication e.g infection, necrosis, ulcer. Fibromyalgia. Congenital foot and ankle deformity e.g club foot, cleft foot, pes cavus. Lower limb fracture. Deep vein thrombosis both acute and chronic. Diabetic neuropathy. Intervention groups: Two interventional groups numbered as group A and group B in which group A received primal reflex release technique and group B received positional release technique while the baseline treatment was hot pack. Main outcome variables: Pain, ROM, Quality of life

Study aim: To find out the effects of thoracic mobilization with and without sling based thoracic active exercises on pain, function and quality of life in patients with non-specific neck pain. Design: It is a Randomized controlled trial. Sample size is estimated to be 44 i.e: 22 in each group. After adding drop out rate the sample size is 52 i.e: 26 in each group. There are two groups namely group A and group B. Group A will receive sling-based thoracic active exercises with thoracic mobilization and cervical manual therapy for 4 weeks while geoup B will receive thoracic mobilization and cervical manual therapy for 4 weeks. Data will be collected at 3 intervals i.e: 0 week (baseline), 2nd week and 4th week (after completion of treatment) from both groups. Participants will be allocated to the groups randomly by using lottery method to minimize bias. It is a single blinded study, accessor is blinded. Study is conducted at Physiotherapy department of University of Lahore Teaching Hospital Lahore. Settings and conduct: University of Lahore Teaching Hospital Physiotherapy department. It is a single blinded study, assessor will be blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: 20-45 years old, Both males and females are included, diagnosed patients of non-specific neck pain, NDI score equal to or more than 24 Exclusion Criteria: The presence of neurological signs and symptoms, previous surgical history related to spine or neck, Currently undergoing any injection treatment to reduce pain, Neurological issues, Pregnancy, Cardiac disease , Active infection Intervention groups: Group A: sling-based thoracic active exercises with thoracic mobilization and cervical manual therapy Group B: thoracic mobilization and cervical manual therapy Main outcome variables: Pain Function Quality of life

Study aim: The main aim of the study is to compare the effects of phonophoresis with and without diclofenac diethylamine phonophoresis with routine physical therapy in patients who are diagnosed with cervical spondylosis. Design: It will be single blinded study, in which the accessor will be unaware of the treatment group. Settings and conduct: The data will be collected from the University of Lahore Teaching Hospital. The study population will be consisted of patients with cervical spondylosis. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Patients with cervical spondylosis. • Aged from 30 to 60 years of patient with cervical spondylosis. • Pre-diagnosed cases of cervical spondylosis. • Both the genders. • Patients referred by orthopedic surgeons. • Patients who are willing to participate in this study. • Patients who are diagnosed with cervical spondylosis by other professionals/doctors. Exclusion Criteria: • Patients with cervical fracture. • Patients with vertebrobasilar insufficiency. • Presence of other significant rheumatic disease variants. • Patients who have history of any cervical spine surgery. • Patients who have active infection. • Pregnant Females. • Ankylosing Spondylitis. Intervention groups: Intervention Group A: Diclofenac diethylamine phonophoresis will be done on the participants along with routine physical therapy to check the effectiveness of diclofenac diethylamine phonophoresis and how it influence the range of motion, pain and quality of life. Group B: Phonophoresis with only aqua gel and routine physical therapy will be provided to the patients. Main outcome variables: Visual Analogue Scale and Neck Disability Index for Pain and Cervical Disability respectively and Universal goniometer will be used for Range of motion and Short Form -36 for Quality of Life.

Study aim: To find the effects of Chest Expansion exercises on pulmonary function, chest expansion, trunk control ability and quality of life among stroke patients. Design: Two parallel groups, double blinded, randomized controlled trial with pre and post assessment Settings and conduct: Physiotherapy department of Jinnah Memorial Trust Hospital Gujranwala Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Patients between age group of 40-55 years • Both genders • Chronic stroke from at least last 6 months-2 years of both forms (ischemic and hemorrhage). • Hemiplegic patients caused by stroke • Patients are able to sit independently • Patients who are able to walk independently with or without walking aid Exclusion Criteria: • Patients with any pulmonary disease before onset of stroke • Patients with thoracic deformity or rib fracture • Patients who received respiratory rehabilitation for stroke • Patients with any neurological disorder other than stroke Intervention groups: Conventional neurorehabilitation program along with Chest expansion exercises Main outcome variables: Pulmonary function test by using Diagnostic Spirometry, Assessment of quality of life using SS-QOL (Stroke Specific Quality Of Life) questionnaire, Trunk Impairment Scale used to assess trunk control (TIS), Measurement of Chest Expansion using measuring tape.

