Study aim: To determine comparative effectiveness of Elongation Longitudinaux Avec Decoaptation Osteo Articulaire and upper thoracic mobilization and mobility exercises for treatment of Forward head posture Design: Study Design: Parallel Two-Group Randomized Clinical Trial Total sample size: 36 Randomization: Participants will be randomly assigned to either the ELDOA group or the upper thoracic mobilization group using a computer-generated sequence. Settings and conduct: Controlled clinical trial was conducted at GOVT TEACHING HOSPITAL GM ABAD, Faislabad. Participants/Inclusion and exclusion criteria: Inclusion Criteria: Both Gender, Age 20 to 40 years Patients having FHP Patients having CVA less than 50. Pain more than 3 on NPRS scale with FHP Exclusion Criteria: History of whiplash injury within 3 months of examination. History of tumor History of surgery of cervical or thoracic spine. Positive neurological signs Congenital deformity Intervention groups: Parallel Two-Group Randomized Controlled Trial, Group A received ELDOA exercise. firstly hot pack was applied for 7-8 mins after that participants was explained specific body movements . Four ELDOA position shows to the participants was asked to make these positions and maintained each position for 1 min. .Group B received upper thoracic mobilization and mobility exercise. Main outcome variables: primary outcome measure : Craniovertebral angle Secondary outcome measure: NDI NPRS Cervical range of motions

Study aim: To compare the effectiveness of dexmedetomidine plus propofol infusion versus intravenous xylocaine (lidocaine) plus propofol infusion in preventing intraoperative awareness among patients undergoing elective coronary artery bypass grafting (CABG) under general anesthesia. Design: RCT Settings and conduct: National hospital lahore Participants/Inclusion and exclusion criteria: Patients aged 30–75 years, of either gender. Scheduled for elective isolated CABG under general anesthesia. ASA physical status III–IV. LVEF ≥35%. Able to provide written informed consent and complete the Modified Brice Interview postoperatively. Exclusion Criteria Emergency or combined cardiac surgery, or previous cardiac surgery. Allergy or contraindication to dexmedetomidine, propofol, or lidocaine. Neurological or psychiatric disorders affecting awareness assessment. Chronic use of sedatives, opioids, alcohol, or recreational drugs. Severe hepatic or renal disease, significant heart block/bradycardia, or need for preoperative mechanical circulatory/ventilatory support. Inability to complete postoperative interviews, or pregnancy/lactation. Intervention groups: Patients in the intervention group will receive dexmedetomidine (1 µg/kg loading dose over 10 minutes, followed by 0.2–0.7 µg/kg/hour infusion) along with propofol infusion for maintenance of anesthesia during elective CABG. Propofol will be titrated according to the institutional anesthesia protocol to maintain an adequate depth of anesthesia. Standard intraoperative monitoring and anesthetic management will be the same for both groups. Main outcome variables: Primary Outcome Variable Intraoperative awareness, assessed using the Modified Brice Interview at 24 and 72 hours after surgery.

Study aim: This study will be conducted with an aim of comparing the effects of Rood (Inhibitory) approach and Bobath (Reflex Inhibiting pattern) to reduce spasticity and improve Gross motor Functional Movements in Hemiplegic Children of Encephalitis. Design: Randomized clinical design Settings and conduct: 1)children hospital faisalabad 2)Gernal hospital Ghulam Muhammada bad faisalbad Participants/Inclusion and exclusion criteria: N=22 (through epitool, sample size to estimate a simple proportion, apparent prevalence) Patients who agree to give consent will be screened according to set inclusion and exclusion criteria. Patients who meet the eligibility criteria will be enrolled in the study. Patients recruited in the study will be randomly allocated into treatment A (n=11) and treatment B (n=11) groups. Inclusion Criteria: 1. Both gender 2. Hemiplegic Spastic Encephalitis Children 3. Age should be between 2 year to 15 years 4. Spasticity of grade 1 to 3 through Modified Ashworth Scale 5. Chronic Encephalitis children 6. Written Informed Consent. Exclusion Criteria: 1. Spasticity because of any other disease e.g. CP and stroke etc 2. Children having fits and tremors and any red flag sign 3. Children taking any other physical therapy treatment during this study 4. Severe Mental Retardation, Contractures, Decrease Tone 5. Tumor, fractures and any other severe infections 6. Red flag signs that may indicate cauda equina syndrome, such as bladder and bowel Dysfunction and saddle anesthesia 7. History of spinal surgery Intervention groups: Group 1:Rood inhibitory approach Group 2:Bobath reflex inhibiting pattern Main outcome variables: Primary outcome measures:Gross Motor functional scale Secondary outcome measures:Modified Ashworth scale

