Cardiology,Faisalabad,Punjab,Pakistan setting used for research purpose.Patients will be allocated in groups

Study aim: To determine the effects of dry needling combined with spinal manipulative therapy versus spinal manipulative therapy alone on pain, disability, lumbar range of motion (ROM) and muscle endurance in patients with non-specific chronic low back pain. Design: Two arm parallel group randomised trial with blinded outcome assessment Settings and conduct: Setting is Sindh Institute of Physical Medicine and Rehabilitation. Outcome assesor will be blinded to the treatment intervention. Participants/Inclusion and exclusion criteria: Patients diagnosed as having chronic nonspecific low back pain will be included in the study. Any serious spinal pathology will be excluded Intervention groups: After random allocation of the participants into two groups, experimental group will receive spinal manipulative therapy and dry needling while the control group will receive spinal manipulative therapy alone. Main outcome variables: Pain, lumbar range of motion, disability and lumbar muscle endurance

Study aim: To determine the efficacy of Platelet Rich Plasma (PRP) versus 5% topical minoxidil for the treatment of androgenetic alopecia Design: randomized control trial(RCT) parallel group,single blinded study 35 patients will be assign in each group,radomization will be done by lottery method,a single center study Settings and conduct: PNS Shifa karachi after approval from ethical committee,blinding is done for photographic examination,as mentioned earlier Participants/Inclusion and exclusion criteria: inclusion criteria Age 18 to 60 years.Patient Hamilton-Norwood grade ≥2 and ≤ 5 or Ludwig scale grade 1-2.Platelets count more than150, 000 /µl.Duration of androgebetic alopecia > 6 months.Patient has not taken any kind of medical treatment for hair loss or has not used treatment for more than 6 months duration. exclusion criteria Patients with alopecia other than AGA, such as telogen effluvium, alopecia areata, acquired cicatricial alopecia, or anagen effluvium.The patient on warfarin or heparin.The infective disease of the scalp.Patient who has taken any treatment for androgenetic alopecia History of thyroid disorder.Patients with hypersensitivity to minoxidil in past.Any infective skin disease.Pregnancy /lactation.Patient taking aspirin.Unrealistic expectation. Intervention groups: 30 ml of venous blood will be drawn into a tube containing citrate phosphate dextrose,it will be subjected to centrifugation by two spins to produce PRP .Calcium gluconate to PRP ratio used will be 1:9 this will be injected intradermally,each session 1 month apart. Participants of group B will be advised to apply topical 5% minoxidil 1 ml over dry scalp 12 hourly. Main outcome variables: hair pull test ,investigator 7 point score ,patient satisfaction score ,patient standardized hair growth questionnaire,photographic evaluation

Study aim: To compare the outcomes of ultrasound guided dry needling in addition to conventional physical therapy on patellar tendonitis, tendon thickness, tendon width, fibrillar echo-pattern and echogenicity of patellar tendon in patients with jumper’s knee. Design: parallel group, single blinded, randomized controlled trial Settings and conduct: The institute of physical therapy, The university of Lahore Participants/Inclusion and exclusion criteria: inclusion criteria: Athletes with medical diagnosis of Jumper’s knee. Aged between 18 to 45 years. Both genders. A score below 80 on the Victorian Institute of Sports Assessment for PT (VISA-P) questionnaire. Pain provocation on Single leg decline squat test as a score >0 on the NRS. Exclusion Criteria: Knee surgery within the previous 6 months. Chronic knee joint diseases. Corticosteroid injection in the patellar tendon within the last 1 month. Contraindications for needling. Presence of calcification. Use of analgesics for last 48 hours. Any other concomitant treatment for jumper’s knee. Intervention groups: (Experimental group); it will receive ultrasound guided dry needling(three needle insertions lasting 3 seconds each and the number of times the needle will pass through the tendon will range from 15 to 30 passes, depending on the size of the tendon abnormality) in addition to routine physical therapy.(An exercise program will consist of stretching and strengthening exercises of quadricep & hamstring: mini-squats, seated knee extensions, lunges, and lateral steps (3 sets, 15 reps each) & therapeutic modalities) and activity modifications. control group will receive same routine physical therapy intervention as of group A Main outcome variables: Visual analogue scale, Victorian Institute of Sport Assessment Patellar(VISA-P) Score, The Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score , Sonographic tendon assessment

urban area of Lahore Pakistan and measurements will be assessed at the Teaching Bay of Rehmatul-Lil