Study aim: The objective of this study will be to evaluate the effects of quadriceps muscle activation with neuromuscular electrical stimulation in patients with congestive heart failure. Design: Two parallel groups, double-blinded, Randomized Controlled Trial with pre and post-assessment. Sample size will be 54. Settings and conduct: The data will be collected from Gulab Devi Hospital, Lahore. Participants/Inclusion and exclusion criteria: Inclusion Criteria: • 45-60 years of age • Congestive Heart Failure patients • Forced expiratory volume in 1 second (FEV1) less than 50% predicted • Incapacitating breathlessness (Medical Research Council dyspnoea scale ≥4) • Diagnosed CHF patients Exclusion Criteria: • Neuromuscular or neurological disorders • Severe arthrosis or other musculoskeletal limitations • Implanted cardiac pacemaker • Knee osteoarthritis, Rheumatoid arthritis • Any inflammation in knee • Peripheral Neuropathy • Diagnosis of cancer • Acute exacerbation requiring hospital admission or systemic corticosteroids in the preceding 4 weeks. Intervention groups: Group A will receive Neuro Mnuscular Electrical Stimulation therapy, and Group B will undergo traditional strength training and NMES, with both groups following standardized protocols for the same duration and frequency of sessions. Main outcome variables: Maximal Voluntary Contraction (MVC) on the quadriceps muscles of patients by using a dynamometer. Left Ventricular Ejection Fraction (LVEF) will be assessed through echocardiography. The Rate of Perceived Exertion (RPE). Functional Capacity Evaluation (FCE) will be assessed by 6-min Walk Test (6MWT).

Study aim: To compare the effects of knack maneuver with or without diaphragmatic breathing on urinary tract symptoms and quality of life among patients of stress urinary incontinence. Design: It will be single blinded, parallel study groups and randomized clinical trial Settings and conduct: The study will be held at Arif memorial teaching hospital Lahore Participants/Inclusion and exclusion criteria: Participants which will have age 18-50 years and diagnosed with stress urinary incontinence symptoms will be added to this study while Women who are pregnant or already having previous pelvic floor training or patients taking blood pressure medications, sedatives, muscle relaxants, and diuretics and diagnosed with mental illness will excluded from this study. Intervention groups: Group A: Group A will given knack maneuver along diaphragmatic breathing. In group A, We will take diagnosed patients of stress urinary incontinence and will perform knack maneuver along diaphragmatic breathing. Group B: In group B, We will take diagnosed patients of stress urinary incontinence and will perform knack maneuver. The training program will be 2 days per week for 4 weeks. Main outcome variables: Urinary distress incontinence-6: The UDI 6 is a valid and reliable six points survey, use particularly to investigate symptoms associated with lower urinary tract dysfunction; Incontinence Impact Questionnaire (IIQ-7): The IIQ 7 is a seven point's questionnaire specific to UI to impact the quality of life and

Study aim: To compare effectiveness of JANDAS Approach versus McKenzie Retraction exercises on pain, disability and quality of life among Chronic Neck Pain Patients. Design: Randomized clinical trial Settings and conduct: This study will be conducted at Arif Memorial Teaching Hospital, Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients, 25-40 years of age suffering from neck pain duration more than 6 months will be include in this study. Exclusion criteria: Subjects with a history of severe trauma such as fracture, congenital disorder of cervical spine, spondylolisthesis, any neck tumor, myelopathy, tendinopathy, rheumatoid arthritis or having ankylosing spondylosis will be exclude from this study Intervention groups: There will be two intervention groups. Group A will be treated with JANDA,s approach and group B will be treated with McKenzie retraction exercises. Main outcome variables: NPRS questionnaire will be used to check pain severity level, while NDI will be used for neck disability and SF36 questionnaire will be used for quality of life

Study aim: To determine the effects of progressive resistance exercise training on inflammatory markers, cardiorespiratory fitness, pulmonary function in patients with RA. Design: Two parallel group , single blinded, randomized control trial with pre and post assessment Settings and conduct: Will be conducted in private hospital Ittefaq hospital Lahore Participants/Inclusion and exclusion criteria: Inclusion criteria • Patient with RA • Patients with sedentary lifestyle (no participation in structural exercise for the preceding 6 months) • RA factor positive • Both males and females • Age between 40-65 years • Stable disease • No change in DMARDS (Methotrexate, sulfasalazine, hydroxychloroquine) Exclusion criteria. • Joint surgery (in the preceding 6 months) • Cognitive disability • Other joint diseases such as Osteoporosis and Osteoarthritis • Previous history of fracture • Primary neurological disease • Comorbidity incompatible with exercise Intervention groups: ⚫ Patients will ask to perform four exercises utilising large muscle groups (eg, leg press, shoulder press, chest press and pull ups). Intensity will determine during their first resistance exercise session using an established protocol.20 They will required to complete three sets of 12–15 repetitions during each exercise session. Mode and intensity of exercise will adjust monthly. Main outcome variables: 6 minutes walk test Spirometry Blood test