Study aim: Purpose of this study was to investigate the effectiveness of Ergon technique with neuromuscular electrical stimulation (NMES) on pain and functional mobility in patients with chronic low back pain (CLBP). Design: Two-center, parallel group, concealed, double blind, randomized controlled trial of 50 participants. Settings and conduct: 1) Physical Therapy Department, University of Lahore Teaching Hospital. 2) University Physical Therapy and Rehabilitation Clinic, University of Lahore. Participant, and outcome assessor blinded. Participants/Inclusion and exclusion criteria: Both adult males and females; 18 - 60 years of age diagnosed with chronic low back pain (CLBP) duration 3 months or greater and BMI less than 30 were included. Participants were excluded if they have positive nerve root tension signs or neurological deficit. Suffered from any spinal tumor or infection, spinal fracture. Contraindications to Ergon technique and NMES (e.g. skin allergy/wound). Previous experience with myofascial therapy or a history of rehabilitation treatment for back pain within the preceding 1 month. Intervention groups: In group 1 Progression of Ergon Technique from basic to advance using multiple strokes on lower back especially paraspinal muscles, multifidus and transverse abdominis(TrA) for a duration of minimum 10 mins as per patient requirement. The NMES electrodes were placed on multifidus and TrA for 20 mins. Same protocol of physical therapy as in group 2 except for TENS because of NMES protocol. In group 2 Lumbar mobility, stabilisation and strengthening exercises, aerobic exercises, hams stretching, Hot pack, TENS (20 mins) (Continuous mode) The treatment was provided for 1 hour, 3 days per week on alternate basis, for 4 weeks (12 sessions). Main outcome variables: Modified oswestry disability questionnaire was used to assess functional mobility. Numeric pain rating scale was used for pain.

Study aim: To determine the effects of Total motion release in patients with lumbar radiculopathy functional Design: This two arm parallel randomized trial with a sample size of 68 participants, will feature blinded assessors to evaluate outcomes related to quality of life , pain and functional disability outcome will assess Settings and conduct: Data will be collected from Physiotherapy department in University of Lahore teaching hospital. This will be single blinded study where assessor will remain unaware of participants belong to which groups but aware of measuring outcomes. Participants/Inclusion and exclusion criteria: Inclusion Criteria • Aged between 18-50 years • Both Male and females • Patients referred from orthopedic • Patients with positive SLR test • Having at least 5 score of Numeric Pain Rating Scale Exclusion Criteria • Patients with neurological symptoms (such as cognitive) • Patients with inflammatory disorders (rheumatoid arthritis) • Patients with specific disorders of spine (ankylosing spondylitis, severe osteoporosis, sacroiliac joint pathology) • Patients with previous spinal surgery • Current pregnancy or early postpartum period (6 months) Intervention groups: All the screened and willing participants will be randomly allocated to two groups where Group A will receive Total motion release. This technique will be given to unaffected side thus relieving symptoms of affected side with 5 reps & 10 times. It is very simple technique in which patient is made to perform five motion they are: 1) Arm raise 2) Trunk twist 3) Leg raise 4) Sit to stand and 5) Toe reach. And group B will receive conventional Therapy. The nerve sliding technique will be applied for 20-30 repetitions in 2-3 sets per day, and the nerve tensioning technique will be implemented in addition for 15-25 seconds in 5-7 repetitions. Main outcome variables: Pain Quality of life Functional disability