Study aim: To compare the effects of visual scanning exercises on balance, gait and activities of daily livings in patients with post stroke eye movement disorders. Design: Double blinded Randomized controlled clinical trial Settings and conduct: Out patient department of Physical Therapy Department, University of Lahore Teaching Hospital, Lahore Participants/Inclusion and exclusion criteria: Inclusion Criteria: Patients who suffered with eye-movement disorder either an ischemic or hemorrhagic stroke • Clinically diagnosed by a neurologist • Information on the type of stroke will be obtained from the patients’ medical records • Both male and female patients between the age group of 19–60 years • Minimum score of 7 on Mini-Mental State Examination • Patients in the sub-acute stage after the stroke and able to follow instructions and have the capacity to provide informed consent Exclusion Criteria: • Repeated stroke • Severe dementia, identified by applying the MMSE • History of an organic disorder or major psychiatric impairment • Disability or other comorbid disease such as cancer or amputation that will limit or prevent assessment of the patients • Participation in other interventional or pharmacological studies which can affect the results of this study • Patients with vestibular problems who have positive dix-hallpike test • Patients with facial palsy • Patients with ophthalmological problems before stroke onset • Patients suffering from balance problems as a result of muscular problem Intervention groups: The patients will be randomly divided into experimental and control group. 32 patients in each group. Experimental group will receive visual scanning exercises along with task-specific approach while control group will receive task-specific approach alone. Main outcome variables: 1. Berg Balance Scale 2. The Dynamic Gait Index 3. Barthel index scale

Study aim: To determine the effect of Whole Body Vibration on functional performance and balance in chronic stroke patients. Design: Single Blind, randomized controlled clinical trial Settings and conduct: This randomized clinical trial was performed in the Department of Physical Therapy Lahore General Hospital Lahore. Outcome Assessor has been blinded and he was not aware of the allocated group of the participants. Participants/Inclusion and exclusion criteria: Participants of both of the genders aging from 40 to 75 years having a single stroke more than six months ago. Intervention groups: Routine Physiotherapy Group received Strengthening Exercises, Stretching Exercises, Gait Training and Balancing Exercises. WBV Group received routine physiotherapy treatment plus WBV session for 2 weeks. During the intervention, subjects were positioned on the platform in a standing position and both knees extended[0 degrees as the anatomic position] to keep an upright position with even weight distribution on both feet. The time course included 5 bouts of 2 minutes of vibration with a 1-minute rest interval between every two steps making the total time duration of 15 minutes with a frequency of 20-30Hz and a vibration amplitude of 3-6mm for 6 days per week for 2 weeks. The vertical type of vibratory stimulus was used. Main outcome variables: The primary outcomes of the study were the improvement in Stair Negotiation Time and Obstacle Clearance measurements. [Obstacle height that patient can clear without tripping] Secondary outcome measures were the improvement in Self-Selected Walking Speed, Balance Score according to BBS, Muscle Tone according to Modified Ashworth Scale Score, Timed Up and Go Test Score and Timed 10-Meter Walk Test Score.

Study aim: To find the effect of abdominal hypopressive exercise on pain intensity in primiparous female with sacroiliac hypermobility dysfunction To assess the effects of abdominal hypopressive exercise on functional activities of primiparous female with sacroiliac hypermobility dysfunction. To evaluate the effects of abdominal hypopressive exercise on sonographic change in transversus abdominus muscle thickness in primiparous female with sacroiliac hypermobility dysfunction To find the change in quality of life in primiparous female with sacroiliac hypermobility dysfunction Design: Randomized, single blinded, parallel group Settings and conduct: The Physical therapy department, ULTH, The University of Lahore It will be a single blinded trial in which the assessor will be kept blind. Assessor will be senior physiotherapist who will take measurements after giving consent to participate in the study. He will be blind, not confirmed about the group of intervention Participants/Inclusion and exclusion criteria: • Primiparous Female aged between 18-30 years • Patient with vaginal delivery • Within one year after post-partum • Unilateral sacroiliac dysfunction • Positive SI joint dysfunction test Exclusion Criteria: • Pregnancy • History of Cardiopulmonary Disease • History of Spondyloarthropathies Intervention groups: Abdominal hypopressive exercise group Conventional physical therapy Main outcome variables: Pain Intensity functional disability Muscle thickness changes

