Clinical trials

This randomized controlled trial aims to compare the effects of clinical-based rehabilitation and synchronized telerehabilitation on pain, exercise adherence, and functional disability in patients with Grade-II cervical spondylosis. A total of 52 participants will be randomly allocated into two parallel groups. Both groups will receive a standardized 6-week rehabilitation program, including cervical mobility exercises, strengthening, isometric exercises, stretching, and Mulligan self-mobilization techniques. The clinical group will receive in-person physiotherapy, while the telerehabilitation group will undergo real-time supervised sessions via video conferencing. Outcome measures will include pain (Numeric Pain Rating Scale), functional disability (Neck Disability Index), and exercise adherence (Exercise Adherence Rating Scale), assessed at baseline and post-intervention. The study aims to determine whether synchronized telerehabilitation is as effective as clinical-based rehabilitation and may provide a more accessible alternative for delivering physiotherapy care.

This randomized clinical trial aims to compare the effects of Blood Flow Restriction Training (BFR) and Instrument-Assisted Soft Tissue Mobilization (IASTM) on pain, quadriceps muscle strength, knee range of motion (ROM), and kinesiophobia in patients following anterior cruciate ligament reconstruction (ACLR). ACLR patients commonly experience persistent muscle weakness, limited ROM, pain, and fear of movement, which can delay functional recovery and return to activity. A total of 46 participants (8-16 weeks post-ACLR) will be randomly allocated into two groups: a BFR group and an IASTM group. Both groups will receive interventions twice weekly for 8 weeks alongside standard physiotherapy. The BFR group will perform low-load resistance exercises under controlled vascular occlusion, while the IASTM group will receive soft tissue mobilization using specialized instruments combined with conventional rehabilitation. Outcome measures will include quadriceps strength (handheld dynamometer), pain (Numeric Pain Rating Scale), knee ROM (goniometer), and kinesiophobia (Tampa Scale of Kinesiophobia), assessed at baseline and post-intervention. The study aims to determine which intervention provides superior improvements in physical and psychological outcomes during early rehabilitation after ACL reconstruction.

Chronic non-specific neck pain is a common musculoskeletal condition affecting a large proportion of the population worldwide. It is characterized by persistent neck pain lasting more than three months without a specific underlying pathology. Many patients experience ongoing symptoms such as pain, reduced range of motion, functional limitations, and psychological factors like kinesiophobia, which can negatively affect recovery and quality of life. Conventional physiotherapy, including supervised clinic-based rehabilitation, is widely used for the management of chronic non-specific neck pain. These programs typically involve exercise therapy and patient education; however, access to regular in-clinic treatment can be limited due to factors such as travel, cost, and time constraints. Telerehabilitation has emerged as an alternative approach that allows delivery of physiotherapy services through online platforms, improving accessibility and convenience for patients. In addition, pain neuroscience education (PNE) is an evidence-based strategy that helps patients understand pain mechanisms, reduce fear-avoidance behaviors, and improve treatment outcomes when combined with exercise therapy. Although both telerehabilitation and supervised clinic-based rehabilitation are effective, there is limited evidence directly comparing these two approaches when combined with standardized pain neuroscience education. Therefore, this randomized controlled trial aims to compare the effects of telerehabilitation with pain neuroscience education and supervised clinic-based rehabilitation with pain neuroscience education on pain intensity, functional disability, and kinesiophobia in individuals with chronic non-specific neck pain.

The aim of the study is to compare Back School Based Intervention with Cranio- Cervical muscle training in participants with Cervicogenic headache. The study wants to investigate that which intervention helps to mange pain, improve posture and reduce disability. The study aims to answer the question: * How effective is Back School Based intervention on pain, posture and disability in computer users with Cervicogenic headache compared to Cranio-cervical Muscle Training? Participants will * Attend the treatment sessions of the group in which they are placed. * Take treatment session two times a week for eight weeks. * Participants will be asked about their pain and activities throughout the study.

