Clinical trials

Restrictive lung diseases (RLD) represent a significant cause of morbidity, often necessitating intensive interventions such as mechanical ventilation due to diminished lung compliance (LC) and reduced total lung capacity (TLC). Mechanical ventilation, while vital, is associated with ventilator-induced diaphragmatic dysfunction (VIDD), leading to rapid muscle atrophy and impeding patient recovery. This proposed study aims to evaluate the clinical impact of IMT and PEP on improving respiratory muscle strength, lung compliance and mobilizing secretions (effective cough reflex) in patients with RLD who require mechanical ventilation.

This study is a two-arm randomized parallel group trial designed to compare the effects of alternate nostril breathing vs diaphragmatic breathing on oxygen saturation and Heart-rate variability in hemodynamically stable post-PCI patients. Participants will be randomly allocated in a 1:1 ratio to alternate nostril breathing or diaphragmatic breathing and will receive the allocated intervention for 2 consecutive days with three supervised sessions per day in addition to routine post-PCI care. Oxygen saturation will be assessed using a pulse oximeter and heart-rate variability will be assessed using a Polar H10 sensor at baseline and after the intervention. The study will determine whether there is a difference between two breathing interventions in the prescribed outcome measures.

This study is a two-arm randomized parallel group trial designed to compare the effects of Incentive spirometry vs diaphragmatic breathing on oxygen saturation and Heart-rate variability in hemodynamically stable post-PCI patients. Participants will be randomly allocated to either the incentive spirometry group or the diaphragmatic breathing group and will receive the allocated intervention for 2 consecutive days with three supervised sessions per day in addition to routine post-PCI care. Oxygen saturation will be assessed using a pulse oximeter and heart-rate variability will be assessed using a Polar H10 sensor at baseline and after the intervention. The study will determine whether there is a difference between two interventions in the prescribed outcome measures.

This randomized controlled trial aims to compare the clinical effectiveness of ischemic release and sustained pressure direct myofascial release for upper trapezius trigger points. The study will compare their effects on pain pressure threshold, cervical range of motion, and scapular upward rotation following a two-week intervention.

Plantar fasciitis is a common musculoskeletal condition characterized by plantar heel pain, particularly during the first steps after waking or following prolonged rest. It can substantially affect walking, standing, daily activities, and overall functional ability. Although conservative physiotherapy management is commonly used, the relative effectiveness of different manual therapy techniques remains unclear. The present study aims to compare the effectiveness of Transverse Friction Massage (TFM) and Instrument-Assisted Soft-Tissue Mobilization (IASTM) in patients with plantar fasciitis. The study will be conducted as a single-blinded randomized controlled trial at Foundation University College of Physical Therapy, Islamabad. A total of 34 participants will be recruited using purposive sampling and subsequently randomized into two groups through a sealed opaque envelope method. Participants will be adults aged 19-44 years with clinically diagnosed plantar fasciitis and symptoms. persisting for more than three months. Group A will receive Transverse Friction Massage, while Group B will receive Instrument-Assisted Soft-Tissue Mobilization. Both groups will additionally receive a standardized physiotherapy protocol consisting of stretching exercises, strengthening exercises, ultrasound therapy, home-based exercises, and activity modification. The interventions will be administered twice weekly for four weeks, resulting in a total of eight treatment sessions. The primary clinical outcomes will include pain intensity, foot-related functional impairment, and ankle range of motion. Pain will be assessed using the Numeric Pain Rating Scale (NPRS), foot function using the Foot Function Index (FFI), and ankle range of motion using a goniometer. Assessments will be performed at baseline, after two weeks, and at the end of four weeks. Data will be analyzed using SPSS. Appropriate parametric or non-parametric statistical tests will be applied according to data distribution, with statistical significance set at p\<0.05 and a 95% confidence interval. The study is expected to provide evidence regarding the comparative effectiveness of TFM and IASTM for reducing pain, improving foot function, and enhancing ankle mobility in patients with plantar fasciitis.

This research synopsis, titled "Comparative Effects of Niel-Asher Technique and Bowen Technique on Pain, Range of Motion, and Functional Disability in Adhesive Capsulitis," aims to compare the effectiveness of two manual therapy techniques in managing adhesive capsulitis (frozen shoulder). Adhesive capsulitis is a painful musculoskeletal condition characterized by progressive stiffness, reduced shoulder range of motion (ROM), and functional limitations that significantly affect daily activities and quality of life. Although several conservative treatment approaches exist, there is still no consensus regarding the most effective intervention. The study will be conducted as a single-blind randomized clinical trial at the Rehabilitation Department of Fauji Foundation Hospital, Rawalpindi, over one year. A total of 54 participants aged 40-60 years with stage II (frozen stage) adhesive capsulitis will be recruited using purposive sampling and randomly allocated into two groups through a coin toss method. Group A will receive the Niel-Asher Technique (NAT) combined with conventional physical therapy, while Group B will receive the Bowen Technique along with the same conventional treatment. Both groups will undergo treatment three times per week for four weeks.

