Clinical trials

Piriformis Syndrome is a neuromuscular condition with symptoms of pain, numbness and tingling tracing the route of the sciatic nerve, due to the nerve impingement by the piriformis muscle. Two common manual therapy techniques used to treat musculoskeletal conditions are myofascial release and post-isometric relaxation. The intent of the research is to evaluate the effects of myofascial release (MFR) as compared to post-isometric relaxation (PIR) in improving pain and lower extremity function in piriformis syndrome (LEFS). The study population involved 32 individuals aged between 20 to 50 years who will be randomly assigned to two groups; a group that received MFR and a group that received PIR. Both groups received the baseline treatment for four weeks. The Visual Analog Scale (VAS) will be employed to gauge the amount of pain, while the LEFS was used to measure functional mobility

Hemiplegia, or paralysis of one side of the body, often results from stroke and severely limits arm function. Standard physiotherapy helps, but recovery is often slow. This study tests if adding a wearable vibratory device to standard therapy improves arm movement better than standard therapy alone. Thirty patients with subacute stroke (3-6 months) will be split into two groups. One group will receive usual physiotherapy, while the other will receive usual physiotherapy plus the vibratory device for 8 weeks. Doctors will measure changes in spasticity (muscle stiffness), motor function, and daily independence before and after treatment.

Many athletes who play overhead sports like cricket develop tightness in the back of the shoulder. This causes pain and makes it hard to lift the arm. This study will compare two common physical therapy treatments: Kaltenborn joint mobilization (a specific manual therapy glide) versus a Pragmatic Posterior Capsular Stretch (a specific stretching technique). We want to see which one works better for pain, range of motion, and daily function. 28 athletes will be treated for 4 weeks, and we will measure their progress using a goniometer and the SPADI questionnaire.

Stroke is a leading cause of long-term disability worldwide. Many stroke survivors experience persistent weakness, loss of motor control, and poor coordination in their upper limb, which limits their ability to perform daily activities and return to independent living. This study compares two physical therapy approaches for patients in the subacute stage of stroke recovery (1 to 6 months after stroke). The first approach is Rhythmic Initiation, a technique from Proprioceptive Neuromuscular Facilitation (PNF) that uses smooth, guided movement patterns progressing from passive to active movement. The second approach is Isometric Resistance Training, which involves holding static muscle contractions against resistance without moving the joint. The study will enroll 40 patients aged 40 to 60 years with unilateral upper limb weakness from a first-time stroke. Participants will be randomly assigned to receive either Rhythmic Initiation or Isometric Resistance Training for 30 minutes per session, 5 days per week, for 4 weeks. The researchers will measure changes in motor function, muscle strength, coordination, and spasticity before and after the 4-week intervention. The results will help physiotherapists understand which approach is more effective for upper limb rehabilitation in subacute stroke patients.

The trial aims to evaluate and compare the therapeutic outcomes of Blackburn and Egoscue exercise interventions in managing forward head posture. The study will be conducted as a Randomized Clinical Trial enrolling subjects diagnosed with forward head posture. Participants of both sexes will be eligible provided they present with a Craniovertebral Angle (CVA) ranging between 30 and 45 degrees, a Neck Disability Index (NDI) score indicating moderate to severe impairment, and pain levels rated as moderate to severe on the Numeric Pain Rating Scale (NPRS). Individuals currently wearing orthotic devices or having a history of recent trauma or fractures will be ineligible for participation. Written as well as verbal informed consent shall be obtained from each participant prior to enrollment. A total of 28 subjects will be distributed across 2 groups, each comprising 14 individuals, with allocation performed through randomization. Group A will undertake Blackburn exercise protocols while Group B will follow Egoscue method exercises. Transcutaneous Electrical Nerve Stimulation (TENS), isometric exercises, and thermotherapy via hot pack will serve as baseline interventions for both cohorts alongside cervical isometrics. The complete intervention protocol will span 24 sessions administered across 3 sessions weekly on alternate days. The principal outcomes assessed will include pain severity, craniovertebral alignment, and functional disability. Assessment instruments will comprise the Craniovertebral Angle measurement, Neck Disability Index, and Numeric Pain Rating Scale. Baseline measurements will be recorded at the start, pain will be documented before and after every treatment session, whereas forward head posture assessment and neck disability evaluations will be conducted both at baseline and upon completion of the 8-week protocol. Statistical processing of data will utilize SPSS version 23.

