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NCRS
National Conference
on Rehabilitation Sciences
National Conference on
Rehabilitation Sciences
Comprehensive Approach in Rehabilitation Sciences
8-10 May, 2015
Jacaranda Family Club, Islamabad
Abstract Book
Collaborators:
riphah
international
university
faisalabad campus
PIPOS
PAKISTAN INSTITUTE OF PROSTHETIC
AND ORTHOTIC SCIENCES
Conference Secretariat:
Organized By:
riphah
international
university
Riphah College of Rehabilitation Sciences, Al-Mizan
IIMCT Complex, 274 - Peshawar Road, Rawalpindi - Pakistan.
UAN: +92 (51) 111-510-510 | Phone: +92 (51) 5125161-7
Email: [email protected] | Website: ncrs.riphah.edu.pk
NCRS Committee
Chairman:
Secretary:
Dr. Asghar Khan
Director/Associate Professor
RCRS
Dr. Syed Shakil ur Rehman
Principal RCRS
Rawalpindi Campus
Committees:
Steering Committee:
Finance Committee:
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Mr. Hassan Muhammad Khan
Dr. Anis Ahmed
Mr. Asad Ullah Khan
Maj General (R) Masood Anwar
Dr. Asghar Khan
Mr. Aqeel Shazad
Dr. Syed Shakil Ur Rehman
Dr. Syed Imtiaz Hussain Shah
Dr. Arshad Nawaz Malik
Dr. Abdul Ghafoor Sajjad
Dr. Imran Amjad
Dr. Rashid Hafeez
Dr. Salman Bashir
Ms. Ayesha Kamal
Dr. Sikandar Khan
Dr. Asghar Khan (Chair of the Committee)
Dr. Imtiaz Hussain Shah
Dr. Shakil Ur rehman
Dr. Arshad Nawaz Malik
Dr. Abdul Ghafoor Sajjad
Mr. Shahid Mehboob
Mr. Asif Iqbal
Scientific Committee:
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Dr. Arshad Nawaz Malik (Chair of the Committee)
Ms. Ayesha kamal Butt
Dr. Rashid Hafeez
Dr. Maryam
Dr. Sikandar Khan
Dr. Salman Bashir
Organizing Committee:
Venue Management Committee:
· Dr. Abdul Ghafoor Sajjad (Chair of the Committee)
· Dr. Sikandar Khan
· Dr. Rashid Hafeez
Marketing Committee:
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Dr. Imran Amjad (Chair of the Committee)
Mr. Aqeel Shazad
Dr. Aamer Naeem
Ms. Ayesha Kamal
Syed Ali Abbas Zaidi
· Dr. Abdul Ghafoor Sajjad (Chair of the Committee)
· Dr. Imran Amjad
List of Contents
Title
Page No.
Keynote Speakers
Culturally & Linguistically Apt Assessment for Phonology, Language, Vocabulary, Pragmatics
& Aphasia along with Therapeutic Interventions (Ayesha Kamal Butt)
3
Comprehensive Approach in Rehabilitation Sciences “Role of Assistive devices in
Rehabilitation Sciences-Pakistan Perspective” (Bakht Sarwar)
4
Evolving Rehabilitation Sciences in the Context of Integrative and Regenerative Medicine
(Muzaffar K. Awan)
5
Diagnosis and Management of low back pain with Cyriax Manual Therapy approach
(Muhammad Khan)
6
Physical Therapy for a Patient with Osmotic Demyelination Disorder (Farhia Shah)
7
Outcomes of the Community Based Rehabilitation Programme following Anterior Cruciate
Ligament Reconstruction (Haider Darain)
8
Comprehensive Physical Rehabilitation of people with spinal cord injuries in
Pakistan (A Case Study) (Ilyas Syed)
9
What are the factors influencing the community integration of patients following Spinal Cord
Injury: A Systematic Review (Muhammad Kashif)
10
Role of Tapping in Severe Shoulder Pain Due to the Loss the Total Loss of Muscle Strength
(Keramat Ullah Keramat)
11
Revival of Prosthetic & Orthotic Profession in Pakistan (Mazhar Hussain Tazagrami)
12
Meniscal Testing (Muhammad Nazim Farooq)
13
Women’s Health: Scope of Physiotherapy Practice in the Conservative Management of
common UroGynae problems (Patricia MacLoughlin)
14
Curiosity & Hope - Multidisciplinary Approach (Shahid Ahmed Heera)
15
Nerve Conduction Study and Electromyography (Syed Ali Shah)
16
Approach to Cerebral Palsy and Neuro developmental Delay: A Single Centre
Experience in KPK (Yvonne Frizzell)
17
Education and Research Trends in Rehabilitation Sciences (Arshad Nawaz Malik)
18
Oral Presentation
To Determine the Physical Activity and Quality of Life in Geriatric Population (Sana Bashir)
19
Evaluation of the Forward Head Posture, Prevalence and Associated Factors of Neck Pain in
Female DPT Student (Abrish Habib Abbasi)
20
Frequency of Fear Avoidance Beliefs in Patients with Neck Pain (Saba Murad)
21
Effective Tool in Polio Management “Mahboob Power Evaluation and Therapeutic (MPET)
Chart”(Mahboob ur Rahman)
22
Effectiveness of Planter Fasciitis Taping and Calcaneal Taping In Planter Heel Pain (Bushra
Babar)
23
The Effect of Combining Phonophoresis and Mobilization with Movement in the
Management of Knee Osteoarthritis: A Clinical Trial with Randomization (Atif Dustgir)
24
Prevalence of De Quervain’s Syndrome among Young Mobile Phone users (Taimoor-ulHassan)
25
Title
Page No.
