Clinical trials

The purpose of this randomized controlled trial is to determine the optimal exercise duration of a combined exercise program (aerobic + resistance) in patients undergoing hemodialysis by evaluating its effects on dialysis adequacy, fatigue, depression, VO2 max, muscle strength, physical functioning, and QOL in patients undergoing hemodialysis.

The study will take place at Akbar Niazi Teaching Hospital and AL kauther International hospital, Bhara Kahu, Islamabad with formal permission obtained from the institution. Patients with forward head posture, who meet the inclusion criteria, will be selected and asked for consent. Participants will be randomly assigned to either a pressure bio feedback training group or a visual biofeedback training group using a computer randomizer. Before starting the training, baseline measurements of neck muscle activation and posture will be recorded. Group1will receive pressure bio feedback training using a cuff, while Group 2 will use visual feedback through a mirror or screen to correct posture. An 6 weeks intervention will be implemented, with treatments administered three times per week. Outcome measures will be assessed at baseline and again at the conclusion of the 6 weeks intervention period. The results will be analyzed using the latest version of SPSS (Statistical Package for the Social Sciences).

This study aims to compare the effect of isometric exercises and eccentric exercises on calf muscles in cricketers. The exercises will be evaluated for the effectiveness of calf muscle strength, power, and sprinting of the player and enhancing their performance.

This randomized controlled trial will evaluate the effectiveness of pressure biofeedback-assisted deep cervical flexor training with and without scapular stabilization exercises in patients with cervical spondylosis. The study will compare the effects of the two treatment approaches on pain intensity, cervical range of motion and neck disability.

EFFECTIVENESS OF KALTENBORN MOBILIZATION TECHNIQUES VERSUS MAITLAND MOBILIZATION ON MANAGEMENT OF CERVICOGENIC HEADACHE

Type 2 Diabetes Mellitus (T2DM) is a major global health concern associated with chronic hyperglycemia, oxidative stress, and accumulation of advanced glycation end-products, which impair connective tissue function and commonly restrict ankle (tibiotalar) mobility. Reduced ankle range of motion, neuropathic pain, and gait instability significantly impair daily activities and quality of life in this population, and reduced ankle mobility is further associated with increased risk of diabetic foot ulceration. Conventional physiotherapy is widely used to address these impairments through exercise, stretching, and strengthening, but may not fully resolve mechanical joint restrictions. Mulligan's Mobilization with Movement (MWM) is a manual therapy technique in which a sustained glide is applied to the ankle during active weight-bearing movement, correcting positional faults and improving dorsiflexion range of motion. While MWM has shown benefit in non-diabetic ankle conditions, its effectiveness relative to conventional physiotherapy in patients with T2DM remains unclear. This study is a randomized controlled trial comparing the effects of Mulligan Mobilization with Movement (Group A) versus conventional physiotherapy (Group B) on pain intensity, ankle range of motion, functional mobility, and quality of life in adults aged 50-70 years with Type 2 Diabetes Mellitus of more than 5 years' duration. A total of 56 participants will be recruited using non-probability purposive sampling and randomly allocated by coin-toss method into two equal groups of 28. Both groups will receive baseline treatment (hot pack application and gentle active ankle movement) followed by their assigned protocol - Group A receiving MWM (sustained anteroposterior/posteroanterior glide to the distal tibia or fibula during active dorsiflexion or plantarflexion, 3 sets of 10 repetitions) and Group B receiving conventional physiotherapy (active/passive range-of-motion exercises, calf raises, and calf/Achilles stretching) - three sessions per week for six weeks. Outcomes will be assessed at baseline and following the six-week intervention period. Primary outcome measures include pain intensity (Numeric Pain Rating Scale), ankle range of motion (goniometer), functional mobility (Timed Up and Go test), and quality of life (SF-12 Health Survey). Data will be analyzed using IBM SPSS Statistics version 27, with normality assessed via the Shapiro-Wilk test and within- and between-group comparisons made using parametric or non-parametric tests as appropriate. This trial is expected to generate direct comparative evidence on whether Mulligan Mobilization with Movement offers superior outcomes to conventional physiotherapy for ankle-related impairments in patients with T2DM, helping physiotherapists select more targeted, evidence-based rehabilitation protocols for this population.

This randomized controlled trial compares the effectiveness of Instrument-Assisted Soft Tissue Mobilization (IASTM) and Deep Transverse Friction Massage (DTFM) in patients with trapezius myalgia. A total of 42 participants aged 18-45 years will be randomly assigned to either intervention group. Both groups will also receive conventional physiotherapy consisting of TENS, hot packs, range-of-motion exercises, and stretching. Treatment will be provided four sessions per week for four weeks. Outcomes include pain intensity, cervical range of motion, muscle strength, and functional disability.

