Clinical trials

The aim of this study is to determine the safety and therapeutic effect of HbF inducers (combination therapy: thalidomide and hydroxyurea) on beta thalassemia patients. The main objectives of this study are: * To determine the therapeutic efficacy of HbF inducers (combination therapy: thalidomide and hydroxyurea) on hemoglobin level and blood transfusion in beta thalassemia patients. * To determine the safety of HbF inducers (combination therapy: thalidomide and hydroxyurea) in beta thalassemia patients * To determine effect of HbF inducers (combination therapy: thalidomide and hydroxyurea) on quality of life of beta thalassemia patients

Cerebral Palsy (CP) is a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The primary motor impairments in CP often include issues with muscle tone, reflexes, and coordination. Among the various motor disorders associated with CP, impairment of the upper extremities is particularly common and functionally debilitating. Specifically, reduced hand dexterity the ability to perform coordinated, fine motor tasks significantly impacts a child's independence in daily activities such as feeding, dressing, and school-related tasks like writing. Therefore, improving hand function is a critical goal in physiotherapy for this population The objective of this study was to compare the effectiveness of a constraint induced movement therapy ( CIMT ) and Proprioceptive neuromuscular facilitation technique on dexterous movement of hands in cerebral palsy .The study design will be Randomized Controlled Trail. The study setting will be Pediatric Rehabilitation Center or Physiotherapy Department. The duration of study will be 10 months after approval of synopsis. The sample size will be 20 which is calculated by epitools. The sampling technique will be Non-probability convenient sampling . Children who are diagnosed with cerebral palsy will be included. Children with other musculoskeletal and neurological issues will be excluded. Data Collection Tools will be Box and Block test and Pediatric Evaluation of Disability Inventory.. The data will be analyzed using SPSS 23. Keyword Cerebral Palsy, Constraint induced movement therapy (CIMT), dexterous movement, Proprioceptive neuromuscular facilitation

This study will examine how two types of exercise programs affect nerve health in people with diabetic peripheral neuropathy. Diabetic peripheral neuropathy is a common complication of type 2 diabetes that can cause numbness, pain, balance problems, and reduced quality of life. Exercise is often recommended for people with diabetes, but it is not yet clear which types of exercise are most effective for improving nerve function. In this randomized controlled trial, participants with type 2 diabetes and confirmed peripheral neuropathy will be assigned to one of three groups. One group will perform a combined program of aerobic and resistance exercises (concurrent training). Another group will perform soleus push-up exercises, a seated ankle movement designed to activate the soleus muscle and improve glucose metabolism. The third group will continue with standard diabetes care and general lifestyle advice without a structured exercise program. The study will evaluate whether these exercise interventions influence biological markers related to nerve repair and neuroplasticity, including brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and the Schwann cell marker S100B. In addition, the study will assess changes in neuropathy symptoms, balance and postural stability, blood sugar control, and quality of life. Participants will complete assessments before the intervention and again during follow-up after the exercise program. The findings of this study may help identify effective and feasible exercise strategies to support nerve health, improve physical function, and reduce the impact of diabetic peripheral neuropathy.

The goal of this observational study is to develop and validate an AI-based prediction model for functional mobility and gait outcomes in children with cerebral palsy using low-cost clinical and gait data collected in rehabilitation settings in Pakistan. The study aims to determine whether machine learning models can accurately predict mobility status, gait symmetry, and functional independence in ambulatory and non-ambulatory children with cerebral palsy. The main questions it aims to answer are: * Can clinical and gait-related variables accurately predict functional mobility and gait outcomes in children with spastic cerebral palsy? * Can video-based assessment tools provide clinically useful data for AI-based rehabilitation assessment in low-resource settings? Researchers will analyze clinical, functional, and gait data to identify patterns associated with mobility limitations and rehabilitation outcomes. Participants will: * Undergo clinical and functional assessments, including measures of balance, mobility, posture, and functional independence. * Perform gait and movement tasks while data are collected using AI-based video analysis tools. * Participate in routine rehabilitation sessions while their movement and functional performance are recorded for analysis. * Provide demographic and clinical information relevant to cerebral palsy severity and functional status.