Study aim: To see the effects of PNF Hold Relax technique on scapular dyskinesis in patients with subacute stroke and to compare the effects of D1 and D2 flexion patterns of proprioceptive neuromuscular facilitation on pain, range of motion, disability and scapular asymmetry in patients with subacute stroke Design: Randomized Clinical Design was used. Both group taking same conservative treatment, with patterns of movement was changed in both groups. As "D1 flexion pattern" to one group and "D2 flexion pattern" to other group. Using " chit and draw" method as patient came according to chit treatment given to patient. Total 43 patient taking treatment, in which group A had 22 patient and group B had 21 patient. Settings and conduct: Ibn-e-Siena Hospital & Research Institute, Multan. Participants/Inclusion and exclusion criteria: Both male and female genders; age range between 40-60 years; stage of stroke attack with onset at least 5 months; patients developing unilateral scapular dyskinesis due to stroke assessed by lateral scapular slide test with type 1 scapular dyskinesia prominent infero-medial border of scapula. Exclusion criteria: patients with neurological deficit of the upper extremity; patients with any surgery of the upper extremity, active infections, hypermobility, calcification of the soft tissues, fragile skin patients with musculoskeletal injuries as upper limb fractures, dislocation, joint instability or any soft tissue injuries on affected side; other illnesses such supraspinatus, bicep tendinitis, fibromyalgia, frozen shoulder and arthritis that produced discomfort in the upper extremities; severe depression or other post-stroke symptoms. Intervention groups: There were two groups, Intervention group 1 was named D1 flexion group and Intervention group 2 named D2 flexion group. Main outcome variables: Shoulder ROM, Visual analogue scale; disability index

Study aim: The aim of the study is to compare the efficacy of ivabradine versus beta blockers in achieving heart rate control in patients with uncontrolled permanent atrial fibrillation and to assess their impact on various clinical parameters and safety outcomes over a specified duration. Design: Randomized Control Trial Settings and conduct: Study setting and conduct will be carried out at Pervaiz Ilahi Institute of Cardiology, Bahawalpur. Study will be single blinded as participants will not know which drug being given to them. Participants/Inclusion and exclusion criteria: Inclusion Criteria; It includes adults more than 18 years of age, fulfilling the criteria of permanent atrial fibrillation, resting heart rate more than 110/min, capable of providing informed consent and previous history of pulmonary vein ablation. Exclusion Criteria; It includes individuals allergic to drugs, decompensated heart failure, Patients of hypertrophic obstructive cardiomyopathy(HOCM), acute pericarditis or myocarditis or myocardial infarction, having conditions like end stage renal disease(ESRD) or liver failure, fever, hyperthyroidism, anemia, pregnant or lactating females, severe comorbidities or history of major surgery. Intervention groups: Two intervention group will be assigned. First group will be ivabradine group containing 30 participants. Other will be Beta blocker group of 30 participants. Main outcome variables: Main outcome variable is heart rate.

assignments.The trial will be conducted in Rehabilitation centers Lahore, Pakistan. Participants/Inclusion and

Study aim: 1. To compare efficacy and safety of sodium stibogluconate/meglumine intralesional therapy in combination with local-thermal therapy and alone 3. To identify reduction in number of intralesional therapy sessions when combined with thermal therapy. Design: open label, parallel group, randomized control trial Settings and conduct: Public Sector Clinic in endemic area. Patients, fulfilling the criteria will be randomly assigned to treatment or control group after consent process. stratified randomization technique will be used Participants/Inclusion and exclusion criteria: Inclusion Criteria: 02 – 80 years of age, either gender, with diagnosis of cutaneous leishmaniasis ( CL ) by direct examination under microscopy, voluntarily agreeing to participate in the study and complying with study follow-up visits will be enrolled. Exclusion Criteria: • Other forms of Leishmaniasis • Patients already receiving treatment for CL • Known hypersensitivity to sodium stibogluconate/meglumine • Pregnancy/lactation • Comorbidities which affecting follow-up of study Intervention groups: On first visit treatment group will have thermotherapy and control group will receive Meglumine. On subsequent weekly visits both groups will receive meglumine intralesional. Main outcome variables: The primary outcome will be treatment response in randomly assigned participants assessed at 4th,8th & 12th week post-treatment. The appearance, induration and size of skin lesion will be measured (using regular scale/measuring tape) .Complete response means complete re-epithelialization with no signs of inflammation .Partial response means decrease in lesion size not more than 50%, without appearance of epidermal crease while failure to response meant no re-epithelialization or a positive direct smear at the end of treatment, at 8th or 12th week of treatment. Safety outcome will be observed.