The goal of this interventional study is to evaluate the different materials used for pulpotomy procedures in deciduous molars. this will help us find out which medicament is more effective in releving which medicament is more effective in releving pain and resolution of signs of infection.it will help us find out less chair time for procedure and cooperation of child .

This randomized controlled trial will compare the effectiveness of Kaltenborn mobilization and Mulligan mobilization in individuals with Forward Head Posture. The study will compare their effects in neck pain, craniovertebral angle, cervical range of motion, cervical proprioception, and deep neck flexor endurance after a two-week treatment program.

Participants will be divided into two groups, with both receiving conventional physical therapy along with their respective thoracic intervention. One group will receive thoracic manipulation at the identified T1-T7 segment using a controlled High-Velocity, Low-Amplitude thrust in the prone position at the end of full exhalation, while the other group will receive central PosterioAnterior thoracic mobilization in the prone position for 30 repetitions with a 1-minute rest between two sets. The most painful or stiffest segment will be identified using the Passive Accessory Intervertebral Movement (PAIVM) test; if no joint sign is present, mobilization will be performed at T6-T7.

This study aims to compare the effects of Post Isometric Relaxation (PIR) and Reciprocal Inhibition (RI) in individuals with cervicogenic headache, a secondary headache originating from dysfunction of the cervical spine, particularly the upper cervical segments. Cervicogenic headache is characterized by unilateral head and neck pain, restricted cervical mobility, muscle tightness, and functional limitations that negatively affect daily activities and quality of life. The study will employ a randomized controlled trial involving 46 participants aged 18-45 years who meet the inclusion criteria. Participants will be randomly allocated into two groups: Group A will receive Post Isometric Relaxation, while Group B will receive Reciprocal Inhibition. Both groups will also receive a standard physiotherapy protocol consisting of hot packs, cervical isometric exercises, and C1-C2 Sustained Natural Apophyseal Glides (SNAGs), administered three times per week for four weeks. Pain intensity, functional disability, and cervical range of motion will be assessed before and after the intervention using the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and goniometric measurements, respectively. By comparing these two muscle energy techniques, the study seeks to determine which intervention is more effective in reducing pain, improving cervical mobility, and enhancing functional outcomes, thereby providing evidence to support clinical decision-making and optimize physiotherapy management for individuals with cervicogenic headache.

This randomized controlled trial aims to compare the effectiveness of Autogenic Inhibition Muscle Energy Technique (MET) and Reciprocal Inhibition MET in individuals with Lower Crossed Syndrome. Participants will be randomly assigned to two intervention groups. One group will receive Autogenic Inhibition MET, while the other will receive Reciprocal Inhibition MET for the iliopsoas, rectus femoris, and erector spinae muscles. Both groups will also perform the same standardized strengthening exercises targeting the transversus abdominis, gluteus maximus, and gluteus medius muscles to improve muscle balance and functional outcomes.

This randomized controlled trial compares two manual therapy interventions for adults with thoracic spine hypo mobility. Fifty-two participants are randomly allocated by coin toss to one of two equal groups (n = 26 each). Both groups first receive an identical preparatory protocol consisting of a combined session of TENS (transcutaneous electrical nerve stimulation) and hot pack application for 20 minutes, intended to reduce baseline pain and prepare the tissue for mobilization. Following this preparatory phase, Group A receives Maitland oscillatory mobilization, applied as small and large amplitude rhythmic passive movements directed at the spinous processes of the thoracic vertebrae (T1-T12). This is delivered as 3 sets of 15 repetitions, using Grades I-II to reduce pain and Grades III-IV to increase range of motion once pain has eased. Group B receives Kaltenborn sustained mobilization, which applies a slower, held stretch to the same thoracic spinous processes. This consists of 3 repetitions of a 30-60 second sustained hold, using Grades I-II for pain relief and Grade III (stretch beyond the point of restriction) to improve mobility once pain has decreased. Both interventions target the same spinal segments and are delivered in a single session by the same non-blinded protocol. Immediately after treatment, outcomes are reassessed: pain via the Numeric Pain Rating Scale (NPRS) and thoracic range of motion (flexion, extension, and right/left rotation in a lumbar-locked position) via a smartphone inclinometer application. The trial thus isolates the difference between a rhythmic, oscillatory mobilization technique and a slower, sustained-hold mobilization technique, allowing a direct immediate-effect comparison of the two manual therapy approaches for thoracic hypo mobility.