Effectiveness of Thoracic Spine Manipulation on Subjects with Subacromial Impingement
Syndrome (Danish Hassan)
26
The Gap between Education and Practice: A Survey about Physical Therapists’ Perceptions
(Bilal Umer)
27
Speech & Language Pathology
Common Co-Morbidities Associated With Language Delay (Sumera Nawaz Malik)
28
Parental Preferences for the Marriage of their Children with Hearing Impairment (Sidra
Munir)
29
Efficacy of Color Coding vs. Traditional Method for Phrase Development in Mild to Moderate
Children with Special Needs (Shehla Yasmin)
30
Development of Assessment Tool for Diagnosis of Aphasia (Saima Haider)
31
Efficacy of Video Modeling Technique for Word Production in Children with Intellectual
Disability (Sobia Taj)
32
How we learn: Learning Style Preferences of Riphah International University’s SpeechLanguage Pathology students as per the VARK test (Hajra Gull)
33
Evaluation of SLP Knowledge and Perception Regarding PECS with Children on ASD in Twin
Cities (Saiqa Yasmin)
34
Evaluation of Phonological Assessment Practices By Speech and Language Pathologists in
Pakistan of Children with Suspected Speech Sound Difficulties (Munaza Parveen)
35
Poster Presentation
Community Awareness of the Warning Signs, Symptoms and Risk Factors of Stroke in
Rawalpindi / Islamabad (Nausheen Irum)
36
Effect of Sleep Quality on Grades of University Students of Rawalpindi / Islamabad
(Anam Zafar)
37
To determine the preference and feedback of Patients about treatment in physical therapy
OPDs (Ibadullah)
38
Association of Maternal Obesity and Preeclampsia with Gestational Diabetes Mellitus (GDM)
(Wardah Qazi)
39
Physiotherapy Student's Attitude towards Physiotherapist - Patient Relationship
(Maryam Shabbir)
40
Frequency of Fine Motor Impairments in Patients with Guillain Barre Syndrome
(Yusra Nayab)
41
Epidemiological Survey on Prevalence of Musculoskeletal Injuries in Elite Class Rugby Players
of Pakistan (Rashid Hafeez Nasir)
42
Prevalence and Severity of Temporomandibular Disorders in Undergraduates of Khyber
Medical University: A Cross Sectional Study (Hajra Mukhtar)
43
Learning Style Preferences of Physical Therapy Students in Lahore (Eisha Amin)
44
Quality of Life Issues in Older Adults Suffering From Parkinson’s Disease (Nadia Hussain)
45
Common Health Problems in Office Executives; A Cross Sectional Study (Zahra Jabeen)
46
The Satisfaction of Students of Doctor of Physical Therapy and their Future Retention
(Misbah Amanat)
47
Title
Page No.
Speech & Language Pathology - Poster
Frequency of Voice Disorders among Teachers and Associated Risk Factors
(Anam Yaqoob)
48
Frequency of Social Phobia in People Who Stutter (Madiha Maqsud)
49
Effectiveness of the use of Hearing Aid vs Cochlear Implant for Children with Profound
Defenses (Faiza Jabeen)
50
Prosthetic & Orthotic- Poster
Frequency of Congenital Anomalies of the Extremities (Anam Razzaq)
51
Functional Outcome of Colle’s Fracture Brace in the Treatment of Colle’s Fracture After
Removal of Circumferential Pop Cast at 2 Weeks (Neelam Nadeem)
52
Role of mother’s smoking to cause CTEV (Amir Shahzad)
53
Non-Operative Treatment of Tibial Fracture with Orthotic Intervention (Amina Jamil)
54
Malalignment of Ankle-foot Orthosis & its Relative Effects on Body (Laraib Nawaz)
55
Effectiveness of Boston Brace in treating Scoliosis (Saroosh Bilal)
56
NCRS
National Conference
Keynote Speakers
NATIONAL CONFERENCE ON REHABILITATION SCIENCES
Culturally & Linguistically Apt Assessment for Phonology, Language,
Vocabulary, Pragmatics & Aphasia along with Therapeutic Interventions
Speaker: Ayesha Kamal Butt
Ayesha Butt is an Assistant Professor and the Head of Department of Speech and Language
Pathology in RCRS. She completed her postgraduate degree in Speech and Language Pathology
from the University of Reading, UK. She went on to pursue a course in Linguistics and Child
Language at the University of Hertfordshire, UK, where she graduated with commendation. Ms
Ayesha is a member of the Royal College of Speech and Language Therapists, UK. Since
graduating in 2004, she has worked in a range of settings both in Pakistan and in the United
Kingdome. Currently she is a docotral research scholar in Malaysia. In Pakistan she has worked in
hospitals such as Shaukat Khannum Memorial Hospital and Shifa International Hospital.
Ms Ayesha is on the
advisory pannel of the American Embassy and her services are often
sought by other diplomatic panels. She is a pioneer in establishing a centre at Riphah for children
with special needs. Ms Ayesha is the first LSVT trained therapist in Pakistan. Her main areas of
research are autism, language delay, specific language impairment and clinical decision making
in speech pathology, however, she is also actively involved in establishing Urdu language
assessments. She is well respected in her circle for the quality of her researh and has several
publications to her credit.
The key note will provide participants with an opportunity to gain insight into the latest research
at Riphah, It will provide an overview of the research carried out at Riphah International University
and the contributions that have been made by the department in the world of speech and
language therapy through research and clinical work in terms of assessment and management.
Culturally and linguistically apt assessments for phonology, language, vocabulary, pragmatics
and aphasia will be discussed along with therapeutic interventions such as video modeling, video
therapy, color coded sentence building, group therapy and a range of interventions for
stammering and aphasia. Speech and Language Pathologists, psychologists, educators, linguists,
students and a range of rehabilitation professionals will benefit from the presentation.
01
“Role of Assistive devices in Rehabilitation Sciences-Pakistan Perspective”
Speaker: Prof. Dr. Bakht Sarwar
More than 700 million people in the world experiences disabilities of various types and degrees.
An estimated 80% of the world’s disabled people live in developing countries. The majority of
them is poor and find difficulty in accessing health and rehabilitation services which ultimately
leads to their exclusion from society. With appropriate rehabilitation services, the majority of
people with disabilities can become important contributors to society and allocating resources to
their rehabilitation is an “Investment”
Demographic factors such as health and fitness as well as gender and age determine the
likelihood of individuals to participate in a society and benefits from the social services provision
given the availability of such provisions. Disability limits and in extreme cases fully inhibits the
ability of an individual to gain access to education and employment and in this way they are
excluded from economic system. Less mobility due to disability and the negative attitude of
society as a whole towards disabled people further leads to social exclusion. Despite the
incremental progress made in the past 25 years, today, the vast majority of people with disabilities
cannot access even basic rehabilitation services.
Mobility is the first step allowing individuals access to basic rights such as education, health care,
employment, equal opportunities and equal citizenship. The most important components in the
restoration of mobility are assistive devices. Assistive devices and technologies such as
prostheses, orthoses and mobility aids increase mobility and communication capacities. With the
aid of these technologies, people with a loss in functioning are able to enhance their abilities, and
are hence better able to live independently and participate in their societies.
As per World Health Organization the persons with physical disabilities, who have a need for
prosthetics/orthotics and related rehabilitation services in developing countries, represent 0.5 %
of the population. With a population of 190 million, Pakistan have nearly one million disabled
people who need provision of prosthetics and orthotics services. The majority of these persons
can remain free of deformities or be re-established to function in society if provided with
appropriate prosthetic/orthotic devices.
They can be at least partly removed from poverty and become active contributors to their
families, communities and society welfare at large, if provided with rehabilitation services by an
integrated multi-disciplinary health and social welfare team. Beneficiaries of prosthetics and
orthotics can contribute positively to the socio-economic condition of the country.
02
Evolving Rehabilitation Sciences in the Context of Integrative and
Regenerative Medicine
Speaker: Muzaffar K. Awan
PT, MD. Medical Director, Allen Park Health & Rehab Center, Allen Park, Michigan, USA
A Pakistani - American Physician & physical therapist will present the topic in the light of his own personal & professional journey.