* To determine the effects of moderate intensity exercise vs high intensity interval training on functional capacity in women with heart failure * To determine the effects of moderate intensity exercise vs high intensity interval training on quality of life in women with heart failure

The goal of this clinical trial is to learn whether Sahrmann exercises or McGill exercises are more effective for reducing pain and improving function in adults with non-specific low back pain. It will also evaluate which exercise program is more effective in improving spinal range of motion. The main questions it aims to answer are: Do Sahrmann exercises reduce pain more effectively than McGill exercises? Do Sahrmann exercises improve disability more effectively than McGill exercises? Do Sahrmann exercises improve lumbar range of motion more effectively than McGill exercises? Researchers will compare a Sahrmann exercise program with a McGill exercise program to determine which approach produces better outcomes in patients with non-specific low back pain. Participants will: Be randomly assigned to either a Sahrmann exercise group or a McGill exercise group. Receive standard physical therapy treatment, including heat therapy and transcutaneous electrical nerve stimulation (TENS). Perform the assigned exercise program under the supervision of a physiotherapist. Attend exercise sessions 3-5 times per week during the study period. Complete assessments of pain, disability, and lumbar range of motion before and after the intervention. Have pain measured using the Numeric Pain Rating Scale (NPRS), disability measured using the Oswestry Disability Index (ODI), and lumbar range of motion measured using a Baseline Bubble Inclinometer.

Osteoarthritis (OA) of the knee, also referred to as degenerative joint disease, is normally due to wear and tear and progressive cartilage loss in the articular cartilage. Osteoarthritis is most prevalent condition among older adults. The objective of the study will be to compare the effects of Sahrmann's approach versus conventional treatment on pain, valgus angle and functional disability in patients with knee osteoarthritis.

This randomized clinical trial aims to evaluate the effectiveness of combining Low Volume Nose Resistance Breathing Exercises (LVNRBE) with Incentive Spirometry (IS) on respiratory outcomes in patients with cervical spinal cord injury (SCI). Respiratory complications are a major concern in cervical SCI due to impaired respiratory muscle function, leading to reduced lung volumes, dyspnea, ineffective cough, and sputum retention. The study will recruit 42 inpatients aged 18-38 years with cervical SCI (C4-C7), randomly divided into two groups: Data Analysis: Statistical tests (paired and independent t-tests) will determine intra- and intergroup differences using SPSS v25, with significance set at p \< 0.05. * Group A (Intervention): Receives LVNRBE using an Acapella device plus IS for 20 minutes, three times daily, five days a week for four weeks. * Group B (Control): Receives conventional respiratory physiotherapy with the same frequency and duration. Outcomes will be assessed pre- and post-intervention using: * Pulmonary Function Tests (FVC, FEV1), * Modified Borg Dyspnea Scale, * Cough Frequency Scale, * Sputum Grading Scale.

Rotator cuff syndrome is a common cause of shoulder pain and functional limitation, often associated with myofascial trigger points. Myofascial Trigger Point Release (MFTR) and the Neil Asher Technique (NAT) are manual therapies aimed at reducing pain and improving mobility. This study compares their effects on pain, range of motion, and disability in individuals with rotator cuff syndrome.

Adhesive capsulitis, also known as frozen shoulder, is a musculoskeletal condition that causes significant shoulder pain and restricted joint mobility. It affects the glenohumeral joint and is commonly seen in individuals between the ages of 40 and 60 year. It affects 3 to 5% of the general population with a higher prevalence among females and patients with diabetes or thyroid disorders. Adhesive capsulitis progresses in four stages: painful, freezing, frozen, and thawing, and the condition may persist for 1 to 2 years. This study aims to determine the effects of Deltoid Strengthening Exercises on pain, range of motion, muscle strength and disability in patients with Adhesive Capsulitis.

Piriformis Syndrome (PS) is a condition which is characterized by pain, numbness, and limited range of motion (ROM) due to compression or irritation of the sciatic nerve by the piriformis muscle. It often leads to discomfort in the buttock region, radiating pain along the posterior thigh, and functional limitations in daily activities. Manual therapy techniques, particularly Muscle Energy Techniques (METs), have been widely used for the management of musculoskeletal dysfunctions, including piriformis syndrome.

Stroke is a focal neurological deficit of sudden onset, with symptoms lasting more than 24 hours leading to consequences like impacting physical abilities, cognitive functions and emotional well-being, speech and language difficulties. Among various rehabilitation program, Blood flow restriction (BFR) therapy with low intensity resistance training has shown its promising results. Blood flow restriction training, also called Kaatsu, originated in Japan. So this study aims to determine the combined effects of Low Intensity Resistance Training with Blood Flow Restriction Therapy on Upper Limb Strength, Forward Reach and Sensorimotor function in Post-Stroke Patients.