Study aim: To evaluate the effects of Hand arm bimanual intensive therapy including lower extremities (HABIT-ILE), in pre-school children with CP on functional parameters Design: Randomized controlled trial Settings and conduct: Hospitals of Faisalabad Participants/Inclusion and exclusion criteria: Inclusion Both male and female Children will be considered Diagnosed children of Spastic Cerebral Palsy CP Child of Grade 3 and 4 aged between 3 to 6 years (corrected age if preterm birth), capable of following instructions and completing all necessary tests according to their Exclusion Limb fracture Uncontrolled epilepsy With any other congenital disease (e.g. Diabetes, Hyperthyroidism, Hypothyroidism etc.) Botulinum toxin injections or orthopedic surgery within the past 6 months. Have severe visual or cognitive impairments that could interfere with treatment/testing. Parents are unable/unwilling to provide consent for their child’s participation Intervention groups: Group A Interventional group consist of 25 participants will receive Early Hand arm Bimanual Intensive Therapy Including Lower Extremities (E-HABIT-ILE), while Group B will receive treatment through a Conventional Physical therapy. Both interventions will be given for 3 hours per day in hospital by dividing the both groups into sub groups Main outcome variables: 1. Five classification levels of the Gross Motor Functional Classification System (GMFCS) 2. Modified ACTIVLIM-CP Questionnaire 3. Pediatric Evaluation of Disability Inventory Questionnaire (PEDI-CAT)

Study aim: To compare the effects of Spencer muscle energy techniques and Bowen therapy on pain, Range of motion and disability in patients with Adhesive capsulitis. Design: Single blinded randomized clinical trial with parallel assignment of 32 participants to two groups equally. Settings and conduct: The study will be conducted at Arif memorial teaching hospital. Outcome assessor will be kept blind in it. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Both male and female patients between age of 40 - 60 years. Patients with positive capsular pattern. Patients experiencing pain, stiffness, and limited range of motion in the affected shoulder. Patients who have not undergone shoulder surgery or received corticosteroid injections in the past three months. Exclusion Criteria: Patients with a history of shoulder fractures, dislocations, or other significant shoulder injuries. Patients with fracture in and around shoulder. Patients with any neurological disorder Intervention groups: Group A: Spencer muscle energy technique Group B: Bowen Therapy Main outcome variables: Pain measured by numeric pain rating scale ROM measured by universal goniometer Disability measured by shoulder pain and disability index Questionnaire

Study aim: To compare the effect of conventional physiotherapy with and without hold- relax PNF Exercises on knee torque and motor function in children with spastic cerebral palsy. Design: single-blind randomized controlled trial Settings and conduct: Ambulatory patients of cerebral palsy having GMFC of 1 and 2 in the rehabilitation department of Rehab Care School for Special Children Lahore fulfill the inclusion criteria of the study. The assessor was not aware of the treatment given to either group. Participants/Inclusion and exclusion criteria: 8-16 years old cognitive children with spastic cerebral palsy having Knee flexor and extensors grade 3 and above according to manual muscle testing. Intervention groups: hold- relax peripheral neuromuscular facilitation technique along with conventional physical therapy. The exercise program included: o Dynamic stretching utilizing the principles of hold relax peripheral neuromuscular facilitation. Keeping the knee straight, the patient was asked to lift the leg for 7 seconds while the therapist held the leg from moving. The muscles were relaxed for 2 seconds while holding the new position. The process was repeated five times and the whole set was done 66 times with a 2-minute rest between each set. o Conventional static stretching was done at the start of the protocol for 5 minutes. Main outcome variables: • knee torque. • motor function • functional capability • spasticity

Study aim: To determine significant effectiveness of teach back training intervention with breathing exercises including diaphragmatic breathing , pursed lip breathing and effective cough to improve the pulmonary functions in COPD patients. Design: Randomized Control Trial with parallel groups , Single blinded with pre and post treatment readings Settings and conduct: Fatima Memorial Hospital, Jinnah Hospital And Services Hospital Participants/Inclusion and exclusion criteria: Inclusion Criteria: Age from 18 to 75 years old ,Male and Female, Diagnosed COPD with FEV1/FVC ratio <70% ,Lack of cognitive impairment ,Ability to attend training session, Clinical diagnosis of COPD confirmed by smoking history Exclusion Criteria: Long Term Bed Rest, Inability To Perform 6-minute Walk Test, Malignancy, Cardiovascular disease (Angina, MI),Stroke, Immunocompromised conditions, Cardiac and pulmonary surgical History Intervention groups: Interventional Group(A):Teach Back training with breathing exercises along with Conventional treatment and educational session protocols among COPD patients. Control Group(B):Breathing Exercises with Conventional Training among COPD patients Main outcome variables: Pulmonary Function Assessment using Digital Spirometry and Borg Dyspnea Scale