Rehabilitation Sciences in the 21st century are being propelled by innovative scientific
knowledge and clinical skills aimed at offering integrated and better solutions for an ever
increasingly populations afflicted by acute, sub-acute and chronic debilitating disorders and
painful conditions.
Increasing being recognized as one of the core components of the evolving integral health care
system in the East and the West, the role of regenerative medicine underscores a paradigm shift
in patient management targeted at restoring and normalizing physiologic function and
restituting a better quality of life.
Newly discovered regenerative technologies and techniques (through a translational science of
‘bench to bed-side and back’) offer unprecedented prospects in achieving repair, regeneration
and complete healing of the degenerated, diseased, or damaged tissues and dysfunctional
systems of human anatomy and physiology.
In this context, principles of regenerative science are being urgently integrated into rehabilitation
sciences as will be illustrated in the presentation. Thus encompassing a growing multidisciplinary
domain, the emergent era of regenerative rehabilitation bringing the most promising
innovations at the forefront of integral healthcare system for the brighter future of human health.
03
Diagnosis and Management of low back pain with
Cyriax Manual Therapy approach
Speaker: Muhammad Khan
MSPT (UK), BSCPT (UK), PGD Orthopaedic Medicine (UK) MCSP (UK), SRPT (UK)
Assistant Professor & HOD Physiotherapy, IPM&R, DUHS, Karachi
Introduction: Assessment and treatment of low back pain is a complex phenomenon and in even
today’s modern practice it is a considerably high challenge for physical Therapists. Many interventions have been applied for the treatment of back pain includes electrotherapy, exercises and
manual therapy. In manual therapy itself many school of thoughts such as Maitland, Mulligan,
Kalterborn and Cyriax concepts. These techniques when applied to appropriate group of patients
can improve outcomes in back pain patients. Hence there is a need to look at strategies for
evidence based manual therapy assessment and treatment skills. Thus this workshop will be
focused on looking at the use of Cyriax Manual therapy techniques in managing low back pain.
Objective: To improve participant’s Cyriax manual therapy clinical skills to deal with patients
having low back pain.
Significance: Traditional physiotherapy care for back pain consists of TENS, Hot and Cold packs,
SWD, exercises and rest. In today’s evidence based era there is a need to explore manual therapy
skills based on clinical reasoning, diagnosis and application of specific techniques. In manual
therapy practice Cyriax way of patient’s management is an area which needs to be explored
further.
Method / Plan of delivery of the lecture: This 25 minutes session is a combination of short
videos and a presentation.
Learning Outcomes: At the end of this session, participants will be able to:
Learn about back pain clinical models used in Cyriax method. Apply Cyriax manual therapy techniques in the management of low back pain.
Conclusion: This session is a combination of shor videos and a presentation aims to improve clinical reasoning, diagnosis and Cyriax treatment skills in treating low back pain.
Keywords: Cyriax, Manual Therapy, Back pain
04
Physical Therapy for a Patient with Osmotic Demyelination Disorder
Presenter: Farhia Shah
DPT (USA) Head of Department, Fatima Memorial Hospital College of Medicine & Dentistry, Lahore
Impairments and functional limitations that result from neurological disorders mostly require
intensive neuro-rehabilitation. Such is the case with Osmotic Demyelination Syndromes. An
evidence based approach to comprehensive physical therapy provided to for attainment of a
patinet’s functional independence goals and outcomes will be presented.
Outcomes of the Community Based Rehabilitation Programme following
Anterior Cruciate Ligament Reconstruction
Presenter: Dr. Haider Darain - PhD (UK), M.Sc (Pak), BSPT (Pak), Assistant Professor
Institute of Physical Medicine and Rehabilitation, Khyber Medical University
Rehabilitation programme following anterior cruciate ligament (ACL) reconstruction is
multifaceted and may be influenced by a variety of factors. The role of the environment for care
and the levels of supervision from physiotherapists on the outcomes of ACL rehabilitation, have
not received robust attention in the literature. Therefore, this clinical trial was designed to
evaluate the effects of the environment on ACL rehabilitation programme. A total of 76 patients
[hospital-based rehabilitation group, n = 48 (age: mean ± sd: 31.5 ± 12.1 yr, height: 1.74 ± 0.06 m,
body mass: 78.2 ± 10.8 kg, waiting time: 37.3 ± 33.7 months) and community-based rehabilitation
group, n = 28 (age: mean ± sd: 34.5 ± 9.9 yr, height: 1.71 ± 0.07 m, body mass: 75.2 ± 12.4 kg,
waiting time: 31.1 ± 26.7 months)] self-selected themselves into the hospital and the
community-based rehabilitation programmes.
The patients in the hospital-based rehabilitation programme followed contemporary
rehabilitation in the hospital and the patients in the community-based rehabilitation were guided
to the same rehabilitation programme. The patients in the latter group attended an average of
four rehabilitation sessions in the hospital while the rest of rehabilitation programme was selfmanaged by the patientsin the community. The patients in both the hospital and the
community-based rehabilitation programmes were assessed by selected patient-reported
outcome measures (PROMs) included IKDC, KOOS, K-SES, VAS and Lysholm at four different
occasions (pre-surgery and at the 6th, 12th and 24th weeks post-surgically). Significant
differences at early phase of rehabilitation (up to 12th week post-surgery) on PROMs of function,
favoring the outcomes of the hospital-based rehabilitation programme compared to the
community-based rehabilitation programme, were observed. However, no differences between
the outcomes of the latter two programmes were observed across 24 weeks rehabilitation
programme following ACL reconstruction. This suggested that community-care had offered a
similar environment to the hospital for achieving the outcomes of rehabilitation.
05
Comprehensive Physical Rehabilitation of people with spinal cord
injuries in Pakistan (A Case Study)
Speaker: Dr. Ilyas Syed (Chief Executive Paraplegic Center Peshawar)
The key note presentation will have a brief overview of the types and causes of spinal cord
injuries, epidemiology, complications and its overall impact on the society at large. It will also
include An Introduction to comprehensive physical rehabilitation and Along with the focus on
the following component of comprehensive physical rehab
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Medical & nursing care
Physical therapy
Occupational therapy
Orthotic management
Selection & Customization of wheel chair
Psychological counseling
Re-creational therapy
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Patient & Attendant education/training
Skills building
Community Re-integration
Competitive sports & games
Minor home modifications
Socio-economic support
Awareness & advocacy
What are the factors influencing the community integration of patients
following Spinal Cord Injury: A Systematic Review
Speaker: Muhammad Kashif
Assistant Professor Riphah International University, Faisalabad Campus
Background: Spinal cord injury (SCI) is a high cost disabling condition, which brings a huge
number of changes in individual’s life. A traumatic SCI is one of the most dramatic injuries a
person may experience. Traumatic SCI has great influence on individuals’ life and their families.