Anterior cruciate ligament (ACL) injuries are among the most common and functionally disabling knee injuries, particularly in physically active individuals. Despite advancements in surgical techniques, optimal post-operative rehabilitation remains critical for successful functional recovery, minimizing re-injury risk, and restoring pre-injury performance levels

Lumbar radiculopathy is a spinal condition caused by compression or irritation of the lumbar nerve roots, leading to radiating leg pain, sensory changes, and functional disability. It commonly affects middle-aged and older adults, impairing daily activities and quality of life. Conservative treatments include medication, physiotherapy, and exercise. Spinal Mobilization with Leg Movement (SMWLM), a Mulligan technique, uses passive vertebral mobilization with active leg motion to reduce nerve compression and improve mobility. Neural flossing, or neurodynamic mobilization, enhances nerve mobility by promoting gliding of nerve roots, especially in cases of restricted neural movement. This study aims to evaluate the effects of spinal mobilization with leg movement (SMWLM) with and without neural flossing technique on pain, disability, and range of motion in patients with lumbar radiculopathy.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition characterized by persistent respiratory symptoms and airflow limitation. Patients with COPD often experience not only physical symptoms like breathlessness and fatigue but also psychological issues such as anxiety and poor sleep quality, which further compromise their quality of life. Non-pharmacological interventions, especially relaxation techniques, have shown promise in improving psychological well-being and physiological outcomes in COPD patients. Among these, Laura Mitchell's relaxation technique and Benson's relaxation response have gained attention for their simplicity and effectiveness. The primary objective of this study is to assess and compare the effects of Laura Mitchell's relaxation technique and Benson's relaxation technique on anxiety, sleep quality, and fatigue levels in patients diagnosed with moderate to severe COPD. By evaluating these parameters, the study aims to determine which method provides greater benefits in managing psychological and physical symptoms associated with COPD. The study will use a randomized experimental design. Participants will be randomly assigned into two groups: Group A will receive Laura Mitchell's relaxation training, and Group B will receive Benson's technique. Both interventions will be practiced daily for 15-20 minutes over a 6-weeks period. Baseline and post-intervention (week 6) data will be collected. Outcome measures will include anxiety (GAD-7), fatigue (FSS) and sleep quality (PSQI). Data will be analyzed using paired and independent t-tests to assess within-group and between-group differences, with significance set at p \< 0.05. The data will be analyzed using SPSS v 25.

After childbirth, many women experience difficulty losing pregnancy-related weight, which can affect their health, self-esteem, and physical activity. Regular exercise, including Pilates and moderate-intensity aerobic exercises, is considered a safe and natural method to improve fitness and support weight loss during the postpartum period. This study aims to compare the effects of Pilates and aerobic exercise on body weight, Body Mass Index (BMI), and waist-to-hip ratio in postpartum women over 8 weeks. Participants will be randomly assigned to either a Pilates group or an aerobic exercise group, with both groups exercising three times weekly for 45-60 minutes. The results will then be compared to determine which exercise method is more effective.

Muscular imbalance due to prolonged sitting or standing posture leads to a condition lower cross syndrome(LCS) or lumbopelvic syndrome. Several stretching and strengthening regimens are used to treat cross pattern of muscular tightness and weakness in LCS. This study aims to compare the effects of Sahrmann's versus Janda's approach on pain, pelvic tilt and lumbar lordosis in lower crossed syndrome patients.

The study aims to compare the effectiveness of these two core training approaches in improving urinary incontinence, pelvic floor function, and quality of life in postpartum women.

One common pelvic floor condition, particularly in postpartum or later life, is uterine prolapse. It is caused by weak pelvic floor muscles and connective tissues and often presents with pain, urinary incontinence, and reduced quality of life. Although pelvic floor muscle training (PFMT) is commonly used, newer methods such as Hypopressive Exercises (HE) and Pelvic Floor Functional Movement Retraining (PFFMR) offer promising approaches. HE focuses on posture and breathing strategies to reduce intra-abdominal pressure, while PFFMR retrains pelvic stability and function through integrated movement patterns. This study aims to evaluate the combined effects of HE and PFFMR on pain, urogynecological symptoms, and quality of life in women with uterine prolapse, compared to single interventions. This randomized clinical trial will include 32 women aged 30-60 years with stage I-II uterine prolapse at Ganga Ram Hospital, Lahore. Participants will undergo an 8-week program with supervised sessions three times per week. Outcomes will be assessed using the Pelvic Floor Bother Questionnaire (PFBQ), Numeric Pain Rating Scale (NPRS), and Prolapse Quality of Life Questionnaire (P-QoL), and analyzed using SPSS version 25.0.