This study has important clinical, academic, and practical relevance in neuromuscular rehabilitation. Clinically, it aims to identify effective and tolerable rehabilitation strategies for individuals with Parkinson's disease by comparing Tai Chi Therapy with Qi-Gong there by supporting evidence-based physiotherapy practice and improving patient adherence. Academically, it contributes to the limited literature on comparative effectiveness of these interventions and incorporates patient-centered outcomes such as exercise perception, which are often underreported. From a practical and societal perspective, identifying a more acceptable and effective approach may enhance long-term participation in rehabilitation, potentially slow disease progression, and reduce the overall healthcare burden associated with Parkinson's disease.

This study focuses on patients diagnosed with Grade II hip osteoarthritis, a degenerative joint condition characterized by pain, reduced range of motion, muscle weakness, and functional limitations. Hip osteoarthritis is commonly assessed using the Kellgren-Lawrence (KL) classification system, with Grade II representing definite osteophyte formation with possible joint space narrowing, where conservative management is strongly recommended. Exercise therapy, particularly strengthening of the hip abductor muscles, plays a key role in improving pelvic stability, reducing pain, and enhancing functional outcomes. Clamshell exercises are widely used to activate the gluteus medius and minimus muscles, while modified clamshell exercises are designed to optimize muscle recruitment and reduce compensatory movements. A total of 54 participants with Grade II hip osteoarthritis will be included in the study and allocated into three groups. Group A will receive clamshell exercises along with conventional exercise therapy, Group B will receive modified clamshell exercises in addition to conventional exercise therapy, and Group C will receive a conventional exercise program alone. Pain intensity will be assessed using the Visual Analog Scale (VAS), which ranges from 0 to 10. Hip joint range of motion will be measured using a goniometer, and functional outcomes will be evaluated using the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12). The aim of this study is to compare the effects of clamshell exercises, modified clamshell exercises, and conventional exercise programs to determine the most effective intervention for reducing pain, improving hip joint range of motion, and enhancing functional outcomes in patients with Grade II hip osteoarthritis.

Stroke is a clinically delineated syndrome, which is characterised by an acute, focal neurological deficit resulting from vascular injury (infarction or haemorrhage) within the central nervous system. Notably, around 80 percent of stroke survivors experience post-stroke deficits in upper extremity (UE) motor performance, impacting grip strength, dexterity, and functional independence, which greatly hinder the ability of stroke patients to carry out activities of daily living (ADL), and in turn affects their overall quality of life (QOL).One potential solution to these difficulties is the creation of rehabilitation robotic devices that incorporate hand technology and electrical stimulation. Although soft robotic assistive devices and electrical stimulation have each shown positive effects on motor recovery, their combined use has yet to be thoroughly investigated. This study intends to determine if the simultaneous application of these therapies can speed up rehabilitation results in comparison to independent therapies. Stroke Participants will be divided into two groups, Experimental group and Control group. Both the groups will receive intervention for 40 min/day, 03 days/week, for 08 week and measurements will be taken prior to the treatment, after 4 weeks of treatment and 8 weeks post-treatment.

Cerebral palsy (CP), particularly the spastic diplegic subtype, is characterized by motor impairments such as spasticity and mobility limitations. In addition to motor dysfunction, children with CP often experience cognitive impairments affecting decision-making, problem-solving, working memory, selective attention, and inhibitory control. These non-motor challenges contribute to reduced social interaction and quality of life. Hand-Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) has demonstrated improvements in gross motor function among children with spastic CP. However, evidence regarding its impact on cognitive outcomes remains limited. This randomized controlled trial (RCT) aims to evaluate the effects of HABIT-ILE compared with conventional therapy on both motor and cognitive functions in children with spastic diplegic CP. By addressing both upper and lower limb the research seeks to provide a comprehensive therapeutic approach that may yield more significant developmental benefits. Ultimately, the findings could inform the interventions for improving outcomes in pediatric populations affected by diplegic cerebral palsy. Participants will receive 90 hours of intervention, with assessments conducted at baseline, mid-intervention, and post-intervention. The study will investigate outcomes across motor domains and cognitive functions such as inhibitory control and working memory. Findings are expected to inform comprehensive therapeutic approaches to improve developmental outcomes and quality of life in pediatric populations affected by spastic diplegic CP.