Unfortunately, situation for Person living with SCI is not favorable in developing countries. Due to
lack of basic health facilities in developing countries including Pakistan, no special considerations
are given towards rehabilitation of physically disable people.
Purpose: This systematic review was carried out to identify and evaluate the factors associated
with community reintegration of patients after Spinal cord Injury, to critically assess and evaluate
the quality of included studies, to investigate and document the evidences related to the factors
accountable for community reintegration after SCI and to make recommendation for the further
improvement in practice area to handle the factors influencing the community reintegration
following SCI.
Methods: Databases including AMED, BIOMED central, Cochrane Library, MEDLINE, Psycho INFO,
PUBMED, Science DIRECT, Scirus and Wiley Online Library were searched by using he key words
‘Spinal cord injury’ ‘Spinal Cord Lesion’ or ‘Spinal Cord Lesion’ were cross-linked with community
reintegration, community participation, community access.
The methodological quality of included studies was analyzed by using McMaster university tool
and Thomas Tool. The data from these studies was extracted, the data used include: sample size,
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intervention, duration, results, and outcome measures, follow up period, etc.
Results: Eleven articles that addressed the research questions were included in the study. The
evidence extracted from included studies was classified into four groups; health related barriers
or facilitators, environmental related barriers or facilitators, psychological barriers and social
barriers that are associated with community reintegration of SCI individuals.
Conclusion: This review approves that there are more barriers in the form of health related issues,
personal and environmental, psychological and social that hinder the community reintegration of
SCI subjects as compared to facilitators. Most studies notified special challenges related to
environment in the sense of accessibility of home and public buildings and transportation.
Restraining barriers, which are related health, environment, and psychological and social factors,
can enhance community reintegration of patients suffering from SCI.
Role of Tapping in Severe Shoulder Pain Due to the Loss the
Total Loss of Muscle Strength
Speaker: Keramat Ullah Keramat
MS in Sports and Sports and Exercise Physiotherapy (Ireland)
Principal / Assistant Professor, Helping Hand Institute Rehabilitation Sciences Mansehra
Brachial plexus injury, axillary nerve injury and supra scapular nerve entrapment are common
occurrences in shoulder region and causes partial or total loss of strength in the muscles crossing
the glenohumeral Joint. Due to the loss of power in rotator cuff muscles and deltoid muscles, the
gleno-humeral joint relies solely on the inert structure for the stability. Due to the constant
gravitational pull in erect posture the joint sub luxate inferiorly and the inert structure are under
constant stretch which over a period of time causes severe pain. Injuries may also occur during
passive mobilization by an inexperienced person or self.
Pain management in this scenario poses a greater challenge for the clinicians. OTC or NS AIDS
offer very little relief. Electrical modalities may seem ineffective. Shoulder tapping in such a way
as to reinforce the action of rotator cuff provides sufficient pain relief.
07
Revival of Prosthetic & Orthotic Profession in Pakistan
Speaker: Mazhar Hussain Tazagrami
CPO (ISPO Cat.1) Department of Prosthetic and Orthotic Sciences
Riphah College of Rehabilitation Sciences, Riphah International University
Prosthetic & Orthotic profession at degree level was started in 1987 at PIPOS (PETCOT).It was
started in collaboration between Department of Health KPK (Sp. interest of Dr. Manzoor Ahmad
Khan, Principal KMC) and German Agency for Technical Co Operation (GTZ).A purpose built
building was built inside the premises of Hayat Shaheed Teaching Hospital. The Idea was to
introduce Prosthetic and Orthotic profession at a different level than the existing Technician Level
at that time. Right from the beginning this profession was under conspiracies passed through
different ups and down where PIPOS was always a focus. This institute created limited number of
Graduates who never got a respectful and peaceful career inside PIPOS and Pakistan. Most of the
graduates have to leave the institute and the country to have peaceful and productive life. All
those who stayed in the country, never got a leading role and exposure to give some recognition
to this profession. The profession only developed in NGOs sector because of some vested
interests and never flourished in Private and Public sector. Worst time started sometimes before
10 years when PIPOS was turned into a production company than to flourish as center of
excellence for the capacity building and higher education of the working P&Os. Another blow
came in, when a conflict based technology was introduced in a way to be the future of the
profession and the patients in Pakistan. Latest modular technology became a dream and
Technician's level activities took the lead everywhere.
What we have today?
What measures needs to be taken to bring the profession back on track?
08
Meniscal Testing
Speaker: Muhammad Nazim Farooq
MSPT, PhD SCHOLAR, Margalla Institute of Health Sciences Rawalpindi
Meniscus tears are an extremely common cause of knee pain and constitute 10-20% of all
orthopedic injuries and 50% of knee surgeries. It is important to make an accurate diagnosis of
meniscus tears so that the appropriate treatment can be given. A detailed history and physical
examination can help differentiate patients who have a meniscus tear from those whose knee
pain arises from other conditions.
Unfortunately, literature regarding the ability of the comprehensive examination to detect a torn
tibial meniscus is equivocal. Despite frequent reports that items like “locking” and “giving-way” are
common with tibial meniscus tears, history alone is insufficient as a diagnostic tool. Therefore,
historical items are often combined with physical examination procedures, such as range-ofmotion and strength testing, in an attempt to improve diagnostic accuracy. Physical diagnostic
tests, sometimes referred to as “special tests,” have been an integral part of this process
historically. There are numerous special tests purported to diagnose torn tibial menisci, including
traditional non-weight-bearing tests like McMurray’s test and Apley’s test, and newer weightbearing tests like the Thessaly test. This lecture will provide an updated review of published
literature pertaining to the most common and newest meniscal tests.
Women’s Health: Scope of Physiotherapy Practice in the Conservative
Management of common UroGynae problems
Speaker: Patricia MacLoughlin
Smutternagh, Knockvicar, Boyle, Co. Roscommon Physiotherapy Dept., St. Patrick’s Hospital, Carrick-on-Shannon, Co. Leitrim.
An outline of the conditions with which women are referred:
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Stress Urinary Incontinence
Pelvic Organ Prolapse
Diastasis Rectus
Referral Sources
Urgency / Urge Incontinence
Pelvic Floor Muscle Rehab / Strengthening
Pelvic Girdle Pain during Pregnancy
An outline of different types of physiotherapy treatments:
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Assessment / treatment of core strength
Assessment / treatment of pelvic floor strength
Assessment of breathing patterns
Assessment of existing risk factors and how they can be modified
Education for the patient in strengthening/protecting pelvic structures
Use of biofeedback / electrostim where necessary
An example of a typical physiotherapy intervention in the case of early-stage pelvic organ
prolapse:
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History taking
Assessment of posture / BMI / core strength / pelvic floor strength
Education of patient re existing risk factors and aggravating factors
Prescription of exercise programme
Information booklets re condition
Schedule of appointments
Curiosity & Hope - Multidisciplinary Approach
Speaker: Dr. Shahid Ahmed Heera
Associate Professor, HOD Physical Therapy, University of Faisalabad, Faisalabad
Background:
Physical Rehabilitation is always considered a team work and multidisciplinary approach based.