Study aim: To find out the effect of ischemic compression therapy and shock wave therapy for releasing trigger point on temporomandibular dysfunction. Design: It will be single blinding randomize clinical trial in which 45 individuals will be recruited. Settings and conduct: This study will be conducted on Islamabad diagnostic center Faisalabad. Participants will be blinded these individuals will not known in which group they will be allocated. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Functional disorder within masticatory muscle, Complaint of acute pain and presence of joint clicking. Exclusion Criteria; If individual have diabetes, Cardiovascular problem, sensory deficient , Skin lesion, fibromyalgia and tuberculosis. Intervention groups: Interventional groups are three. Group A will receive ischemic compression therapy, Group B will receive shock wave therapy, And group C will receive the combination effect of ischemic compression therapy and shock wave therapy. Main outcome variables: Pain will be measure by using visual analogue scale. Functional ability will be measure by using temporomandibular dysfunction questionnaire before and after treatment

Study aim: To compare the effects of Pilates Exercise versus McGill’s Exercise on Pain, Flexibility, Core Stability and Functional Disability in patients with chronic mechanical low back pain. Design: The trial will be conducted at Zainab Siddique Poly Clinic Engineer Town Lahore. The participant will be blinded by concealment of the technique that will be used on the participant. Settings and conduct: Randomized clinical trial, single blinded study, two parallel groups with 32 patients from Zainab siddique Poly Clinic Engineer Town Lahore . Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA: ⦁ Both male and Female ⦁ Age between 20 and 40 years (11) ⦁ Having mechanical low back pain without radiation to lower limbs, for more than 6 weeks were enrolled in the study. EXCLUSION CRITERIA : ⦁ Patients with any systemic disorder or who were undergoing intervention ⦁ Patients having a history of spine surgery were also not included.(11) ⦁ Have a pacemaker or a history of serious cardiac event or of cardiorespiratory dysfunction. ⦁ Participants who have a history of uncontrolled hypertension or arrhythmias. ⦁ Participants who are currently participating in another clinical trial. ⦁ Participants who have not undergone any recent surgical intervention for low back pain within the last six months. Intervention groups: Group A : The Pilates group in the study will follow a six-week exercise regimen, where they will participate in Pilate’s sessions twice a week with 6-10 repetition : ⦁ Single leg lower ⦁ Straight-leg bicycle ⦁ Oblique double knee tucks ⦁ Oblique tucks Group B The Mc Gill group in the study will follow a six-week exercise regimen, where they will participate in Pilate’s sessions twice a week week with 6-10 repetition : ⦁ Curl-Up, ⦁ Bird-Dog, ⦁ Side Plank Main outcome variables: Pain , Flexibility ,Core Stablity and functional disability are the main outcomes variable .

Study aim: The purpose of this study to check the effects of Roods Ontogenic motor patterns on trunk control and balance in spastic diplegic cerebral palsy children. Design: Non-Probability Consecutive sampling, single blinded , no phase Settings and conduct: study was conducted at children hospital Faisalabad. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA Child age with 3-10 years. Both gender male and female. Child able to follow verbal command. Children with GMFS level (II, III, IV) Children with Modified Ashworth scale (0-2) Pediatric balance scale more than 20 score children diagnosed with spastic cerebral palsy EXCLUSION CRITERIA Participants are excluded on following criteria: • Children who were uncooperative • Children who have visual and intellectual impairments • Use of anti-epileptic & anti-spasticity medications • CP include (Hemiplegic CP, Quadriplegic CP, Ataxic CP, Athetoid CP, Mixed CP, Hypotonic CP) • With any Hearing deficit • Sensory loss Tumors Children with severe mental abnormality Any cardiac anomalies affecting exercise tolerance Less than 4 months after undergoing orthopedic surgery Usage of botulism toxins Injections With any bony Malalignment Contractures Intervention groups: Baseline Treatment with Functional Electrical Stimulation then our intervention depands on Roods Ontogenic Motor patterns through inhibitory approaches were applied. Main outcome variables: the trunk control; Gross Motor Function Scale-88, Pediatric Berg Balance Scale