This study aims to determine whether transcutaneous vagus nerve stimulation (tVNS) via auricular or cervical branches enhances recovery when combined with task-specific training in subacute stroke patients. We anticipate finding that both stimulation methods may improve upper limb motor function compared to conventional therapy. The research is expected to reveal specific cognitive domains (attention, memory, executive function) that benefit most from each stimulation approach, while also demonstrating meaningful improvements in patients' quality of life measures. These findings may make a significant practical contribution by providing clinicians with evidence-based guidance on suitable tVNS approach for improving functional independence and quality of life for stroke survivors.

This study is a single-blind, two-arm parallel-group randomized controlled trial designed to evaluate the effects of core stabilization exercises combined with rotational angular breathing exercises on adolescents with idiopathic scoliosis. Participants aged 10-18 years with a Cobb angle between 10° and 25° will be randomly assigned to either an experimental group receiving a structured exercise program or a control group receiving standard care. The intervention will be conducted over 12 weeks, with outcomes assessed at baseline, post-intervention, and follow-up periods. Primary outcomes include Cobb angle, angle of trunk rotation, inspiratory capacity, and spinal appearance. The study aims to determine whether the combined exercise approach is more effective than standard care in improving spinal alignment, respiratory function, and physical appearance.

The current study is a single-blind, parallel-group randomized controlled trial involving 108 participants with diabetes during pregnancy. The trial will compare leg ergometer with arm ergometer. Interventions will be delivered three times per week for eight weeks. The primary outcomes are glucose, exercise tolerance, weight, and psychological stress. Assessments will be conducted at baseline and after eight weeks. The trial will be carried out at Jinnah hospital, Services hospital, Sir Ganga Ram Hospital, Lahore. The hypothesis is that the leg ergometer including aerobic exercise will result in greater reduction in glucose and exercise tolerance, weight and stress management than arm ergometer.

Total knee arthroplasty (TKA) is a commonly performed procedure for advanced knee osteoarthritis. Despite successful surgery, many patients experience postoperative impairments including pain, reduced range of motion (ROM), swelling, impaired proprioception, and kinesiophobia, which may delay functional recovery. Conventional physiotherapy is the standard rehabilitation approach following TKA; however, high-load strengthening exercises are often limited in the early postoperative phase due to pain and reduced tolerance. Blood flow restriction (BFR) exercise is an emerging rehabilitation technique that enables low-load exercise to produce strength adaptations similar to high-intensity training. While evidence supports its effectiveness for improving muscle strength, its effects on other outcomes such as pain, swelling, proprioception, and kinesiophobia are not well established. This randomized controlled trial will compare progressive BFR exercise combined with conventional physiotherapy versus conventional physiotherapy alone in patients following unilateral TKA. A total of 48 participants will be randomly allocated to two groups. The intervention will be delivered over 6 weeks with supervised sessions conducted three times per week. Outcomes will include pain, knee ROM, swelling, proprioception, kinesiophobia, and functional performance. This study aims to determine whether BFR exercise provides additional benefits in postoperative rehabilitation following TKA.

The current study is a single-blinded, parallel-group pilot randomized controlled trial involving 20 participants diagnosed with knee osteoarthritis (KOA). The trial will compare the effects of a knee and heel off-loader brace combined with non-weight bearing (NWB) strength training versus a conventional knee off-loader brace combined with NWB strength training. Interventions will be delivered three times per week for four weeks. The primary outcome of the study is pain intensity, while secondary outcomes include gait variability and functional outcome. Assessments will be conducted at baseline and after completion of the intervention period. The study will be carried out at the outpatient physiotherapy departments of Kaazi Hospital and Ghurki Trust Hospital, Lahore. The hypothesis is that the combination of knee and heel off-loader brace with NWB strength training will result in greater reductions in pain, improved gait variability, and enhanced functional outcomes compared to the conventional knee off-loader brace with NWB strength training.