This is a randomized control trial aims to evaluate the efficacy of gross myofascial release with neural mobilization versus neural mobilization alone on pain, functional limitations, and cervical range of motion in cervical radiculopathy. Cervical radiculopathy, is characterized by neck pain, pain radiating down the arm, numbness, tingling, weakness of muscles and functionality limitations with compression or irritation of the cervical nerve root due to cervical spondylosis, cervical disc herniations or degeneration of the cervical spine leading to cervical radiculopathy and the diminished quality of life from decreased day-to-day functional capacity and productivity at work. The study will evaluate pain, functional limitations, and cervical range of motion.

This randomized controlled trial aims to evaluate the effects of mirror therapy combined with conventional training on gait and lower limb motor function among post-stroke patients. Stroke remains a worldwide health crisis, persistently ranking as a leading cause of long-term severe disability. The study will evaluate the gait and lower limb motor function.

This randomized controlled trial aims to compare the effectiveness of Vestibular-Oriented Balance Training and Motor Dual Task Training on balance, postural control, and fall risk among chronic stroke survivors. Forty-six participants diagnosed with chronic stroke will be randomly allocated into two intervention groups. Both groups will receive conventional physiotherapy along with their assigned intervention for six weeks. Outcome measures will include the Biodex Balance System (Overall Stability Index, Anterior-Posterior Stability Index, Medial-Lateral Stability Index and Fall Risk Index), Modified clinical test of sensory interaction on balance( m-CTISB). The findings will provide evidence regarding the most effective rehabilitation strategy for improving, Overall stability, and functional balance and reducing fall risk in chronic stroke survivors.

This randomized controlled trial aimed to evaluate the effectiveness of a Virtual Reality (VR)-mediated gamified rehabilitation program compared with conventional physical therapy in children with spastic diplegic cerebral palsy. Forty-two children aged 7-15 years with Gross Motor Function Classification System (GMFCS) Levels II and III were recruited from Rafsan Neuro Rehab Center, Peshawar. Participants were randomly allocated into two equal groups. The intervention group received VR-based gamified rehabilitation using Xbox Kinect along with physiotherapy, while the control group received conventional physiotherapy only. Both groups completed 18 treatment sessions over six weeks. Outcome measures included the Timed Up and Go Test (TUG), Pediatric Balance Scale (PBS), Trunk Impairment Scale (TIS), and Gross Motor Function Classification System (GMFCS). The findings demonstrated that VR-mediated rehabilitation significantly improved functional mobility, balance, and trunk control compared with conventional therapy. The study concludes that VR-based rehabilitation is an effective, motivating, and clinically useful intervention for children with spastic diplegic cerebral palsy and may improve rehabilitation outcomes and functional independence.

This randomized controlled trial was conducted to compare the effectiveness of Modified Constraint-Induced Movement Therapy (MCIMT) and Mirror Therapy in improving upper limb function among children with spastic hemiplegic cerebral palsy. Upper limb dysfunction, including reduced grip strength, impaired manual dexterity, and increased spasticity, limits functional independence and participation in daily activities in these children. Although both interventions are widely used in pediatric rehabilitation, direct comparative evidence remains limited. A total of 42 children aged 5-9 years diagnosed with spastic hemiplegic cerebral palsy were recruited from Akbar Kare Institute and Comprehensive Physical Rehabilitation Center, Peshawar. Participants were selected through convenience sampling and randomly allocated into two equal groups using the sealed envelope method. Group A received Modified Constraint-Induced Movement Therapy, while Group B received Mirror Therapy. Both groups received treatment for 30 minutes per session, five sessions per week, for six consecutive weeks. Grip strength was assessed using the Hand-Held Dynamometer, manual dexterity using the Box and Block Test, and spasticity using the Modified Ashworth Scale. The findings of this study provide evidence regarding the comparative effectiveness of these two rehabilitation approaches and may assist clinicians in selecting the most appropriate intervention for improving upper limb function in children with spastic hemiplegic cerebral palsy.

This randomized controlled trial aims to compare the effectiveness of ice pack therapy and cold bath immersion when combined with standard exercise therapy in adults with plantar fasciitis. Plantar fasciitis is a common cause of heel pain that can limit daily activities and reduce quality of life. Participants will be randomly assigned to receive either ice pack therapy or cold bath therapy in addition to the same standardized exercise program. The primary outcome will be pain intensity measured using the Visual Analogue Scale (VAS), and the secondary outcome will be foot function measured using the Foot Function Index (FFI). The findings of this study may help identify the more effective cryotherapy method for reducing pain and improving function in individuals with plantar fasciitis.

Children with spastic diplegic cerebral palsy often experience upper extremity impairments, including reduced coordination, muscle control, and functional hand use, which limit independence in daily activities. Proprioceptive Neuromuscular Facilitation (PNF) and Task-Oriented Training (TOT) are commonly used rehabilitation approaches to improve motor function; however, evidence comparing their individual and combined effects on upper extremity function remains limited. This randomized controlled trial aims to compare the effects of PNF alone, TOT alone, and a combined PNF plus TOT intervention on upper extremity function in children with spastic diplegic cerebral palsy. Sixty-three children aged 6 to 12 years with Gross Motor Function Classification System (GMFCS) levels I to III will be randomly assigned to one of three intervention groups. Each group will receive supervised 45-minute treatment sessions, three times per week for six weeks. Upper extremity function, functional independence, and joint range of motion will be assessed at baseline, mid-intervention (3 weeks), and post-intervention (6 weeks) using the Melbourne Assessment of Unilateral Upper Limb Function (MA2), Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS), and goniometric measurements. The findings of this study are expected to provide evidence regarding the most effective rehabilitation approach for improving upper extremity function in children with spastic diplegic cerebral palsy.