This study will compare the effectiveness of two manual therapy interventions combined with a standardized conventional physiotherapy protocol in individuals with Upper Cross Syndrome. Participants will be randomly allocated into two groups. Group A will receive Reverse Natural Apophyseal Glides, while Group B will receive Sustained Natural Apophyseal Glides. Both manual therapy interventions will primarily target the lower cervicaland upper thoracic spine specifically C6 to T2 and will be administered for 3 times a week for 4 weeks. The conventional physiotherapy protocol will be identical for both groups and will include a 10-minute hot pack followed by stretching of the pectoralis, upper trapezius and levator scapulae, each stretching exercise will be performed for 10 repetitions, 3 sets, with a 10 second hold per repetition. The strengthening program will target the deep cervical flexors and scapular stabilizers, including middle trapezius, lower trapezius, serratus anterior and rhomboids. Strengthening exercises will be performed for 10 repetitions, 3 sets, with a 10 second hold per repetition. The manual therapy component will differ between groups, allowing comparison of Reverse Natural Apophyseal Glides and Sustained Natural Apophyseal Glides when used alongside the same conventional intervention. This standardized approach aims to evaluate the comparative effects of the two manual therapy techniques on the postural and functional impairments associated with Upper Cross Syndrome.

This randomized controlled trial aims to evaluate the additional effects of kinetic chain training combined with standard shoulder exercises in patients with Subacromial Pain Syndrome (SAPS). SAPS is one of the most common causes of shoulder pain and is associated with altered scapular mechanics, reduced thoracic mobility, and impaired lumbopelvic stability. Conventional rehabilitation primarily targets the shoulder joint and local musculature, often overlooking the contribution of the kinetic chain. This study wil investigate whether integrating kinetic chain training into standard rehabilitation provides superior clinical outcomes.A single-blinded, parallel-group randomized controlled trial will be conducted involving 46 participants aged 35-60 years diagnosed with unilateral SAPS. Participants will be recruited through purposive sampling and randomly allocated into either a control group receiving standard shoulder rehabilitation or an experimental group receiving standard rehabilitation plus kinetic chain training for six weeks. The kinetic chain intervention includes lower trapezius strengthening, thoracic spine and rib mobilization, longissimus and multifidus activation, and gluteus maximus strengthening. Primary outcomes will include pain intensity, shoulder range of motion, functional disability, scapular dyskinesis, and shoulder muscle strength. These will be assessed using the Numeric Pain Rating Scale (NPRS), Shoulder Pain and Disability Index (SPADI), universal goniometer, bubble inclinometer, and handheld dynamometer before and after the intervention. The findings of this study are expected to determine whether a biomechanically integrated rehabilitation approach offers greater improvements than conventional shoulder-focused exercises alone, thereby providing evidence to guide physiotherapy management of SAPS.

Patellofemoral pain (PFP) is a common musculoskeletal-related condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retro-patellar and/or peripatellar region of the knee. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lower-limb loading activities (e.g. squatting, prolonged sitting, ascending/descending stairs, jumping, or running). This randomized controlled trial compares the effects of McConnell taping and Kinesio taping, each combined with a standardized hip and knee strengthening exercise program, in patients with Patellofemoral Pain Syndrome (PFPS). A total of 34 participants (17 per group), aged 26-44 years, will be randomly allocated into two groups. Both groups will undergo a 4-week intervention, consisting of supervised sessions on alternate days. Outcomes will be assessed at baseline and after the intervention. Group A will receive conventional physical therapy, hip and knee strengthening exercises, and McConnell taping. The intervention includes TENS, heating pad application, progressive strengthening exercises, functional training, stretching, and rigid McConnell taping applied before each session to provide medial patellar glide and improve patellar alignment. Group B will receive the same conventional physical therapy and strengthening program but with Kinesio taping. Elastic Kinesio tape will be applied using standardized I-strip and Y-strip techniques to facilitate patellar alignment, improve proprioception, and provide neuromuscular support. The tape may remain in place for 1-2 days, if tolerated. The primary outcomes include pain (Numeric Pain Rating Scale), range of motion (universal goniometer), and functional disability (KOOS-Patellofemoral questionnaire), measured at baseline and after the 4-week intervention.