Sacroiliac joint dysfunction (SIJD) is a frequent source of low back and pelvic pain and contributes significantly to movement restriction, altered gait patterns, and functional disability in adults. It is associated with impaired lumbopelvic motor control, weakness of key stabilizing muscles, and faulty load transfer across the pelvis. SIJD is prevalent in both physically active individuals and sedentary populations. In addition to its clinical impact, SIJD imposes a considerable socioeconomic burden due to reduced work productivity and long-term disability. Contemporary management of SIJD emphasises on pain reduction, restoration of movement, functional independence, and participation in daily activities. Manual therapy techniques such as Mulligan's Mobilization with Movement (MWM) are widely used to correct positional faults and restore pain-free movement, while kinetic control training targets deficits in motor control of the lumbopelvic stabilizing muscles. Although both approaches are individually supported in the literature, evidence regarding their combined effectiveness on pain, range of motion, gait parameters, and functional disability remains limited. Therefore, this study aims to compare the effects of combined Mulligan's Mobilization with Movement and kinetic control training versus kinetic control training alone in patients with sacroiliac joint dysfunction using validated outcome measures.

The current study is a single-blind, parallel-group randomized controlled trial involving 18 participants with knee osteoarthritis. The trial will compare a program of two-bar knee off-load brace combined with non-weight bearing strength training with a program of standard knee off-loader brace combined with non-weight bearing strength training. Interventions will be delivered three times per week for six weeks. The primary outcomes are pain, stiffness, and patient satisfaction. Assessments will be conducted at baseline and after six weeks. The trial will be carried out at Water and Power Development Authority Hospital Complex and Fatima Memorial Hospital, Lahore. The hypothesis is that the two-bar knee off-load brace combined with non-weight bearing strength training will result in greater reductions in pain and stiffness as well as improved patient satisfaction compared with the standard knee off-loader brace with non-weight bearing strength training.

The current study is a single-blinded, two-arm parallel-group randomized controlled trial involving 62 participants with non-specific neck pain among computer users. The trial aims to compare the effects of tele-rehabilitation and supervised rehabilitation on neck pain, disability, and exercise adherence. Both groups will receive the same structured exercise program along with postural correction instructions. The tele-rehabilitation group will perform exercises remotely with digital guidance, reminders, and follow-ups, while the supervised group will receive in-clinic physiotherapy sessions under professional supervision. Interventions will be carried out three times per week for a duration of six weeks, with each session lasting approximately 40 minutes. Outcome measures will include neck pain (VAS), neck disability (NDI), and exercise adherence (ATEMPT tool).Assessments will be conducted at baseline and at the end of treatment at 8th week.The study will be conducted at the Physical Therapy Department of Sehat Medical Complex Lake City, and the University of Lahore Teaching Hospital. The hypothesis is that tele-rehabilitation will be more effective than supervised rehabilitation in reducing neck pain and disability, and may result in better exercise adherence due to its convenience and accessibility.