The professionals in developed countries are practicing physical rehabilitation its true spirit, but
in Pakistan it is still emerging and we have facing some problem regarding team work and
multidisciplinary approach.
Objective:
The objective of this key-note presentation will be: to discuss issues and hope for
multidisciplinary approach in physical rehabilitation in past, present and future perspectives.
Methodology:
The discussion will be started from the beginning of the profession in the country along with a
quick overview of the academics upgrading in physical rehabilitation over time. The discussion
will be also made on the role and importance of all sub specialties of rehabilitation or we can say
on all stake holders involved in physical rehabilitation. The current situation of practice will be
discussed and the future practice will idealized.
Results:
Multidisciplinary approach very important for the effective patient care and coordinated
approach towards rehabilitation of patients with disability.
Conclusion:
Finally it will be concluded that what was our past, what is our currents trends in practice and how
will be our practice in future in physical rehabilitation.
10
Nerve Conduction Study and Electromyography
Speaker: Dr. Syed Ali Shah
Lecturer, College of Physiotherapy, Jinnah Sindh University Karachi
Abstract of Presentation:
Nerve Conduction Study (NCS) and Electromyography (EMG) are the Electrodiagnostic procedure
which are performed for the evaluation of Neuromuscular system and are said to be extension of
the clinical examination. NCS and EMG are complementary to each other and only NCS or EMG
will not be enough for the precise diagnosis. The clinical applications of NCS/EMG are:
• To identify the location of and type of Neuromuscular Disorders.
• To diﬀerentiate between the acquired and hereditary Neuromuscular Disorders.
• To diﬀerentiate nerve disease from Neuromuscular Junction or primary muscle disease.
• To distinguish among neuroprexia, axonal degeneration, neurotmesis and segmental demyelination.
Like other investigations NCS/EMG are also having some parameters on the basis of which one
can interpret if there is any abnormality in the neuromuscular system.
Altogether a patient’s
history, Neurological Clinical examination and NCS/EMG establish a diagnosis which may be helpful for therapeutic and surgical interventions.
Approach to Cerebral Palsy and Neuro developmental Delay:
A Single Centre Experience in KPK
Speaker: Yvonne Frizzell
Abstract of Presentation:
Given that Pakistan has a population where approximately 40% are children less than 14 years of
age, a conference on rehabilitation must consider Paediatric topics in its program. Cerebral Palsy
(CP) is globally the largest cause of physical disability in children. Akbar Kare Institute (AKi) began
by exclusively offering free therapy for these children with CP in Khyber Pukhtunkhwa. Two years
ago we developed services to include Spina Bifida (NTD) as this was another area where we could
find no comprehensive care being offered post-operatively. Now with more than 5,200 children
seen and a catchment area of KP, and often from other provinces as well as IDP’s and Refugees, we
have a good estimation of the scale of this problem of hidden children.
Our presentation will show how we at AKi aim to improve the lives of every child who come to us.
We recognise the need for good diagnosis and classification to guide appropriate therapy plans.
We understand the imperative is to have sustainable solutions to the problems families encounter
in the everyday management of issues that children with CP encounter. For this to be useful in the
lives of children we must work in collaboration with the primary carers and be educators to
achieve more permanent changes in function.
11
The talk will illustrate the environment and equipment needed to have an enriched but locally
available and low cost therapy centre. It will show how the problem solving for posturally
challenged children is both possible and essential as part of therapeutic care. It will show how the
use of status symbols of the professionals can be counter-productive in promoting trust and
confidence for parents and carers to implement therapy plans in their home setting. (No white
coats at AKi).
The presentation will include specific illustrated information on both serial reflex inhibiting
casting for the management of equinus and how we have developed protocols for the use of m
CIT in our children with hemiparesis.
All work and pictures shown are from real and original activities in Akbar Kare Institute.
Education and Research Trends in Rehabilitation Sciences
Speaker: Arshad Nawaz Malik
Assistant Professor Riphah International University Islamabad
Background:
Education has significant role in the professional development of rehabilitation sciences. Recently
there is development of different new institutes; HEC has accredited the curriculum of doctor of
physical therapy in 2010. Now this is time to modify the curriculum according to the international
standards. Research is one of integral part of professional development, in rehabilitation sciences
research oriented activities need to be addressed.
Purpose:
The objective of presentation is to explore the education and research in rehabilitation trends in
Pakistan and future outcome regarding the rehabilitation sciences.
Methodology:
A 15 minutes presentation will be delivered on the education and research. In presentation the
latest evidence and the current situation of education and research trends will be discussed.
Learning Outcome:
After the session, the participants will be able to understand the current scenario of education
and research of rehabilitation in Pakistan and the international standards of education. The
participants will be able to understand the gap of national and international standards.
Conclusion:
The session will add the knowledge of current and latest literature regarding the research and
education in the rehabilitation sciences.
Keywords:
Education, Research, Rehabilitation sciences
12
NCRS
National Conference
Oral Presentation
To Determine the Physical Activity and Quality of Life in Geriatric Population
Presenter: Sana Bashir
Co-author: Furqan Ahmad Siddiqui, Faryal Naweed, Saira Akhter Cheema, Sobaina Hussain, Imran Amjad
Background:
Aging is an inevitable process which has to take place at any cost & has been experienced by all of
us, as it is a true reality of life. They become more fragile & prone towards diseases which greatly
impact their health & activity limitations & finally prevent them for being active.
Objective of Study:
The purpose of study was to determine the physical activity and quality of life in geriatric population.
Methods:
A Descriptive Cross Sectional survey was conducted in elderly population. This study was
conducted from elderly people living in Rawalpindi, Islamabad. For these OPDs of the hospitals of
Rawalpindi, Islamabad has been visited. The sample size was 700 elderly individuals including
males & females of ages 65 years & above. The Lawton Instrumental Activities of daily living Scale,
that consists of 15 questions. The data was analyzed on SPSS-20.
Results:
The results of Lawton’s scale (which measures the level of effectiveness of physical activity) show
that out of 700 total elderly populations, 564(80.5%) participants are physically active whereas
136 (19.4%) participants are inactive. Males are more active 283 (64.4%) then the females 84
(32.2%) among geriatric population.
Conclusion:
Physical activity has shown to have extremely positive benefits on health, mind, body & quality of
life of an individual. The physical activity is a very powerful tool to delay the degenerative process
which inevitably takes place in the body. Males are in less quantity than females to suffer from
diseases because they are still physically active hence more capable & enthusiastic up till now
than females. Females are in less quantity for being physically active but out of them those
females who are physically active are still engaged in household work & activities till they reach
their old ages. So physical activity is proved to be extremely cardio protective in elders. Delay the
disease process & protect them against many harmful effects of aging which would otherwise
make elderly bed-stricken from the very beginning of aging process in geriatric population.