Study aim: To compare the effectiveness of functional progressive resistance exercise and eccentric muscle control on muscle strength, dynamic balance, functional ability and muscle tone in children with spastic paraplegia. Design: Parallel group randomized clinical trial and Randomization will be achieved through computer generated random allocation software. Settings and conduct: Syeda Khatoon-e-Jannat Trust Hospital and Special Education Centre, and Tanzeem-al-Lissan It will be assessor who will be blinded about the type of intervention. Treatment will be given by principal investigator. Participants/Inclusion and exclusion criteria: Inclusion criteria: Age: 6-13 years old, Gender: both male and female children, Children who follow the verbal instructions of the therapist, GMFCS between I and III, Male children having BMI range of 13.0-20.8, Female children havingBMI range of 12.7-21.8. Exclusion criteria: Surgical procedures on hamstrings or bilateral lengthening of triceps surae. Fixed deformity of lower limb, Visual or auditory impairments. Intervention groups: Intervention group A: They will receive conventional physical therapy and functional progressive resistance exercises, which consist of sit-to-stand, half-kneeling standing, and side step-up exercises for 1-3 sets of 8–12 repetitions for 30 minutes. Exercises, repetitions, and weight will be gradually increased. Intervention group B: They will receive conventional physical therapy and eccentric muscle control exercises, which consist of stand-to-sit, standing and shifting weight anteriorly, sitting and returning to rock lying, and standing and kicking a large ball exercise for 10 sets, and each exercise will be performed five times for 30-minutes. The treatment duration for both groups will consist of three sessions per week for six weeks. Main outcome variables: Muscle Strength, Dynamic Balance, Functional Ability and Muscle Tone

single-centered trial was conducted in Mega NADRA office in Gujranwala, Pakistan. Participants/Inclusion

,department of Physical therapy ferozpur road Lahore Pakistan. Baseline pre-treatment measurements will be

Study aim: To evaluate the effects of neck acupressure with and without stretching on perceived stress related sub-acute neck pain and to evaluate the effects of neck acupressure on disability, perceived stress and range of motion of the neck. Design: Single blinded, parallel assigned, multi-centred, randomised clinical trial, quantitative study,sample size 48(2 groups each with 24 participants) with perceived stress related sub-acute neck pain assessed by pain and stress,Simple random sampling technique Settings and conduct: This study was conducted at physiotherapy department of Chatha Hospital Jaranwala. The study was completed in 4 months that included,collection and analysis of data. Participants were kept anonymous or conducted in single blind trial Participants/Inclusion and exclusion criteria: Included participants:Middle aged male and female participants,moderate score perceived stress scale score (14 or greater),with neck pain history of >30 days,complain of neck pain > 30mm on VAS,non-radiating neck pain and not undergoing psychiatry treatment ExcludedParticipants:with any diagnosed musculoskeletal disorder,Pregnant females, or participants suffering from cancer,undergone surgery in past 3 months,with neck pain history of chronic,HIV disorders, swelling, skin issues,high blood pressure,any wound or contagious disease at the acupressure points,any neurological disorder,any vascular disorders and any infectious disease were excluded from study. Intervention groups: participants were enrolled into 2 equal treatment groups, Group A (acupressure with stretching group) and Group B (acupressure alone group). Both groups with neck isometrics as baseline treatment Main outcome variables: Primary Outcome Measure The cervical pain was assessed by VAS Secondary Outcome Measure The cervical disability was measured by using the Neck Disability index and the range of motion was measured by goniometer

Study aim: The study investigate the of Comparative effects of roods ontogenic motor patterns and swiss ball stabilization exercises on primitive reflexes in spastic diplegic cerebral palsy children. Design: Randomized Clinical trial , Single Blinded, Parallel group Settings and conduct: The Children Hospital & Institute of child health Faisalabad Participants/Inclusion and exclusion criteria: Children aged 3-10 years with a confirmed diagnosis of spastic diplegia and persistent primitive reflexes (Moro, ATNR, STNR, or Tonic Labyrinthine) are included. They must perform voluntary movements with minimal assistance, be at least 6 months post-surgery, have a stable medical regimen, follow verbal commands, and fall within GMFS levels II-IV and a Modified Ashworth Scale score of 0-2. Parental consent is required. Exclusions include cognitive impairments preventing participation, additional neurological conditions (epilepsy, severe autism), fixed contractures, recent Botox or surgery (within 6 months), uncontrolled seizures, uncooperative behavior, visual, intellectual, or hearing impairments, and other CP types or conditions affecting exercise tolerance. Intervention groups: For Group A, functional electrical stimulation (FES) was applied as a baseline treatment, followed by Rood’s Ontogenic Motor Patterns using inhibitory techniques. In Group B, FES was also administered as the baseline treatment, followed by Swiss ball stabilization exercises. Screening for primitive reflexes was conducted in both groups. Main outcome variables: Primitive Reflexes chart