This research compares two rehabilitation strategies for people with sacroiliac joint dysfunction (SIJD): Dynamic Neuromuscular Stabilization (DNS) and Core Stability Exercises (CSE). SIJD is presented as a biomechanical source of low-back, buttock and leg pain caused by altered joint mechanics, muscle control problems, or asymmetric pelvic alignment; diagnosis relies on clinical provocation tests and exclusion of other causes. The study aims to determine which of the two exercise-based approaches better reduces pain and improves lumbopelvic control. The trial is a single-blinded, parallel randomized controlled trial conducted in an outpatient physiotherapy setting with supervised sessions over four weeks. Adults aged 20-50 with at least three positive SIJ provocation tests and moderate, chronic pain were included; important exclusions were prior spinal/pelvic surgery, systemic inflammatory disease, pregnancy, cardiopulmonary limitation or poor session attendance. Each participant received a baseline conventional physiotherapy package; one arm received a DNS program (breathing-based and developmental movement patterns) and the other performed progressive core-stability training emphasizing transversus abdominis and multifidus activation. Primary outcomes are pain (Numeric Pain Rating Scale) and lumbopelvic stability measured with a pressure biofeedback unit (PBU). Data were collected at baseline and after four weeks; the analysis plan uses SPSS with paired and independent t-tests, ANCOVA to adjust for baseline differences, and effect sizes/confidence intervals to interpret clinical relevance. Safety, informed consent, assessor blinding and standard ethical safeguards are described. The synopsis notes a gap in direct RCT evidence comparing DNS and CSE for SIJD and positions this trial to address that gap with clinical and mechanistic outcomes.

Cerebral Palsy is a non-progressive condition caused by early brain injury that affects movement, posture, and muscle tone. Spastic diplegia mainly involves the lower limbs, leading to stiffness, weakness, and abnormal gait patterns. These impairments reduce functional independence and increase caregiver burden. Loaded Treadmill Training and Task Specific Training are two rehabilitation approaches used to improve strength and Gait function. This study compares their effectiveness in improving gait and functional mobility in children with spastic diplegic CP.

Chronic non-specific low back pain (NSLBP) is a highly prevalent musculoskeletal condition and a leading cause of disability worldwide. Psychological factors such as fear-avoidance beliefs and kinesiophobia significantly contribute to pain chronicity, reduced physical activity, and functional limitations. Pain Neuroscience Education (PNE) is a biopsychosocial educational approach designed to reconceptualize pain as a protective output of the nervous system rather than solely a marker of tissue damage. This randomized controlled trial aims to determine the effect of Pain Neuroscience Education combined with Core Stabilization Exercises on pain intensity and kinesiophobia in patients with chronic non-specific low back pain. A total of 62 participants aged 20-55 years with mechanical low back pain lasting ≥3 months will be randomly allocated into two groups: (1) Core Stabilization Exercises plus PNE (experimental group) and (2) Core Stabilization Exercises alone (control group). The intervention duration will be four weeks, with three sessions per week. Primary outcomes include pain intensity measured by the Numeric Pain Rating Scale (NPRS) and kinesiophobia measured using the Fear-Avoidance Beliefs Questionnaire (FABQ). Assessments will be conducted at baseline and post-intervention. The study hypothesizes that the addition of PNE will produce greater reductions in fear-avoidance beliefs and pain intensity compared to exercise therapy alone.

The goal of the current study is to evaluate the plyometrics and resistance band training in recreational football players, aged 18-25 years. The main question it aims to answer are: Does the plyometrics significantly improve agility and reduce Rate of Perceived Exertion (RPE)? Does the resistance band training significantly improve agility and reduce RPE? Participants will be assigned to either an experimental group receiving plyometrics or arm comparator group receiving resistance band training, and will complete standardized assessment of agility and RPE before and after the intervention.

This study aims to evaluate the effectiveness of two rehabilitation techniques- Functional Electrical Stimulation (FES) and Mirror Therapy (MT)-in improving motor recovery among stroke survivors. Stroke often results in long-term impairments, particularly in foot clearance, which is critical for daily activities. Although current rehabilitation strategies help, more effective solutions are needed to enhance recovery. Participants, aged 18- 85 years old with subacute stroke and foot clearance impairments, will be randomized into two groups: Group A will receive functional electrical stimulation (FES) with routine physical therapy; and Group B will receive mirror therapy (MT) with routine physical therapy. The interventions will take place three times a week for 4 weeks, and participants will undergo motor function assessments, including the Fugl-Meyer Assessment and Functional Independence Measure, before and after the intervention. The study will compare the effects of each intervention on motor recovery, specifically focusing on tibialis anterior function and motor control. The findings could lead to improved rehabilitation protocols, offering stroke survivors better therapeutic options and enhancing their quality of life.