Study aim: The purpose of this study to check the effects of Swiss ball stabilization exercises on trunk control ,balance,motor skill in spastic diplegic cerebral palsy children and to evaluate the trunk control in children with spastic diplegic cerebral palsy and to measure the functional performance by using Pediatric berg balance scale. (PBBS). Design: Randomized Clinical trial , Single Blinded, Parallel group Settings and conduct: The Children Hospital & Institute of Child Health Faisalabad Participants/Inclusion and exclusion criteria: inclusion • Child age with 3-10 years. • Both gender male and female. • Child able to follow verbal command. • Children with GMFS level (II, III, IV) • Children with Modified Ashworth scale (0-2) • Pediatric balance scale more than 20 score exclusion • Children who were uncooperative • Children who have visual and intellectual impairments • Use of anti-epileptic & anti-spasticity medications • CP include (Hemiplegic CP, Quadriplegic CP, Ataxic CP, Athetoid CP, Mixed CP, Hypotonic CP) • With any Hearing deficit • Sensory loss • Tumors • Children with severe mental abnormality • Any cardiac anomalies affecting exercise tolerance • Less than 4 months after undergoing orthopedic surgery • Usage of botulism toxins Injections • With any bony Malalignment and Contractures Intervention groups: As a baseline treatment functional electrical stimulation was done. Then the Swiss ball stabilization exercises were applied. Swiss Ball Stabilization Exercises Main outcome variables: The Trunk Control Gross Motor Function Scale-88 Pediatric Berg Balance Scale

Study aim: This study aims to evaluate the effects of high-intensity versus low-intensity resistance training along with blood flow restriction on pain, range of motion, strength, muscle thickness, and functional performance in patients with total knee arthroplasty. Design: parallel-group, single-blind, randomized clinical trial Settings and conduct: Setting: Allied Hospital, Faisalabad single-blinded study. assessor will be blind. Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA • Both male and female patients • 50 to 65 years of age • Post-total knee arthroplasty for osteoarthritis • Unilateral joint replacement surgery EXCLUSION CRITERIA • Impaired cognitive function and mental disease (e.g., diagnosis of Alzheimer's disease) • Paraplegia/extremity amputation • End-stage renal disease requiring dialysis • Uncontrolled cardiovascular disease or Severe pulmonary disease • Active neoplasm • Body mass index greater than 40 kg/m² • Peripheral vascular disease or deep vein thrombosis • Opioid use and Chronic oral steroid use and anticoagulation use • Ipsilateral joint disease involving hip, ankle, or spine • Neurologic or other etiology of quadriceps wasting Intervention groups: Both groups will receive the same baseline treatment. Group A: BFR with Low-Intensity Resistance training 5 min light cycling • Start with 10 repetitions of unliteral leg press at light weights • Calf raises • Knee flexion • Knee extension Progress to 20-30% of predicted 1RM Group B: BFR with High-Intensity Resistance training 5 min light cycling • Start with 10 repetitions of unliteral leg press at light weights • Calf raises • Knee flexion • Knee extension Progress to 65-70% of predicted 1RM Main outcome variables: NPRS → Pain Universal goniometer → ROM Hand-held dynamometer → Strength Muscle mass → Ultrasound imaging Functional Performance • Lower extremity function scale • 6-Minute walk test

: Dermatology opd of our tertiary care hospital (Pak Emirates Military Hospital, Rawalpindi, Pakistan