Keywords:
Geriatric population, quality of life, physical activity & inactivity
13
Evaluation of the Forward Head Posture, Prevalence and Associated Factors of Neck Pain
in Female DPT Student
Presenter: Abrish Habib Abbasi
Co-authors: Arshad Nawaz Malik Mamoona Aslam, Tehseen Ashraf
Background:
The CV angle in subjects with neck pain is significantly smaller than that in normal subjects. There
is moderate negative correlation between CV angle and neck disability. Patients with small CV
angle have a greater forward head posture, and the greater the forward head posture, the greater
the disability.
Purpose of Study:
The purpose of the study is to assess the forward head posture in female university students and
also to determine the association of posture with disability. To quantitatively describe the CV
angle of upright, static, sagittal head posture in female students aged between 20 to 25 years old.
We also sought to assess the relationship between the forward head posture and the incidence of
neck pain in students.
Methods:
It is a cross sectional study. Forward head posture was assessed in 64 female DPT students who
complaint of mild to moderate neck pain, they were asked to fill in Neck Disability Index
Questionnaire and SF-36 Questionnaire. Goniometer was used to measure appropriate
craniovertebral angle and after seeking consent from students their side-view pictures were
taken in both relaxed-sitting and standing positions to measure craniovertebral angle.
Results:
The results showed maximum students with neck pain had slight postural deformity having mild
FHP and fewer students (3.1%) had severe postural deformity. Neck Disability Index, showed that
majority of students were lying in moderate level of disability 31(48.8%). SF-36 (Energy & Fatigue)
depicted that majority of students were having loss of energy and some fatigue, which is (3170%). There was an association between CVA (photogrammetric values) and quality of life Energy
& Fatigue level having a p value of 0.052.
Conclusions:
Our findings suggested that majority of students were having loss of energy and some fatigue. As
most of the students were presenting with acute neck pain that is why energy and fatigue
element was markedly reduced in such students making them more prone to develop severe
forward head posture in future.
Keywords:
Neck Pain, Forward Head Posture (FHP), Craniovertebral Angle (CVA)
14
Frequency of Fear Avoidance Beliefs in Patients with Neck Pain
Presenter: Saba Murad
Background:
Psychological factors like fear leads to decrease movement and development of beliefs that
results in avoidance from physical activity in patients with neck pain.FAB i.e. fear avoidance beliefs
(either with work or physical activity) not only restrict the participation of patient in active
rehabilitation program but also hinder social interactions and leisure activities.
Purpose of the Study:
The purpose of the study was to determine how frequently FAB prevails in neck pain patients in
Wah Cantt & twin cities of Pakistan and to find out relationship of FAB with chronicity and severity
of neck pain that hinders them to work effectively and to engage in physical activities.
Materials & Methods:
A descriptive cross sectional study was conducted in Wah Cantt & twin cities of Pakistan from July
2014 to December 2014 and patients with neck pain were recruited from six physiotherapy
outpatient departments, office workers, school teachers and bank workers(N=405). For
quantitative analysis, FAB was evaluated with modified Fear Avoidance Belief Questionnaire
(FABQ) by the examiner. The modified FABQ consists of two subscales pertaining to physical
activity (FABQ-PA with questions 1-5) and work (FABQ-W with 6-16 questions)
Results:
The total population was 405 in which 76% (309) patients have FAB for physical activity
(mean=17) and 70% (282) have FAB for work (mean=27).Results of all themes showed
(p<0.05).the t-statistics depicted significant relation of gender with FAB( both FABPA & FABW) i.e.
p<0.01 and p< 0.05 respectively FAB and pain duration are strongly related to each other with
56% patients having pain >6months (p<0.001). FABW and FABPA are strongly associated with
pain intensity (Χ2 <0.001). High and very high FABPA corresponds to moderate and severe pain
intensity while high scores of FABW have severe pain intensity respectively Patients who have
scored high and very high FABPA and FABW usually do not perform any exercise indicating a
strong association. (Χ2 <0.001).No significant results were obtained with pain pattern and FABPA
& FABW respectively.
Conclusion:
The study results clearly depicted the high frequency of FABPA and FABW prevailing in neck pain
patients in Wah Cantt & twin cities of Pakistan. There is significant relationship of gender with
FABPA & FABW. The frequency of FABPA & FABW is high with pain >6 months duration concluding
that avoidance beliefs results in the chronicity of pain. FAB has greater effect on pain intensity as
those with high FABW and very high FABPA have severe pain intensity. Those who have strong
FAB do not engage themselves in physical activity
15
Keywords:
FAB (fear avoidance beliefs), Neck pain, FABPA (fear avoidance beliefs for physical activity), FABW
(fear avoidance beliefs for work) FABQ (fear avoidance belief questionnaire)
Effective Tool in Polio Management “Mahboob Power Evaluation and
Therapeutic (MPET) Chart”
Presenter: Mahboob ur Rahman
Background: Elimination of disease of Polio is the top most priority of the Govt. of Pakistan as
well as all the provincial governments.Each year polio eradication efforts are made on regular
basis in which various government, non-government organizations, INGOs, International donors
and civil society takes active part. But despite all these enormous efforts still a considerable
number of polio affected children emerge throughout the country. The province of Khyber
Pakhtunkhwa is especially very vulnerable in this regard due various reasons; the migrantrs and
refusals are the two most common causes. Thus, the people especially the children when get
affected by the polio and become paralysed then they need special and long treatment at home
and the at the health facilities. There are various treatment and rehabilitation measures for
treatment of polio and use of MPET chart is one of them.
Objectives: The aim of our study was to use and see the utility of the redesigned Mahboob Power
Evaluation and Therapeutic chart in the treatment of polio affected children.
Discussion: Muscle Power of Polio affected children were assessed and evaluated by Oxford
Muscle Testing Chart. The chart as a diagnostic tool gives the strength of muscles for the purpose
of surgical interventions or physical regime. But the said chart could not be used successfully as it
focused only on the diagnostic component and did not give the Therapeutic Regime. Thus, the
need was felt to fill the gap in the Oxford chart and to make it useful in the Therapeutic Regime of
polio affected children. Mahboob School of Physiotherapy took an initiative and its Chairman,
Dr. Mahboob ur Rahman, redesigned the said chart with the name of MPET chart which also
includes the Therapeutic component. The redesigned chart may now be called as Mahboob
Power Evaluation and Therapeutic (MPET) chart. It gives Therapeutic plan alongwith the
diagnostic or assessment of the muscle power of the polio affected children. By using this chart
by the Therapist, the parents of the children or even the children by themselves can perform the
exercise and improve the muscle power. It has been practiced since the last decade and has
proved its worth.
Methods: The study was under taken in a controlled environment in Habib Physiotherapy
Complex, Peshawar. Physical Observation method was used for treatment and assessment of
results of the Physiotherapy tool. In the treatment muscle assessment was done, reviewed after 4
months. The improvement in Muscle power is noted and new plan given.