Study aim: To determine the effects of core strengthening exercises with and without proprioceptive neuromuscular facilitation on balance, coordination and mobility in post stroke hemiplegic patients Design: Two arm parallel group randomised trail with single blinded outcome assessment. Settings and conduct: This study was e a single blinded study in which assessor was kept blinded.Department of Physical Therapy, The university of lahore teaching hospital Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Aged between 40-65 years • Both Male and females • Stroke Onset ≥3 months • Ambulatory with and without aid • Patients with berge balance scale score less than 45 Exclusion Criteria: • Patients with Cardiopulmonary disease • Patients with any type of orthopedic injury • Patients with visual and vestibular dysfunction • Patients who struggle to follow exercise instructions Intervention groups: Two groups of thirty-one stroke patients, ages forty to sixty-five, were chosen at random. Proprioceptive neuromuscular facilitation was applied with core strengthening exercises among Group A and only proprioceptive neuromuscular facilitation were applied among Group B. Main outcome variables: 1.Balance (Berg Balance Scale) 2. Mobility (Barthel Index) 3. Coordination (Trunk Impairment Scale)

Study aim: The study investigate the of Comparative effects of roods ontogenic motor patterns and swiss ball stabilization exercises on trunk control, balance, motor skill and primitive reflexes in spastic diplegic cerebral palsy children. Design: Randomized Clinical trial , Single Blinded, Parallel group Settings and conduct: The Children Hospital & Institute of child health Faisalabad Participants/Inclusion and exclusion 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 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 Group A Functional electrical stimulation before the treatment was done as a baseline treatment. Then, the Roods Ontogenic Motor patterns through inhibitory approaches were applied. Group B 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 Primitive Reflexes

& National hospital and Medical Centre Lahore Pakistan. Participant Blinding Researcher/Healthcare Provider

Study aim: To compare the effects of Carpal Bone mobilization with and without neurodynamic technique in chronic carpal tunnel syndrome patients Design: A randomized, single blinded, clinical trial with a parallel group design of 112 patients (divided into two groups), were selected from Physical therapy department of University of Lahore Teaching Hospital, and followed for six weeks. Settings and conduct: The data will be collected from the University of Lahore Teaching Hospital. The study population will be consisted of patients with carpal tunnel syndrome. Participants will be randomly allocated into two groups Group A (Carpal Bones Mobilization with Neurodynamic technique) and Group B (Carpal Bones Mobilization without Neurodynamic technique). Participants/Inclusion and exclusion criteria: Inclusion criteria will be bth gender who aged between 30-60 years with Positive Tinnel sign and reporting a Numeric Pain Rating Scale score between 4 and 7cm Exclusion Criteria will be patients with systemic pathology (i.e Hypothyroidism) , inflammatory disorder (i.e Rheumatoid arthritis) , Patients with Cervical radiculopathy , Patients with any deformity in hand or wrist , Patients who have undergone carpal tunnel treatment within the past 3 months and Pregnant Intervention groups: Experimental Group A will receive Carpal Bone Mobilization with neurodynamic Technique. The CBMT will be performed in 3 sets with 30 repetitions in each set, keeping a one minute gap between sets. The ND Technique will be performed in 2 sets of 5 minutes each with 1-minute rest between sets. It will be performed three times per week for six weeks consecutively. In Experimental Group B participants will receive Carpal Bone Mobilization without neurodynamic Technique Before apply mobilization routine physical therapy consist of heat therapy for 15 minutes will be applied. Main outcome variables: Pain Functional Status Range of Motion

Study aim: Primary purpose of this research to investigate the effects of the McConnell taping on pain and gait parameters with patello-femoral pain syndrome To investigate the effects of the Kinesio taping on pain and gait parameters with patello-femoral pain syndrome To compare the effects of the Kinesio taping and the McConnell taping on pain and gait parameters with the patello-femoral pain syndrome such pain, activities, gait parameters, and cadence. Design: Randomized clinical trial Settings and conduct: Study 'll be conduct in Allied Hospital, District HQ Hospital, Madinah Teaching Hospital Faisalabad Participants/Inclusion and exclusion criteria: INCLUSION CRITERIA Age 20-40 Persons those are experiencing the knee pain anteriorly Pain at worst once, within the last three months in two or more movements throughout prolonged squatting, sitting, stair climbing, kneeling, running, and jumping Unilateral(one sided) PFPS BMI 20 to 32 kg Patellar apprehension test EXCLUSION CRITERIA History of subluxation moreover dislocation of the patella Surgery of Lower extremity (LE) within the last year Due to damage of neurological damage, Sensory or motor paralysis On anterior knee pain scale, score of 80 or high Meniscal injury Osteoarthritis of Knee joint old fractures in the knee region with or without internal fixation tendon pathology of patella Any deformities of lower limb Pain is referred from the area of spine Intervention groups: Both group MT group and KT group will receive McConnell taping & Kinesio taping with baseline treatment stretching, strengthening as well as patellar mobilizatio Main outcome variables: pan, activities, gait parameters and cadence