Study aim: To evaluate if pilates exercises have significant effects than neck-stabilization exercises in treating chronic neck pain, sleep disturbance as well as decreasing kinesiophobia in non-specific chronic neck pain patients Design: Sixty participants will be randomly allocated into 2 groups , thirty in each group via computerized random number generator. Group 1 will receive neck stabilization exercises and Group 2 will receive Pilates exercises . The interventions will be given for 8 weeks Settings and conduct: Sample will be selected through Convenient sampling technique from physiotherapy department of Allied Hospital, Faisalabad, Physical therapy department of DHQ Faisalabad Participants/Inclusion and exclusion criteria: Inclusion criteria: • Both gender • Age 18-45 years . • Recurrent history of neck pain from 3 months. • Intensity of pain greater than or equal to 5/10 on numerical pain rating scale. Exclusion criteria: • History of cervical spine injury or surgery • History of neck trauma , spinal deformity . • History of specific neck pain such as fibromyalgia , Rheumatological diseases • History of neck-pain secondary to other conditions including neoplasm, any neurological or vascular disease • History of radiculopathy • History of Degenerative arthritis of cervical spine • History of osteoporosis • History of low back pain Intervention groups: Sixty participants will be randomly allocated into 2 groups , thirty in each group via computerized random number generator. Group 1 will receive neck stabilization exercises and Group 2 will receive Pilates exercises . The interventions will be given for 8 weeks Main outcome variables: Numerical pain rating scale, Insomnia severity index and Tampas scale of kinesiophobia will be used for pre and post assessment

Study aim: The comparative effects of progressive resistance exercise and task-specific training in Ischemic stroke patients. Design: Randomized control trial with participants divided into two group progressive resistance exercises and task specific training with 52 sample size. Settings and conduct: Trial is conducted in the University of Lahore Teaching Hospital with assesser is blinded and physiotherapist is not blinded Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Both male and female • Age between 40 and 70 years • First event of ischemic stroke • A Mini- Mental Status Examination score more than and equal to 24 • No facial palsy and receptive aphasia • No prior thoracic or abdominal surgery • Subjects able to sit for 30 secs without using upper extremities for support • Stable patients Exclusion Criteria: • Other disorders such as blindness, deafness, amputation of lower or upper limb, cerebellar stroke • Impaired cognition or other severe medical condition • Patients with abdominal aortic aneurysms; unstable chronic disease; life-incapacitating cardiac disease, severe balance impairment; psychiatric illness. • Musculoskeletal problems in the pelvis or spine • Sensory involvement Intervention groups: Both groups will receive interventions for 12 weeks, 2 times/week with routine physical therapy for 20 mins before every session. The first intervention group received Progressive Resistance Training for 12 weeks with increased repetitions after every two weeks. The second intervention group received Task Specific Training for 12 weeks with different task after every two weeks Main outcome variables: Reflex activity, Volitional Movement Within Synergies, Volitional Movement Mixing Synergies, Volitional Movement With little or no Synergies, Normal Reflex Activity, Coordination/speed, Sensation, Passive joint motion, Joint Pain

Study aim: To compare the effectiveness of muscle energy technique versus kinesiotaping on mobility, pain kinesiophobia in information technology professionals with ergonomic related low back pain. Design: A concealed, randomized, blinded, sham controlled clinical trial with a parallel group design of 30 patients enrolled. Settings and conduct: • The University of Faisalabad • Superior University Faisalabad Campus Participants/Inclusion and exclusion criteria: Both male and female patients of low back pain with the age of 20-40 years was selected after meeting the inclusion and exclusion criteria Intervention groups: 1: muscle energy technique 2: kinesiotaping Main outcome variables: Pain Mobility Kinesiophobia