Data was collected through recording results from the Muscle chart. The participants were
selected randam on the basis of as and when came to HPC for treatment. The whole polio affected
population of Khyber Pakhtunkhwa was the population of the Study and 30 number of polio
affected people was the sample size.
Conclusion: The MPET Chart is an effective tool in Post Polio Paralysis Management.
Keywords: Physiotherapy, MPET Chart, Redesigned MPET Chart, Therapeutic Regime, Oxford
Muscle Testing Chart
16
Effectiveness of Planter Fasciitis Taping and Calcaneal Taping In Planter Heel Pain
Presenter: Bushra Babar
Co-authors: M. Salman Bashir, Rabiya Noor
Background:
Heel pain is one of the most common foot problems especially among older individuals. Mechanical factors plays very important role in heel pain. Pain under the heel on weight bearing can cause
disability towards movement.
Objective:
To compare the effectiveness between planter fasciitis taping and calcaneal taping along with
stretching and therapeutic ultrasound on heel pain.
Methodology:
It was a study in which data was collected fromCanada Orthopedic and Rehabilitation Centre.
Non Probability convenience sampling technique was used for data collection. Research data was
recorded by using prescribed validated questionnaire, which include Standardized VAS scale and
foot function index.
Results:
The Comparison of percentage of pain decrease post-treatment after evaluation on VAS and FFI in
both groups. The decrease of pain in both indicators was significantly higher in group-A as compared to group-B. The decrease of pain in VAS significant at P=0.019 and in FFI at P =0.000 level
showing that plantar fasciitis taping is more effective than calcaneal taping.
Conclusions:
In short term treatment of plantar heel pain (one week) it was found that plantar fasciitis taping
along with starching and ultrasound is more effective than calcaneal taping along with stretching
and ultrasound. Accordingly, plantar fasciitis taping is recommended for the treatment of plantar
heel pain.
Keywords:
Plantar heel pain, taping, visual analogue scale and foot function index scale.
17
The Effect of Combining Phonophoresis and Mobilization with Movement in the
Management of Knee Osteoarthritis: A Clinical Trial with Randomization
Presenter: Atif Dustgir
Co-author: Rabiya Noor, Mmuhammad Salman Bashir
Background:
Knee osteoarthritis (KOA) is a major musculoskeletal problem especially in senior population. It is
mechanical dysfunction and reflects degenerative changes. Clinically it manifests as pain and
disability in performing activities of daily livings (ADLs).
Objectives:
The aims of this study is to establish effect of combining Phonophoresis with MWM in patients
with knee osteoarthritis in terms of patient’s self perception of pain & stiffness level, functional
abilities, and maximum walking distance in 6 minutes.
Material and Methods:
The study design used was interventional study design (randomized clinical trial). A sample size
of 75 participants with Osteoarthritis of knee was randamized into 3 groups of 25 participants.
Group-A was treated With the Phonophoresis (Ultrasound with ketoprofen gel) alone and
Group-B with Mobilization with movement alone while Group C with combination of
Phonophresis and Mobilization with movement. All the three groups were treated 6 times over 3
weeks. Data was collected before first treatment as baseline, after 6th treatment as post treatment
and at 6th week as follow-up. The outcomes measure was determined through the NRS-101 pain
scale (NPRS), Short-Form McGill Pain Questionnaire (SFMPQ) and goniometry (ROM) for assessment of patient’s perception of pain, stiffness and measurement of range of motion (ROM). In
addition, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 6
Minute Walk Test (6MWT) were used to assess pre and post treatment functional abilities. The
Kruskal-Wallis test was used to compare among groups while Friedman’s T-test compared
changes within group.
Results:
In this study, statistically significant intra-group changes (p<0.05) were noted for mobilization
with movement (Group B) and particularly mobilization with movement and Phonophoresis
(Group C) in all outcome measures.
Conclusion:
This randomized clinical trial contributes to the current evidence available to practitioners about
the potential utility of mobilization with movement, particularly mobilization with movement in
combination with Phonophoresis in the symptomatic treatment of knee osteoarthritis.
Keywords:
Knee Osteoarthritis (KOA), Mobilization with Movement (MWM), Phonophoresis.
18
Prevalence of De Quervain’s Syndrome among Young Mobile Phone users
Presenter: Taimoor-ul-Hassan
Co-authors: Zaib-un-Nisa, Salman Bashir, Rabiya Noor
Background:
Among the hand held devices the use of mobile phone is increasing day by day. Repetitive
movements of thumb lead to repetitive strain injury. Repetitive strain injury causes inflammation
and swelling of tendons. Tendinitis is common in young mobile phone users which manifest as de
Quervain’s disease. As there is an increase in mobile phone user so there is a potential risk of
painful thumb due to its overuse especially while texting.
Objective:
This study was done to estimate that how many people are suffering from this condition and to
inform them to avoid it’s over use or use this with a correct position of thumb.
Total 384 cases of thumb pain age range from 16-30 years of both genders were selected. Patients
with thumb fracture and having De quervain’s syndrome but not using mobile phone were
excluded. Informed consent was taken from each person meeting the inclusion criteria,
explaining to them the purpose of the study and ensuring the confidentiality of information. Data
was collected by filling the designed questionnaire.
Results:
Mean age of patients was 22.43 ± 4.02 years. Out of these 384 patients, 247 (64.32%) were male
and 137 (35.58%) were females with male to female ratio of 1.8:1. De Quervain’s syndrome was
present in 223 (58.07%) while 161 (41.93%) patients had no De Quervain’s syndrome.
Conclusion:
This study concluded that the prevalence of de Quervain’s syndrome among mobile users was
58.07% which is relatively high. Moreover, majority of patients affected were young teenagers
male.
Keywords:
Tenosynovitis, text messaging, teenager
19
Effectiveness of Thoracic Spine Manipulation on Subjects with
Subacromial Impingement Syndrome
Presenter: Danish Hassan
Co-author: Umair Ahmad, Rashid Hafeez Nasir
Background:
Subacromial impingement syndrome is one of the most debilitating conditions affecting the
shoulder joint and principal cause of shoulder pain. Though the role of manual physical therapy
of thoracic spine along with the other treatment options at shoulder joint is well established, the
specific effects manual physical therapy techniques is not adequately reported.
Objective:
This study was primarily designed to investigate the effectiveness of high velocity low amplitude
thrust manipulation of thoracic spine on the patients with the subacromial impingement
syndrome.
Methodology:
This study is a quasi experimental trail in which 30 patients were recruited using a convenience
sampling technique, for a single treatment session of high velocity low amplitude thrust
manipulation at thoracic spine. Immediate effects of this intervention were recorded on 100mm
Visual Analogue Scale and improvement in ROM at shoulder joint as primary outcome measure
and on 14 points patient reported Global Rating of Change scale as secondary outcome measure.