Study aim: To compare the effects of foam roller and J-stroke myofascial release on pain intensity, pain threshold, range of motion and functional disability in patients with plantar fasciitis. Design: Randomized clinical trial, single blinded study, two parallel groups with 44 patients from Sheikh Zayed hospital Rahim yar khan Settings and conduct: The trial will be conducted at Sheikh Zayed Hospital Rahim Yar Khan. The participant will be blinded by concealment of the technique that will be used on the participant. Participants/Inclusion and exclusion criteria: Inclusion criteria: Both male and female, Patients age between 25-55 years with heel pain, Pre-diagnosed and referred patients of plantar fasciitis by orthopedic surgeon, Complain of plantar fasciitis since last 6 weeks, Pain in the heel on the first step in the morning, Heel pain felt maximally over plantar aspect of heel, Patients with unilateral plantar fasciitis Exclusion criteria: Inflammatory and degenerative joint disorder, Impaired blood circulation, Ankle and foot bone fracture, Patients with skin diseases i.e., Dermatitis or any infective disorder in which ultrasound is contraindicated, Metal implants and post-surgical, Altered sensation in lower extremity, Patients with history of corticosteroid injection in heel in last 3 months, Malignancy, Referred pain due to neurological disorders Intervention groups: Group A: Foam roller will be given to group A along with the conventional treatment. Group B: J-stroke myofascial release techniques will be given to group B along with the conventional treatment. Main outcome variables: Pain Intensity, Pain Pressure Threshold, Ankle dorsiflexion ROM, Functional disability

study will be conducted in Pakistan sports board complex and Model town football club. Participants

Study aim: To compare the effects of dry needling and conventional physical therapy patients with piriformis syndrome Design: Two arm parallel group randomized trails with blinded outcome assesor and with sample size of 86 enrolled Settings and conduct: Participants were referred by the orthopedic physician of Nishtar hospital to the Physical Therapy Department Participants/Inclusion and exclusion criteria: Inclusion criteria was as follows: • Aged between 30-50 years • Both Male and females • Patients with positive FAIR & Lasegue test • Having atleast 4 score of Numeric Pain Rating Scale Exclusion Criteria: • Patients with any abnormality in spine column • Patients with any systemic inflammatory disease (rheumatologic Conditions) • Recent fracture/dislocation in and around the Hip Joint • Patient with psychological impairment (Parkinson's disease) • Pregnancy Intervention groups: All the screened and willing participants were randomly allocated to two groups (Group A: Experimental group / Dry needling group, Group B: Comparative Group / Conventional therapy group) by lottery method. Main outcome variables: 1. Pain (Numeric Pain Rating Scale) 2. Lower extremity Functional Scale (LEFS) 3. Range of Motion (Goniometry)

Study aim: Compare the effects of positional release technique and myofascial release technique with foam roller on Pain, Range of motion, Functional Mobility and Quality of Life in patients with piriformis syndrome. Design: Parallel group randomized clinical trial and Randomization will be achieved through computer generated random allocation software. Settings and conduct: Government General Hospital Faisalabad, National Hospital and Mujahid Hospital. Patients and outcome assessor will be blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Both male and female patients, Age group 25-40 years, A score of 8 or more out of 12 scoring system according to Clinical scoring system for the diagnosis of piriformis muscle syndrome Exclusion criteria: Mentally retarded, Any pathology or recent injury near the hip, sacroiliac joint, or lumbar spine, Limb length discrepancy, Recent buttock trauma and bladder/bowel dysfunction, Ischiogluteal/ischiofemoral bursitis or impingement, Referred pain from gastrointestinal or pelvic source Intervention groups: Group A: They will receive Positional release technique and conventional treatment in the form of TENS and hot pack for 15 minutes then piriformis muscle and hamstring/calf muscle stretching will be performed (3 repetitions) for 5 minutes after the PRT. Session duration will be 30-35 minutes, twice a week and with 8 sessions over 4 weeks. Group B: They will receive Myofascial release technique with foam roller and conventional treatment in the form of TENS and hot pack for 15 minutes then piriformis muscle and hamstring/calf muscle stretching will be performed (3 repetitions) for a duration of 5 minutes after the MRT. Session duration will be 30-35 minutes twice a week and with 8 sessions over 4 weeks. Main outcome variables: Pain, range of motion, functional mobility and quality of life