Study aim: To compare the effects of active and positional release technique on pain, range of motion and functional disability in cervicogenic headache patient. Design: Two arm parallel group randomized trial with blinded 4th week follow up and outcome assessment with sample size of 68 Settings and conduct: Tehsil Head Quarter hospital Shakargarh Participants/Inclusion and exclusion criteria: Inclusion Criteria: • Aged between 20-50 years • Both Male and females • Individuals diagnosed with neck pain accompanied by cervicogenic headaches • Patients experiencing unilateral pain due to cervicogenic headaches • Individuals suffering from cervicogenic headaches characterized by restricted cervical range of motion Exclusion Criteria: • History of tension type headache • History of trauma to the cervical • History of Vertebrobasilar insufficiency • History of Malignancy in the cervical area • History of operative procedure done in the cervical region Intervention groups: Participants will be randomly allocated into two groups (Group A: Active Release Technique, Group B: Positional release technique). The participants of group A will be given instructions on how to carry out each exercise properly, by the Kibler squeeze to perform active release technique. The participants randomly allocated in Group B will be received the Positional release technique. in side-lying position on unaffected side. Create a score of 10 by lightly pinching or squeezing the point. Then, try changing the subject's arm posture by raising it over their heads to relax the Sternocleidomastoid muscle that are tracing, or by bending their necks so they are facing the uncomfortable side while lying on a thick cushion. For 90 seconds, this position will be retained. The subject will be returned to its original position after being released. Main outcome variables: Pain؛ Function؛ Range of Motion

will be conducted across four major maternity hospitals in Karachi, Pakistan, namely Jinnah Post

Study aim: This study aim to determine the combined effect of Active cycle Breathing Technique with Respiratory Muscle Stretching on dyspnea related kinesiophobia in patients with Chronic Obstructive Pulmonary Disease Design: The design of this study is Randomized, parallel Clinical Trial. Randomization is done by lottery method. In this method, the researcher gives each participant of the trial a number. Researchers draw numbers from the box randomly to allocate participants in two groups Settings and conduct: This study is conducted at Arif memorial teaching hospital and Gulab Devi Chest Hospital. In this trial participants are blinded through concealment to avoid biasness Participants/Inclusion and exclusion criteria: Inclusion criteria: Patients diagnosed with moderate-to-severe COPD clinical stability (no changes in medication during the last month), no supplemental O2 dependence Exclusion criteria: Presence of comorbidities affecting ambulation/activity (e.g., severe cardiac or neurological disorders, cancer, musculoskeletal problems) history of cognitive disorders Intervention groups: Group A: Active Cycle Breathing Exercise Group B: Active Cycle Breathing Exercise + Respiratory Stretching Exercise (Pectoralis Major, Pectoralis Minor, Upper Trapezius, Scalene, Sternocleidomastoid, Intercostal and anterior serratus) Main outcome variables: • Tampa Scale (Kinesiophobia) To evaluate kinesiophobia, the Tampa Scale (Kinesiophobia) is used, which consist of 17 items rated on a 4-point Likert scale: “strongly disagree (1 point),” “disagree (2 points),” “agree (3 points),” and “strongly agree (4 points).” For questions 4, 8, 12, and 16, the scores are reversed. Total scores range from 17 to 68 points, with higher scores indicating a stronger degree of Kinesiophobia. TSK’s internal consistency, retest reliability, and validity have already been confirmed.