Study aim: Objectives of current study are to compare effects by Muscle Energy Technique and Proprioceptive Neuromuscular Facilitation on Non-specific Low Back Pain to reduce pain, gain range and overcome disability in female with iliopsoas tightness. Design: Randomised, Parallel, single blinded, Randomised Control Trial. Settings and conduct: Out patient Department of Physical therapy unit in Allied Hospital Faisalabad. Patient was blinded of two different treatment protocols given in separate groups. Participants/Inclusion and exclusion criteria: Female, Aged 20-50, having, Non-specific low back pain for past one month with Thomas test positive having Numeric Pain Rating Scale > 3, Hip Extension Range of Motion >10, Oswestry Disability Index Mild disability (5-34) will be included in study. Patients having carcinomas/tumors, spinal trauma history, anatomical deformities, Open wounds, Severe Osteoporosis, Numeric Pain Rating Scale > 8, Hip Extension Range of Motion > 40 (Hypermobility), Oswestry Disability Index score > 34, Past surgical history of thoracic or lower spine, Infections, Acute Inflammations, Unbearable sharp pain at joints, Wear and tear to soft tissues were excluded from the study Intervention groups: two intervention groups, Muscle Energy Technique and Proprioceptive Neuromuscular Facilitation receiving a baseline treatment of Hot pack and Transcutaneous Electrical Nerve Stimulation to Low Back along with their assigned treatment protocol. Muscle Energy Technique group was treated with Post isometric Relaxation technique on iliopsoas muscle to treat tightness of this muscle, bilaterally. Proprioceptive Neuromuscular Facilitation group received Hold-Relax D1 Flexion-Extension pattern on Iliopsoas muscle bilaterally. Main outcome variables: Pain, Hip extension Range of Motion bilaterally and Oswestry Disability Index

Study aim: The aim of the study was to compare the effect of myofascial release therapy (MFR), and the post-isometric relaxation (PIR) in pain reduction, improving the elbow range of motion (ROM), and strengthening the muscles in the individuals with post-traumatic elbow stiffness. Design: A Randomized clinical trial, blinded with a parallel group design of 34 patients enrolled between March 2024 and May 2024 at Allied Hospital Faisalabad. Settings and conduct: Allied Hospital Faisalabad. Participants/Inclusion and exclusion criteria: Inclusion criteria Age ranging from 15 to 50 years old . • Pain (NPRS score from 3-7). • Stiff elbow . • After 6 weeks of surgery(9). • Restricted ROM: subjects with limited active range of motion A(ROM) . • Both male & female patients. • Participants willing for the enrollment in the study. Exclusion Criteria • Open wound . • ROM not improved after 2nd session . • Acute infection to the elbow region. • Cervical radiculopathy & any other upper limb dysfunction. • Neurological impairments. • Pregnant females . Intervention groups: In Group A, the treatment includes Maitland Mobilization to enhance joint movement, Myofascial Release Therapy to relieve muscle tension and the application of ice to reduce inflammation and pain. In contrast, Group B's approach incorporates Maitland Mobilization as well, but instead of Myofascial Release Therapy, it utilizes Post-Isometric Relaxation to reduce muscle spasms and improve flexibility, followed by ice application. Main outcome variables: Numeric Pain Rating Scale to assess pain, Goniometer for the measurement of range of elbow and Liverpool Elbow Score for functional assessment will be used to collect the data

Study aim: To determine the effect of dialysate temperature on adequacy of hemodialysis Design: A two arm, parallel group, randomized trial to be carried out on minimum 50 patients at a single center. Randomization will be computerized with concealment using opaque envelopes. Settings and conduct: This trial would be conducted at Dialysis Unit of Pak Emirates Military Hospital. Patients would be selected by non-probability convenience sampling. Randomization would be through computer generated sequences and would be concealed in opaque envelopes. Patients would undergo haemodialysis with dialysate temperature at 37.0 or 36.0 degree Celsius. They would be blinded to the treatment strategy. Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients on maintenance haemodialysis for at least 3 months; Use of arteriovenous fistula Exclusion criteria: Acute kidney injury; History of intradialytic hypotension during last one month; Shortening of haemodialysis session for any reason; Interruption in haemodialysis session for more than 5 minutes; Patients known to have central venous stenosis; Uncooperative patients; Lack of consent Intervention groups: Intervention group 1: Dialysate Temperature 37.0 degree Celsius. Patients in this group would have the dialysate temperature set at 37.0 degree Celsius when the machine is being setup for a dialysis session and maintained throughout the 4 hours session. Intervention group 2: Dialysate Temperature 36.0 degree Celsius. Patients in this group would have the dialysate temperature set at 36.0 degree Celsius when the machine is being setup for a dialysis session and maintained throughout the 4 hours session. Ultrafiltration would be done to the usual dry weight. All sessions would be carried out on Fresenius F4008 haemodialysis machines. Main outcome variables: Urea reduction ratios; online Kt/V (as measured by Online Clearance Monitoring)