Study aim: Primary purpose of this research to evaluate the efficacy of Positional Release Therapy versus Post Isometric Relaxation in treating Plantar fasciitis symptoms such pain, ROM , and cadence. Design: A randomized double blinded clinical trial and parallel-group design of 36 patients. Settings and conduct: Study 'll be conduct in Different Government schools. Participants/Inclusion and exclusion criteria: Inclusion Criteria: School teachers,Male and female both , with unilateral PF & pain that persist more than 3 weeks .Windlass test positive , Age between 30 to 60 Exclusion Criteria: Patient with traumatic , nerve related issue ,NSAIDS user ,with any other musculoskeletal disorder of hip knee foot or fracture , with congenital deformities & using assistive devices Intervention groups: Both group 'll receive protocol along theragun on baseline. Group A PIR subject in supine position keeping knee extended and therapist on affected side in walking position. The subject's ankle joint will be dorsiflexed until a resistance feel and will ask to hold this position and exert 20% of force towards plantar flexion for a period of 5 to 7 seconds. Resistance will be released and relaxation of 5 seconds will be given during which the ankle will passively dorsiflexed to a new barrier. 5 repetitions. Group B PRT: Therapist places thumb on tender point at plantar fascia insertion while patient in supine position with ipsilateral knee flexed. Plantar flex the toes and ankle while monitoring sore site with thumb, curling around tender point until monitoring thumb feels relief. Supination/pronation of foot will be added if necessary. position of ease is maintained for 90 sec until the tissues soften. After returning the foot to a neutral position the tender spot is re-evaluated. process is repeated three times with 30-sec resting intervals between each repetition. Main outcome variables: Pain ROM Cadence

Study aim: To determine the effect of Proprioceptive Neuromuscular Facilitation exercises in improving knee ROM, functional activity and balance in total knee arthroplasty patients. Design: two arm parallel group randomized trial with patients and data analyzer blinded Settings and conduct: The study will be conducted at Physiotherapy department of Rehman Medical Institute, Peshawar. The participants will be blinded by not informing them what group they are in, similarly the statistician will be blinded by keeping the allocation of participants concealed. Participants/Inclusion and exclusion criteria: Participants who had unilateral total knee replacement surgery 1 week ago and were able to walk for 10 meters on ground at a comfortable speed, and having MMSE score of 24 or more were included in the study while the participants who had total knee replacement previously, re-operation for total knee replacment (revision arthroplasty or manipulation under anesthesia), past surgical history of any orthopedic procedure at lower limbs, history of fractures at lower limbs, multiple medical comorbidities such as metabolic disorders, cancers, cardiovascular conditions, Cognitive and neurological disorders i.e. stroke, neuropathy, neuromuscular disorders and individuals on Beta Blockers and uncontrolled Hypertension were excluded. Intervention groups: Participants in the control group will receive traditional stretching and exercises using isotonic contractions while those in experimental group will be engaged in stretching using PNF techniques such as Rhythmic Initiation, Combination of isotonic and Hold Relax, along with the exercises given to the control group, each for 30 minutes, conducted 5 times a week for 2 weeks. Main outcome variables: Knee Range of Motion, Functional activity and Balance are the outcome variables, which are to be assesed via goniometer, time up & go test, and mini berg balance scale.

Study aim: the aim of the study is to check the effectiveness of the treadmil trainng alone versus treadmil training with external clues in improving gait and functional ability in parkinsion patient Design: Randomized control trial Settings and conduct: this trial will be conducted at Physicaltherapy and rehablitation ward of Chauhary akram teaching hospital (Teaching hospital associated with Azra Naheed Medical College ,THe superior University ,Lahore) Participants/Inclusion and exclusion criteria: Inclusion Criteria: (1) Age 50 to 65 years (2) Male and female both (3) idiopathic Parkinson’s disease (4) disease severity of II to V on the Hoehn and Yahr Scale and with minimum assistance and support required (5) ability to stand independently and to walk on a treadmill (with body weight support, if required) (6) sufficient visual capacity to see the cues Exclusion Criteria: (1) Patient with Parkinson disease wheel-chair bond and bed-ridden (2) any other neurologic or orthopedic disorder affecting gait and postural stability; (3) change in medication for the treatment of Parkinson’s disease during the study period (4) cognitive impairment (5) severe cardiovascular disorders (6) vestibular dysfunctions Intervention groups: Interventions: Group 1 (Control group) Group 1 in training session will receive the treadmill training session over 30 minutes. Patients in 1 receive the same treatment protocol in 5 days per week and the this treatment protocol must be continue for 6 weeks. Group 2 (Experimental Group): Group 2 in training session received the treadmill training session over 30 minutes along with the external clues like visual, auditory,etc.In 5 days per week and this treatment protocol must be continuing for 6 weeks Main outcome variables: Gait it will be assesed by usiing wisconsin gait scale and Functional ability wil be assesd by Motor Aspects of Experiences of Daily Living (M-EDL)