A stroke occurs when blood stops flowing through a blood vessel to the brain, typically from a burst blood vessel or a blood clot. Hemiparesis is associated with impairment of motor function in the lower limb(s) and with instability of the pelvis. The purpose of this study is to investigate the impact of pelvic stability training on the lower limb motor function after subacute stroke. A randomized clinical trial was conducted with 34 participants (17 in each group). This study will utilize the Non-Probability sampling technique called Consecutive sampling technique. All participants are included/excluded based on the inclusion and exclusion criteria and have signed informed consent (both written and verbal). Participants will be block randomized in to two group, one will get pelvic stability training and lower limb passive stretching and lower limb NMES (Neuromuscular electrical stimulation) and other group will get only lower limb passive stretching and lower limb NMES. Both interventions will be administer over a Eight- week period, thrice a week (alternative days). The results of the study will be pelvic tilt, fugal-meyer assessment lower extremities and cadence of gait. Data will be gathered at baseline and following the 8 week session. Data will be analysed by SPSS 23 program.

Stroke constitutes a principal cause of chronic neurological disability globally, frequently precipitating profound upper limb motor impairment that compromises functional autonomy and overall quality of life. Constraint-Induced Movement Therapy (CIMT) represents a rigorously validated neurorehabilitation paradigm grounded in the doctrine of experience-dependent neuroplasticity, promoting cortical reorganization through enforced utilization of the paretic limb while restraining the unaffected extremity. By counteracting learned non-use and emphasizing high- intensity, task-specific training, CIMT substantially augments motor recovery and functional performance. The primary objective of the present study is to comparatively evaluate the efficacy of CIMT delivery-clinic-based rehabilitation and telerehabilitation-in individuals with stroke. A total of 28 participants will be recruited through a non-probability consecutive sampling technique in accordance with explicitly defined inclusion and exclusion criteria, and will subsequently be randomized into two equal groups (n = 14 per group) using the chit-and-draw method to ensure unbiased allocation. Group A will receive CIMT within a clinical setting under direct supervision, whereas Group B will undergo an equivalent intervention via a structured online telerehabilitation platform under complete supervision. The intervention will be administered to both groups for duration of eight weeks. Outcome measures will include the Action Research Arm Test (ARAT), the Wolf Motor Function Test (WMFT), and the Modified Ashworth Scale (MAS) to comprehensively evaluate upper limb motor function and spasticity. Assessments will be conducted at baseline and at the completion of the eight-week intervention period. Statistical analysis will be performed using SPSS version 23.

The Randomize Clinical Trial will involve 30 participants with post traumatic elbow stiffness recruited from Madinah Teaching Hospital and Chiniot General hospital Faisalabad. Consecutive sampling technique will be used. Study will include individuals with \>30° extension loss and \<120° flexion, 50° in both directions for pronation-supination, who are 3-6 weeks post-POP removal from radiograph confirmation of skeletal/bone healing will be insured, who have elbow pain from 3 to 5/10 on NPRS and have fully healed fractures. Both intra-articular and extra-articular injuries will be accepted. DASH Score with 45 to 50 points. Study will exclude pathological or acute fractures, burns, brain trauma, neurological or psychological disorders, history of pre-operative osteoarthritis. Consent will be taken written and verbal from participants before including into study. Patients will be allocated with online randomization generator method into 2 groups. Group A will receive Mulligan Mobilization with Myofascial release technique, while Group B will receive Mulligan Mobilization alone. Hot pack for 20 minutes before treatment and static stretching after treatment will apply in both groups. Each stretch is performed 10 repetition with hold duration of 30 sec and rest period 15 sec between each stretch. Total 3 sessions per week for 4 weeks (12 sessions) on alternative days will be given. Outcome of study will be elbow pain, elbow range of motion (flexion and extension) and functional disability will be measure by using Numerical Pain Rating Scale, Universal Goniometer and Dash Questionnaire Score respectively. Data will be investigated by using SPSS version 2023.

Knee osteoarthritis (OA) is a common condition causing pain, stiffness, and difficulty walking. Many patients with advanced (Grade III) knee OA also experience neuropathic pain - burning, tingling, or electric shock sensations - which is harder to treat with standard physiotherapy. Oral pregabalin works for neuropathic pain but causes side effects like dizziness and drowsiness. This study tests whether delivering pregabalin through the skin using ultrasound (phonophoresis), combined with calf muscle stretching (Muscle Energy Technique), can reduce nerve pain and improve walking better than ultrasound alone.

