Clinical trials

This randomized controlled trial aims to compare the effectiveness of robotic-assisted physiotherapy and conventional physiotherapy in improving hand function among patients with sub-acute stroke. Stroke often results in weakness, reduced hand strength, impaired dexterity, and difficulty performing daily activities due to upper-limb motor dysfunction. Early rehabilitation targeting hand recovery is essential to improve independence and quality of life. A total of 30 participants with sub-acute post-stroke spastic hemiplegia will be recruited from the University of Lahore Hospital and randomly assigned into two groups. The intervention group will receive robotic-assisted physiotherapy focused on repetitive, task-specific wrist and finger extension training using a robotic hand/wrist device, while the control group will receive conventional therapist-led upper-limb rehabilitation exercises. Both groups will undergo treatment sessions lasting 30-45 minutes, five days per week for four weeks. Outcome measures will include hand muscle strength assessed using a hand-held dynamometer, hand dexterity evaluated through the Action Research Arm Test (ARAT), and functional improvement measured using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Additional measures such as spasticity, activities of daily living, and quality of life will also be recorded. Assessments will be conducted at baseline, during treatment, and after completion of the intervention period by a blinded assessor. The study is expected to determine whether robotic-assisted physiotherapy provides greater improvements in hand strength, dexterity, and upper-limb functional recovery compared to conventional physiotherapy in individuals recovering from stroke. Findings from this research may contribute to evidence-based rehabilitation strategies for improving upper-limb outcomes after stroke.

This randomized controlled trial aims to compare the effectiveness of Constraint-Induced Movement Therapy (CIMT) combined with Functional Electrical Stimulation (FES) versus CIMT alone in improving upper limb function, reducing spasticity, and enhancing functional independence in children with cerebral palsy (CP). A total of 46 children aged 3 to 15 years with spastic or dyskinetic cerebral palsy will be recruited from rehabilitation centers and hospitals in Sukkur, Pakistan. Participants will be randomly assigned into two groups: Group A will receive CIMT combined with FES, while Group B will receive CIMT alone. Both groups will undergo supervised therapy sessions five times per week for six weeks. Outcomes will be assessed before and after treatment using the Modified Ashworth Scale (MAS), Melbourne Assessment of Unilateral Upper Limb Function (MUUL), and Pediatric Evaluation of Disability Inventory (PEDI). The study aims to determine whether combining FES with CIMT provides greater improvements in motor recovery and daily functional performance in children with CP.

Cerebral palsy is one of the most common childhood neurological disorders and often results in weakness, poor coordination, and stiffness (spasticity) in one side of the body in children with spastic hemiplegic cerebral palsy. These difficulties can significantly affect a child's ability to perform daily activities such as dressing, eating, playing, and school-related tasks. Upper limb rehabilitation plays a crucial role in improving independence and quality of life in these children. Two commonly used rehabilitation approaches are bimanual training, which focuses on using both hands together during functional tasks, and unilateral task-specific training, which focuses intensively on improving the affected hand through repetitive, goal-directed activities. Although both approaches are widely practiced in pediatric neurorehabilitation, there is limited direct comparison of their effectiveness in reducing spasticity and improving functional independence among children with spastic hemiplegic cerebral palsy, particularly in the local population of Pakistan. This randomized controlled trial aims to compare the effectiveness of bimanual training versus unilateral task-specific training in children aged 5-12 years diagnosed with spastic hemiplegic cerebral palsy. A total of 46 participants will be randomly assigned to one of two intervention groups. Both groups will receive therapy three times per week for eight weeks. Spasticity will be measured using the Modified Ashworth Scale (MAS), and functional independence will be assessed using the Pediatric Evaluation of Disability Inventory (PEDI). Assessments will be conducted before and after the intervention period. The results of this study may help clinicians, caregivers, and rehabilitation centers determine which therapy approach is more effective in improving upper limb function and independence in children with spastic hemiplegic cerebral palsy. Participation in this study is voluntary, and children may withdraw at any time without affecting their standard care.

This randomized controlled trial will evaluate the effectiveness of sensory reweighting techniques on balance and risk of falls in individuals with chronic ischemic stroke. A total of 46 participants will be recruited using purposive sampling and randomly assigned into two groups through the sealed envelope method. Balance and fall risk will be assessed using the Berg Balance Scale and the Timed Up and Go test at baseline and after completion of the intervention. Participants in the experimental group will receive sensory reweighting-based balance training three times per week for eight weeks, incorporating altered sensory conditions such as reduced visual input, unstable surfaces, and vestibular challenges. The control group will receive conventional balance training of similar duration and intensity without sensory manipulation. Both groups will also receive standard physiotherapy throughout the intervention period. Ethical approval will be obtained prior to data collection, written informed consent will be secured from all participants, and confidentiality and voluntary participation will be ensured.

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus and is associated with sensory loss, impaired proprioception, balance deficits, and altered gait patterns, which significantly increase the risk of falls and functional dependence. Rehabilitation strategies targeting sensory and proprioceptive impairments are essential to improve postural control and mobility in this population. This randomized controlled trial aims to compare the effects of proprioceptive neuromuscular training and sensory re-education on balance and gait performance in patients with diabetic peripheral neuropathy. Participants diagnosed with DPN will be randomly allocated into two groups. Group A will receive sensory re-education, while Group B will undergo a structured proprioceptive training program. Both groups will also receive baseline conventional treatment. Balance and gait outcomes will be assessed using the Berg Balance Scale and the Dynamic Gait Index at baseline, mid-intervention, and post-intervention. The findings of this study may help determine the more effective rehabilitation approach for improving balance and gait in individuals with diabetic peripheral neuropathy, thereby reducing fall risk and enhancing functional independence.