This is a randomized controlled trial aims to evaluate the comparative effect of Pain Neuroscience Education combined with neural mobilization versus neural mobilization alone in patients with diabetic neuropathic pain. This study will Compare pain intensity between intervention groups and assess functional disability outcomes. Furthermore, this will evaluate changes in quality of life and to analyze pain-related beliefs following PNE.

This randomized controlled trial aims to compare the effectiveness of fully immersive Mixed Reality (MR) combined with standard physical therapy versus standard physical therapy alone in improving balance and coordination among adolescents with spastic diplegic cerebral palsy. A total of 40 participants aged 10 to 19 years will be randomly assigned to one of two treatment groups. The intervention will be provided three times per week for eight weeks. Balance and coordination will be assessed before treatment, at four weeks, and after completion of the intervention using validated clinical outcome measures. The findings of this study may help determine whether immersive Mixed Reality can enhance rehabilitation outcomes in adolescents with cerebral palsy.

This study aims to compare the effects of Dry Dynamic Cupping and Instrument-Assisted Soft Tissue Mobilization (IASTM) in patients with chronic myofascial low back pain. The interventions will be evaluated for their effectiveness in reducing pain, improving functional disability, and enhancing quality of life. The findings may help identify a more effective treatment approach for managing chronic myofascial low back pain.

A randomized controlled trial to evaluate the effectiveness of Sensory Motor Control training combined with Muscle Energy Technique in reducing pain and improving function, cervical range of motion, proprioception, and kinesiophobia in individuals with chronic mechanical neck pain

This study compares the effectiveness of Massage Gun Therapy and Deep Friction Massage in individuals with upper trapezius myofascial trigger points. The interventions will be evaluated for their effects on pain intensity, pressure pain threshold, cervical range of motion, and neck disability. The aim is to determine which treatment is more effective in reducing pain and improving functional outcomes.

This study aims to compare the effects of upper-limb plyometric training and traditional strength training on serve velocity, muscular strength, and power in competitive tennis players. Serve velocity is a critical performance factor in tennis, and optimizing upper-limb function is essential for enhancing performance. Participants will be randomly assigned to either a plyometric training group or a strength training group. Both groups will undergo structured training programs over a defined intervention period. Outcome measures, including serve velocity, upper-limb strength, and power, will be assessed at baseline and after the completion of the intervention. The findings of this study will help determine the most effective training approach for improving performance in tennis players and may guide coaches, athletes, and rehabilitation professionals in designing evidence-based training programs.

This randomized controlled trial aims to compare the effectiveness of reactive balance training versus conventional balance training on dynamic stability and change of direction performance. Participants will be randomly allocated into two groups. Each group will receive its respective intervention over a 6-week period. Outcome measures, including dynamic stability assessed by the Y-Balance Test and change-of-direction performance measured using the 505 Agility Test, will be evaluated at baseline and after the intervention. The study is designed to determine which training approach is more effective in improving balance and functional performance.

This randomized controlled trial compares blood flow restriction (BFR) resistance training (leg press and seated knee extension at 30% 1RM) versus BFR cycling (stationary cycling at low resistance) in 60 athletes (aged 18-40 years) diagnosed with patellofemoral pain syndrome. Both interventions are delivered over 8 weeks (3 sessions/week) with a pneumatic cuff set at 80% limb occlusion pressure. Primary outcomes include pain intensity (NPRS), quadriceps strength (handheld dynamometer), and functional ability (Kujala Anterior Knee Pain Scale), assessed at baseline and post-intervention.

This randomized controlled trial investigates the comparative effect of combined strength and balance training versus balance and core training on kinesiophobia (fear of movement), ankle instability, functional outcomes, and athletic performance in adolescent table tennis players with functional ankle instability (FAI). Participants will be randomly allocated into two groups over a 6-week intervention (3 sessions/week). The Experimental Group will receive combined strength and balance training, while the Control Group will receive balance and core training. Outcomes will be measured using validated tools: TSK-17, CAIT, FAAM, Y-Balance Test, Single-Leg Hop Test, T-Test, and Illinois Agility Test.

This is an RCT aims to explore Perturbation-Based Balance Training versus Progressive Neuromuscular Training as an Adjunct to Conventional Physiotherapy for Pain Reduction and Functional Improvement in Knee Osteoarthritis.

focuses on the comparative efficacy of Neuromobilization techniques, tendon gliding exercises, and their combined application in the management of mild to moderate Carpal Tunnel Syndrome through a randomized controlled trial (RCT)