The present study is designed to compare the effectiveness of perturbation-based balance training performed on two different surfaces, stable (firm surface) and unstable (rolling board), for enhancing static, dynamic, and reactive balance in individuals diagnosed with diabetic neuropathy. This randomized clinical trial will recruit a total of 42 participants, with the sample size calculated using Epi Tool software. A consecutive sampling technique will be implemented. Eligible participants who fulfill the inclusion criteria will be randomly assigned into two equal groups (n = 21 each) through an online randomization method. Participants in Group A will undergo perturbation-based balance exercises on a stable surface, whereas participants in Group B will receive similar training on a rolling board to introduce surface instability. In addition to the primary intervention, both groups will receive contrast bath therapy as a standard baseline treatment. Written as well as verbal informed consent will be obtained prior to participation. The intervention protocol will span four weeks, consisting of three sessions per week on alternate days, resulting in a total of twelve treatment sessions. The primary outcomes will focus on balance performance and fall risk. These outcomes will be measured using the Berg Balance Scale, the Mini-Balance Evaluation Systems Test, and the Timed Up and Go test. Screening for diabetic neuropathy will be carried out using the Michigan Neuropathy Screening Instrument. Statistical analysis will be performed using SPSS version 23.

The study will compare the shoulder and wrist treatment approaches to determine their effect on elbow. Thirty-two medically stable participants with active shoulder and wrist movements will be enrolled into two groups. Both groups will receive structured training for six weeks. Outcomes will be measured using standardized assessment tools. The aim is to identify the more effective strategy for improving upper limb kinetic chain which is affected by lateral epicondylitis

This study aims to compare the effects of hip-based and knee-based exercise interventions on medial longitudinal arch height, dynamic balance, and lower limb muscle strength in individuals with flexible flat feet. Participants will be randomly assigned to two groups: one receiving hip-focused strengthening and stretching exercises, and the other receiving knee-focused exercises, while both groups will perform a common set of foot intrinsic exercises. The intervention will be conducted over 6 weeks. Outcomes will be measured pre- and post- intervention and in the middle of intervention to determine which approach is more effective in improving foot stability and functional performance.

This randomized clinical trial will examine upper limb rehabilitation in individuals recovering from stroke. The study will compare unilateral and bilateral task-oriented training approaches to determine their relative effectiveness. Thirty-two medically stable participants with active shoulder movement and adequate cognition will be enrolled into two groups. Both groups will receive structured training for four weeks. Outcomes related to motor function and dexterity will be measured using standardized assessment tools. The aim is to identify the more effective strategy for improving upper extremity function after stroke.

The goal of this clinical trial is to compare the efficacy of lesion sterilization and tissue repair (LSTR) antibiotic paste versus zinc oxide eugenol (ZOE) pulpectomy for the treatment of primary molars with pulp necrosis in pediatric patients. The main questions it aims to answer are: * Is LSTR antibiotic paste (CTZ paste) effective in treating primary molars with pulp necrosis? * Is ZOE pulpectomy effective in treating primary molars with pulp necrosis, and how does its efficacy compare with LSTR therapy? Researchers will compare LSTR therapy (Group A) with ZOE pulpectomy (Group B) to determine which treatment provides better clinical and radiographic outcomes after six months. Participants will: * Be randomly assigned to one of the two treatment groups after diagnosis of pulp necrosis in primary molars. * Receive treatment under standard behavior management techniques with local anesthesia following topical application of 2% lignocaine gel and rubber dam isolation. * Undergo either Lesion Sterilization and Tissue Repair (LSTR) therapy with CTZ paste or zinc oxide eugenol (ZOE) pulpectomy according to group allocation. * Return for a clinical and radiographic follow-up evaluation after six months to assess treatment outcomes. * Allow researchers to record their clinical findings and radiographic results to evaluate the efficacy of both treatment methods.

This study compares the effectiveness of Muscle Energy Techniques (MET) and Neck Calliet Exercises in managing mechanical neck pain and associated disability due to trapezius trigger points among nurses. A total of 38 female nurses were randomly assigned to two intervention groups, each receiving therapy for four weeks. Pain, cervical range of motion, and disability outcomes were assessed.

Comparative effects of motor control and isolated strengthening lumbar exercises on functional outcomes in patients with chronic low back pain

The primary objective of this study is to compare effects of SCS and METs on reduction of neck pain intensity and improvement in functional disability in individuals with CGH. The secondary objective is to assess the impact of both techniques on ROM in cervical spine

1.1Research objective The objective of the study is to find the comparative effects of group based exercises with and without cognitive functional therapy on clinical outcomes in patients with chronic low back? 1.2 Hypothesis Null Hypothesis H0= There is no significant difference of clinical outcomes between the cognitive functional therapy with group exercises and group based exercises only in patients with chronic low back pain. Alternative Hypothesis H1= There is a significant difference of clinical outcomes between the cognitive functional therapy with group exercises and group based exercises only in patients with chronic low back pain.