Study aim: -To determine role of both treatment techniques to improve Global Functional Performance. -To determine the comparative balance improvement among the participants of both groups. -To determine the efficacy of the treatment techniques to improve functions of both upper and lower limb. Secondary Objective: -To assess the “Quality of Life” among participants of both groups. Design: Randomized Control Trial (RCT) Double blind study. Study groups: U-LIFT and HABIT-ILE . Phase: N.A Sample size:30, Randomization: Simple random sampling technique is used by sealed envelop method. The study is double blinded as participants/caregivers and outcome assessors are blinded. Study center: Multi study centers. Settings and conduct: The Children Complex Multan and CMH, Multan. All caregivers will be informed about the study and will sign written informed consent before interventions. Simple random sampling technique will be used by sealed envelop method. Study is double blinded as participants/caregivers and outcome assessors are blinded. Participants/Inclusion and exclusion criteria: Inclusion Criteria: •Diagnosed hemiplegic Cerebral Palsy •Age 5-18 •Gross Motor Function Classification System score II-III • Manual Ability Classification System score II-IV •Ability to follow any 2-step instruction. Exclusion Criteria: •Cognitive Delay •Modified Ashworth score greater than 3 •Uncontrolled epilepsy •Any recent orthopedic surgery •Botulinum toxin injections within last 6 months •Visual or auditory impairments •Open wounds Intervention groups: There are 2 interventional groups; Group A and B. Group A :Upper-Lower Extremity Functional Training (U-LIFT) group; Group B: Hand-Arm Bimanual Intensive Training- Including Lower Extremities (HABIT-ILE) group. Main outcome variables: • ACTIVLIM-CP (Activity Limitations for Patients with Cerebral Palsy) • 1-Min Walk test • Pediatric Balance Scale • The Box and Block Test .

Study aim: My study aim is to assess the effectiveness of Graston technique with taping on the treatment of chronic plantar heel pain, foot function and foot health related quality of life of chronic plantar fasciitis patients. Design: Randomized, parallel groups, single blinded, randomized controlled trial Settings and conduct: Medina Teaching Hospital, participants will be blinded so that they can not know either they will be in intervention group or in control group Participants/Inclusion and exclusion criteria: Inclusion criteria  Patients will be diagnose with chronic plantar fasciitis and Pain started before more than 6 weeks and less than 6 months  Both gender age of 20 to 45 years were included  Pain on first steps of walking out of bed in the morning or after prolonged standing, or sitting  Pain located at the anterio- medial surface of heel or mid-foot and presence of an everted calcaneus greater than or equal to 2 Exclusion criteria No Previous history of severe vascular disease, cancer, joint disease, neurological disorders related to lower limb of affected side and pathological calcaneal spur  Ankle and foot fracture or surgery before 6 months and stress fracture before 8 months  Plantar having fascia release surgery done within 3 month back  Diabetics and altered skin sensation or foot dermal conditions  Who are already taking physical therapy treatment or any other treatment during 30 days of participation  Pregnant female  Who refuse to participate in the study Intervention groups: There will be one treatment group and one control group. 30 participants will include by randomization into treatment group and control group. 15 individuals will include into the treatment group which will GT group, 15 individuals will include into the control group which will control group randomly. Main outcome variables: plantar heel pain, Foot function and General foot health

Study aim: To explore effects of proprioceptive neuromuscular facilitation in addition to routine physical therapy on pain, range of motion and postural alignment in patients with temporomandibular joint disorders. Design: Parallel, 58 Sample size, Randomized Controlled Trial, single blinded Settings and conduct: Trial will be conducted in Physiotherapy department of Punjab Social Security Health Management Company Hospital. Assessor will be completely blind about outcomes. Participants/Inclusion and exclusion criteria: Inclusion criteria: Age 20-50 year individuals, Having temporomandibular joint disorders with abnormal neck alignment, Pre-diagnosed patients referred by dentist and orthotics. Exclusion criteria: Systemic or local pathology like infectious or vascular disease of orofacial region Patient using another form of treatment for temporomandibular disorders Patient using functional appliances H/o frequent open dislocation Cervical radiculopathies Rheumatoid arthritis Osteoarthritis of temporomandibular joint peripheral nerve injury Intervention groups: Group A (control) will follow routine physiotherapy (icing\ ultrasound\TENS and stretching\strengthening) and group B (intervention) will follow proprioceptive neuromuscular facilitation(PNF) program with routine physiotherapy. Both groups will follow 3 sessions per week for 4 weeks and home exercises for 2 weeks. Pain, Range of motion and Postural assessment will be conducted on 1st, 6th and 12th week.The PNF program will compose of a total of 8 therapeutic exercises. Contract relax, Combination of isotonic, Stabilizing reversals, and Rhythmic stabilization techniques will be used for elongation of upper cervical extensors, strengthening of infra-hyoid muscles, Increase stability and mobility of mandible in corrected posture of neck. Main outcome variables: Pain , Range of motion, Impairment of body structure and body function test.