Developmental Coordination Disorder (DCD) affects motor planning and functional mobility in children, leading to long-term functional and psychosocial difficulties. This randomized clinical trial will compare the effectiveness of Obstacle Course Training (OCT) and Neuromotor Task Training (NTT) in improving motor planning and functional mobility in children aged 7-10 years diagnosed with DCD. Participants will be randomly allocated to either OCT or NTT for 9 weeks (two sessions per week). Outcomes will be assessed using standardized motor performance measures to determine the more effective intervention.

The study will be a non-blinded randomized controlled trial, consisting of two groups. Non-probability Convenience sampling will be used to recruit participants who will meet the inclusion criteria. Group allocation will be performed using the sealed envelope method to ensure randomization of participants into experimental and control groups. The sample size will be 38 (19 in each group). Group A will receive neurodynamic stretches while Group B will receive myofascial pain release technique.

Stroke is a neurological disorder causing 70-80 percent deaths in the low income and developing countries. Patients commonly present with common impairments associated with balance, proprioception, poor gait, speech impairment and posture which affect the activities of daily living along with increased risk and fear of fall. This negatively impacts patients' mobility, confidence and role in the society. Lower limb sensorimotor training targets the integration of sensory and motor systems enhancing tactile stimulation, balance and proprioception; whereas whole body vibration stimulates muscle spindles and mechanoreceptors via mechanical oscillations that may promote reflexive muscle contractions, improve muscle tone, and enhance postural responses. The aim of this study is to find the comparative effects of lower limb sensorimotor training and whole-body vibration therapy on balance, posture and fear of fall in post stroke patients. This study will be a randomized clinical trial. Non probability convenience sampling will be used to recruit 42 patients of either gender, aged 50-65 years, and diagnosed with stroke. This study will be carried out in Saira Memorial Hospital, Lahore. The participants will be randomly allocated to Group A and Group B through computerized table generator method. Each group will be given conventional physical therapy treatment as a baseline which includes range of motion exercises, balance and gait training. Group A will receive lower limb sensorimotor training, whereas group B will receive whole body vibration therapy. Each group will perform their respective exercises 45 minutes, three times a week for 8 weeks. The participants will be evaluated at the start and end of the exercise program through Berg Balance scale for dynamic balance, falls efficacy scale for risk of fall and Nottingham sensory assessment scale for sensory assessment. Data will be analyzed by SPSS version 26.

Diastasis Recti Abdominis (DRA) is the separation of the rectus abdominis muscles along the linea alba, commonly seen after childbirth due to the mechanical and hormonal changes that occur during pregnancy. DRA can negatively affect posture, trunk stability, and breathing patterns, and may result in persistent lumbopelvic pain and weakened core muscles if not properly managed. Although hypopressive exercises and abdominal bracing have individually demonstrated positive effects in reducing inter-recti distance and improving core function, limited research exists regarding their combined effects. This randomized clinical trial aims to evaluate the combined impact of hypopressive exercises and abdominal bracing on inter-recti distance, lumbopelvic pain, and abdominal muscle strength in postpartum women with DRA. The study will include 34 postpartum women recruited from Jinnah Hospital, Lahore, who will be randomly assigned into two groups. Group A will receive both hypopressive exercises and abdominal bracing, while Group B will receive only hypopressive exercises along with standard postpartum physiotherapy. Outcome measures will include pain intensity, lumbopelvic disability, abdominal muscle strength, and inter-recti distance, with data analyzed using SPSS version 25.

Restless Legs Syndrome (RLS) is a prevalent sensorimotor disorder affecting pregnant women, particularly in the third trimester, and is associated with sleep disturbances, fatigue and reduced quality of life. Non-pharmacological strategies such as stretching and strength training offer promising alternatives during pregnancy. This randomized controlled trial aims to compare the effects of static stretching alone and static stretching combined with strength training on sleep quality, symptom severity and fatigue in antenatal women with RLS. Thirty pregnant women meeting the diagnostic criteria for RLS will be recruited from National Hospital and medical center and randomly assigned into two groups. Group A will receive static stretching exercises, while Group B will receive static stretching and lower limb strength training exercises for 6 weeks, three sessions per week. Data will be analyzed using SPSS, with a p-value \< 0.05 considered statistically significant.

Text neck syndrome is one such disorder within that group, increasingly affecting individuals worldwide across various age groups. The phenomenon of text neck may occur in individuals who frequently and for prolonged periods adopt a forward-flexed neck and head position while looking at the screens of mobile electronic devices. This posture puts stress on the neck muscles and spine, leading to various symptoms like neck pain, stiffness, and headaches.