This randomized controlled trial with a parallel design was conducted over six months at Ghurki Trust Teaching Hospital to compare the effects of Vestibular Rehabilitation and Routine Physical Therapy on stability, kinesiophobia, and return to sports in athletes with post-concussion syndrome. A total of 34 participants aged 12 to 30 years were enrolled based on specific diagnostic criteria. Non probability convenient sampling was used, followed by random allocation into experimental and control groups through computer generated sequencing and sealed envelope concealment. Single blinding was done, with participants unaware of their assigned intervention. The experimental group received a Vestibular Rehabilitation program consisting of balance training, habituation exercises, and gaze stabilization, while the control group underwent Routine Physical Therapy involving ankle strategies and elliptical training. Both interventions were administered for 30 minutes, three times per week, over four weeks. Outcomes were measured pre- and post-intervention using validated tools: the Balance Error Scoring System (BESS) for postural stability, the Urdu version of the Tampa Scale of Kinesiophobia (TSK), and the Injury Psychological Readiness to Return to Sport Scale (I-PRRS). Data analysis was performed using SPSS version 26, employing appropriate parametric or non-parametric tests based on normality, with significance set at p \< 0.05. Ethical approval was obtained, informed consent was secured, and all procedures adhered to established ethical standards.

The goal of this clinical trial is to determine whether two manual therapy techniques-Integrated Neuromuscular Inhibition Technique (INIT) and Active Release Technique (ART)-can reduce pain, improve neck range of motion, and decrease functional disability in adults with upper trapezius myofascial trigger points. The main questions it aims to answer are: Does INIT reduce pain, improve ROM, and reduce functional disability more effectively than ART? Does ART provide similar or different treatment benefits compared to INIT? Researchers will compare INIT with ART to see which technique produces greater improvements in pain, ROM, and functional disability. Participants will: Receive treatment sessions of either INIT or ART. Undergo assessment of pain, cervical range of motion, and functional disability before and after the intervention.

Parkinson's Disease is a chronic neurodegenerative disorder marked by the progressive loss of dopaminergic neurons in the substantia nigra and accumulation of α-synuclein (Lewy bodies).It impacts both motor and non-motor systems, with growing global prevalence-affecting 7-10 million people, mostly men over 60 years-due to increasing life expectancy and demographic shifts. PD shows motor symptoms like tremors and bradykinesia, along with non-motor issues like depression, REM sleep disorder, and cognitive decline. Diagnosis is often delayed due to subtle early signs like constipation or shoulder pain and atypical cases lacking classical tremors. VR offers immersive, task-specific therapy that enhances motor learning and neuroplasticity in a safe, engaging environment. By integrating sensory feedback and real-time motion tracking, VR reduces tremors, promotes cortical reorganization (notably in the sensorimotor cortex and cerebellum), and increases rehabilitation motivation through gamified experiences. PNF is a hands-on therapy using tactile, auditory, and proprioceptive cues to improve coordination, strength, and movement patterns. Especially useful in Parkinson's rehabilitation, PNF targets rigidity, bradykinesia, tremors, and postural instability by reinforcing neuromuscular coordination and improving movement execution in functional, diagonal planes. Sensorimotor control is the dynamic integration of sensory input, motor planning, and execution, which becomes disrupted in PD due to impaired proprioception and feedback loops. Patients rely excessively on visual feedback, making movement effortful, highlighting the need for focused upper limb rehabilitation strategies.

Purpose of this study was to investigate the effectiveness of core stabilization with pelvic proprioceptive neuromuscular facilitation on trunk control and balance which will be provided an evidence-based selection of the best possible intervention to improve trunk function and balance as compared to the trunk control exercises such as Rhythmic stabilization, Bridging, Side-Lying Trunk Lifts, Quadruped, Kneeling and modified plantigrade positioning, which one can provide the better balance and trunk control in sub-acute stroke patients.