Diabetic peripheral neuropathy (DPN) is a common complication of prolonged hyperglycemia that damages peripheral nerves, leading to impaired sensory function, increased fall risk, and reduced quality of life. Balance training has shown promising effects in improving postural stability and reducing fall risk in individuals with DPN by engaging visual, vestibular, and proprioceptive systems and promoting central nervous system adaptation. This randomized controlled trial aims to compare the effects of Reactive Balance Training (RBT) and Task-Oriented Training (TOT) on postural stability in patients with DPN. The study will be a single-blinded, two-group randomized controlled trial conducted over one year at Foundation University College of Physical Therapy. A sample of 36 participants will be recruited through convenience sampling and randomly allocated into two groups using the coin-toss method. Ethical approval will be obtained from the FUSH ERC, and written informed consent will be obtained after explaining the study procedures, risks, and benefits. Postural stability will be assessed using the Posture Assessment Checklist, Mini-BESTest, Functional Reach Test (FRT), and Timed Up and Go (TUG). Group A will receive RBT, while Group B will receive TOT. Each session will last 30-40 minutes, including a 5-7-minute warm-up, 20-30 minutes of group-specific intervention, and a 5-minute cool-down. Participants will receive 60-second rest intervals after every three sets or 8-10 repetitions. The intervention will continue for six weeks, with three sessions per week, totaling 18 sessions. Assessments will be conducted at baseline, at week 3, and post-intervention at week 6 using the same outcome measures.

Bell's palsy is an acute,unilateral facial paresis that significantly affects patient's facial symmetry,motor function and quality of life.The primary goal of this randomized controlled trial is to determine if integrating the targeted neural mobilization with proprioceptive neuromuscular facilitation improves facial symmetry and motor function more effectively than using pnf alone.participants allocated to either experimental group receiving neural mobilization and pnf or control group receiving pnf alone.after approval from ERC FUSH, participants are assessed using housebrackman scale and sunnybrook facial grading system(scales to asses the degree of severity of facial paralysis) at first and fourth week of intervention application.data will be analysed using spss v.22.

This single-blinded randomized controlled trial aims to compare the effectiveness of maximum versus minimum therapist supervision during home-based telerehabilitation for improving upper limb motor function, task performance, coordination, and proprioception in stroke survivors. The study will be conducted at MDL Rehabilitation FUCP and participants' home settings. A total of 30 stroke survivors aged 40-70 years with mild to moderate upper limb impairment (Fugl-Meyer Assessment of the Upper Extremity \[FM-UE\] score 23-56) and a stroke duration of 3-24 months will be recruited through purposive sampling and randomly allocated to either the maximum- or minimum-supervision group.Participants in the maximum-supervision group will receive three 45-minute videoconference-based telerehabilitation sessions per week, for a total of 24 sessions over eight weeks. Exercises will be individualized according to baseline FM-UE scores. The minimum-supervision group will perform an independent home-based exercise program at the same frequency and duration, supplemented by weekly therapist check-ins and a self-maintained exercise log. Both groups will receive standardized instructional materials, including an exercise booklet and demonstration videos, and will perform exercises within individual fatigue limits.The primary outcomes will be assessed using the Fugl-Meyer Upper Extremity Assessment, Wolf Motor Function Test, Comprehensive Coordination Scale, and Thumb Localization Test, evaluating upper limb motor recovery, functional task performance, coordination, and proprioception.The study is expected to determine whether greater therapist supervision provides superior or comparable outcomes and to contribute evidence for developing effective, scalable, and cost-efficient home-based telerehabilitation models for stroke rehabilitation.

Stroke is a leading cause of long-term disability worldwide and frequently results in persistent upper limb impairment, particularly affecting hand dexterity and motor function. These impairments significantly restrict the performance of activities of daily living, reduce functional independence, and negatively affect quality of life. Task-oriented rehabilitation has become an important component of stroke management because it promotes motor relearning through repetitive practice of meaningful functional activities. Among these approaches, task-specific drawing exercises and fine motor hand training have demonstrated potential to improve upper limb function; however, evidence directly comparing their effectiveness remains limited. This randomized controlled trial will compare the effects of task-specific drawing exercises and fine motor hand training on hand dexterity and hand motor function in individuals with subacute stroke. Twenty-six participants will be randomly allocated to one of two intervention groups. Both groups will receive conventional wrist and finger range-of-motion exercises before participating in their assigned intervention. Participants in the task-specific drawing exercise group will perform a progressively graded drawing program, whereas participants in the fine motor hand training group will complete a structured program of functional object-manipulation activities. Both interventions will be administered on alternate days for 30-45 minutes over a four-week period. The primary outcome will be hand dexterity, and the secondary outcome will be hand motor function. Outcome assessments will be performed at baseline and following completion of the intervention period using standardized assessment tools. The findings of this study are expected to provide comparative evidence regarding the effectiveness of task-specific drawing exercises and fine motor hand training for improving hand function after stroke. The results may contribute to evidence-based neurological rehabilitation and assist physiotherapists in selecting effective intervention strategies to enhance upper limb recovery, functional independence, and quality of life in individuals with subacute stroke.

This randomized controlled trial investigates whether adding Pain Neuroscience Education (PNE) to standard pre-operative physiotherapy improves outcomes after lumbar laminectomy. Chronic low back pain often involves central sensitization, where the nervous system continues amplifying pain signals even after the structural problem is surgically corrected, contributing to persistent neuropathic pain and disability after spine surgery. The study will enroll 44 male and female patients aged 35-60 scheduled for elective one- or two-level lumbar laminectomy, with a pre-surgical waiting period of at least three weeks. Participants will be randomized into two equal groups. The experimental group will receive a three-week "nervous system priming" program: three 45-minute sessions combining PNE (explaining pain biology and neuroplasticity through culturally adapted metaphors) with standard exercises (ankle pumps, quad sets, gluteal sets, isometric abdominal sets, heel slides, and walking), plus a home program. The control group will receive identical standard exercises and session structure, but without PNE, using placebo counselling instead. Outcomes will be measured using the painDETECT questionnaire (neuropathic pain) and the Oswestry Disability Index (functional disability), assessed at baseline, three weeks post-operatively, and three months post-operatively. The study will run for seven months following ethical approval. The research addresses a gap in current perioperative care, which is typically reactive and rarely incorporates neurophysiological education into prehabilitation. If PNE proves effective, it could reduce post-laminectomy neuropathic pain and disability, decrease dependency on painkillers and prolonged rehabilitation, and inform more effective pre-surgical protocols for spine surgery patients.

The primary goal of this study is to compare the number of white spot lesions during fixed appliance therapy between self-etch and one-step bonding systems.

This clinical study is planned to be conducted to compare retention rates of pits and fissure sealants on non carious (ICDAS score 0) vs Initial carious enamel lesions (ICDAS Score 1,2) in posterior permeant teeth at 3 months, 6 months and 12 months follow-up. This will help us guide follow-up strategies for optimal caries prevention.

Plantar fasciitis is a common musculoskeletal condition characterized by inflammation and microtears of the plantar fascia, leading to heel pain, particularly during initial steps after rest. It negatively impacts gait, mobility, and overall quality of life. Physiotherapy interventions such as stretching, strengthening, electrotherapy, and taping techniques are commonly used for management. Among these, Low-Dye taping and calcaneal taping provide biomechanical support by reducing strain on the plantar fascia and improving foot posture; however, comparative evidence between the two is limited. This study aims to evaluate the effectiveness of Low-Dye taping versus calcaneal taping in reducing pain and improving foot function in patients with plantar fasciitis. A total of 36 participants will be randomly assigned to either intervention group and treated over a two-week period. Outcome measures will include pain (VAS), functional ability (FFI), ankle range of motion (goniometer), and gait analysis, assessed before and after intervention. Data will be analyzed using SPSS v27, with statistical significance set at p \< 0.05.

This study examines the effects of autogenic inhibition (PFS) versus reciprocal inhibition in individuals with lower cross syndrome

This study aims to evaluate the combined effectiveness of Mulligan mobilization and core strengthening exercises in managing postpartum sacroiliac joint dysfunction (SIJD). Postpartum SIJD is a common condition resulting from biomechanical and hormonal changes during pregnancy, often leading to pelvic instability and pain. Mulligan mobilization, a manual therapy technique, aims to correct joint alignment and restore pain-free movement. For the SIJ, Mulligan MWM aims to correct subtle positional faults or movement restrictions that may cause pain and dysfunction-especially common postpartum due to ligamentous laxity, hormonal changes, and altered biomechanics.The core muscles provide stability to the pelvis and lumbar spine. When these muscles are weak or imbalanced, it can lead to increased strain on the SIJ, contributing to pain and dysfunction. Strengthening the core improves load transfer through the pelvis and enhances neuromuscular control, thereby reducing SIJ stress and symptoms. Core strengthening exercises enhances outcomes by targeting both mechanical alignment and muscular stability. Core strengthening exercises target muscles that support pelvic stability, including the transverse abdominis and pelvic floor. The study hypothesizes that integrating Mulligan mobilization with core strengthening may provide superior outcomes in pain reduction, joint function, and overall quality of life compared to core exercises alone.