Results:
There was mean reduction of pain by 27.03 ± 12.92 (p-value < 0.05) which was statistically and
clinically correlated. There was also improvement in shoulder range of motion by 25°- 35° and
mean post treatment global rating of change score of 4.03 with median score of 5.
Conclusion:
Thoracic spine manipulative technique is effective in terms of reducing pain and improving range
of motion at shoulder joint in subjects with subacromial impingement syndrome. This also
signifies the potential interdependence between anatomical regions of thoracic spine and
shoulder girdle.
Keywords:
Shoulder pain, Manipulation, Manual Therapy, Subacromial Impingement Syndrome
20
The Gap between Education and Practice: A Survey about
Physical Therapists’ Perceptions
Presenter: Bilal Umer
Co-author: Maryam Shabbir, Hafiz Sheraz Arshad
Background:
In physiotherapy field, it has become an important issue that to what extent graduates be
prepared by for clinical and workplace settings. It is today’s need that physical therapists be
equipped with advance skills and diverse knowledge. However, three is limited literature
available defining parameters for curricula updates.
Objective:
Aim of the study was to investigate the perceptions of physical therapy graduates about the
sufficiency of undergraduate level skills and education for working at clinical setups.
Methods:
70 Physiotherapists included who graduated from 2010 to 2014 from University of Health
Sciences, Lahore and currently working at clinical settings in Lahore were surveyed through
sample of convenience by filling close ended questionnaire that was validated through literature
and experts’ consensus. Non practicing Physiotherapists were excluded. Questionnaires were
distributed as hand outs and through email. SPSS is being utilized for Data Analysis.
Results:
There was 11.9/88.1 male/female ratio, average age of 27 years and predominant work setting
was private sector. From total 11 factors and 59 items, factor analysis showed 61.7% of variance.
47 items had factor loading more than 0.5.
Conclusion:
Physiotherapists’ perceptions indicate gaps between knowledge being given and practice
demands especially in managing workplace management, confidence in clinical role.
Communication skills and ethical practice. Survey concluded strong need of revision in
physiotherapy educational planning.
Keywords:
Education Gap, Clinical Competency, Curriculum Needs, Physical Therapy Education, Entry Level
Physiotherapy Education
21
NCRS
National Conference
Common Co-Morbidities Associated With Language Delay
Presenter: Sumera Nawaz Malik
Co-author: Sikandar Ghayas Khan, Fazaila Ehsan, Nayab Iftikhar, Ammara Nusrat
Background:
Language delay is defined as lack of ability in children to develop language abilities on the usual
developmental chart. Children are considered to have speech delay if their speech development
is considerably below the norm for children of the same age.
Objective:
To find the association between co-morbid conditions and language delay.
Material and methods:
A cross-sectional survey was conducted using convenient sampling technique. Data was
collected from parents in an interview and children were assessed for their language
development by using Portage Guide to Early Education (PGEE).Data of 55 children between the
ages of 2 to 6 years with language delay referred for a psychiatric in Mayo Hospital, Lahore were
included. Data was statistically analyzed through SPSS-16.
Results:
There were82% male and 18% female. Current study findings showed high prevalence of
language delay in males than females and significant comorbidities associated with language
delay are intellectual disability, Hearing Impairment and Global Developmental Delay. Language
delay was most prevalent among children with intellectual Disability (33%), Global
Developmental Delay (12.7%) and Hearing Impairment (12.7%). Other co-morbidities include
Epilepsy (7.2%), Attention Deficit and Hyperactive Disorder (5.5), Autism (3.6%) and Physical
Disability (3.6%).
Conclusions:
Exact cause of language delay is unknown but there are much co-morbidities associated with it.
These co-morbidities have significant association with normal development. To avoid delay in
normal development of language, it is important to consult pediatrician, neurologist, audiologist,
psychologist, and speech and language pathologist on regular basis for better intervention
depending upon the type of co-morbidity.
Keywords:
Language delay, comorbidities, language
22
Parental Preferences for the Marriage of their Children with Hearing Impairment
Presenter: Sidra Munir
Co-author: Saima M. Munir, Sikandar Ghayas Khan, Nayab Iftikhar, Sumaira Nawaz Malik
Background:
The parents of deaf people worry about the future of their deaf children specifically about marital
affairs. They have specific preferences regarding social financial and psychological well-being of
their children.
Objective:
To explore the preferences of parents of deaf children about their marriage.
Methodology:
A cross sectional survey was conducted during 16th August 2014 to 14th January 2015 through
questionnaire. The questionnaire was developed from the literature review and experts opinion.
40 parents of hearing impaired children were selected by using convenient sampling technique.
Data was analyzed by using SPSS version 17.
Results:
The results show that 28 (70 %) out of 40 individuals agree that they are not against the marriage
of deaf- deaf children. 34 (85%) parents disagree to have a girl with multiple disabilities for their
child.34 (85%) Parents agree to prefer character over other attributes while selecting their son in
law. 21(52%) parents agree to family traditions in the matrimonial relation of their daughter.
Conclusion:
Parents do not have objection on deaf-deaf marriage while they consider consent of their son for
his marriage, however they do not prefer girl with multiple disabilities. Most of the parents are
willing to consider family traditions in marriage relationship of their daughter and prefer
character over other attribute while selecting their son in law.
Keyword:
Hearing impaired children, Marriage, Parents of hearing impaired children
23
Efficacy of Color Coding vs. Traditional Method for Phrase Development in
Mild to Moderate Children with Special Needs
Presenter: Shehla Yasmin
Background:
Language development is a major issue among intellectually challenged children. There are
several different approaches used to develop language. Colour coding is an approach employed
for language improvement at phrase levelwas adapted from the ‘Semantic Colour Coding
Scheme applied through colour coding. Traditional verbal approach was most frequent method
previously employed for language development. There are several evidence bases available to
demonstrate the effectiveness of colour coding approach for oral language improvement in
children with autism, specific language impairment, and developmental delay and language
disorder however present study focuses on effectiveness of the colorful coding approach for
phrasa development in mild to moderate children with special needs.
Objective:
The objective of the study was to compare the effectiveness of colour coding approach versus
traditional method for phrase development in mild to moderate children with special needs.
Methodology:
Interventional study was conducted at Special Education School Hamza Camp Faizabad.
10 diagnosed mild to moderate ID children were selected with age range between 7-10 years.
10 intellectually disable children were divided into two groups. Two different approaches Colour
coding and traditional method provided to two different groups. Each group containing 5
intellectually challenge children. Each student was provided 20-25 minutes per session each day
for 6 weeks.
Results:
The results of the statistical analysis carried on the SPSS 21. Independent t test was used to
compare the effectiveness of intervention. Results indicated that colour coding approach has
significant impact on language development at phrase level. Significance value of .05, .023, .002
for phrase one, phrase two and phrase three respectively.
Conclusion:
Results depict that the color coding approach has improved language development at phrase
level and enhanced memory retrieval in children with intellectual disability. Color coding
provided most optimum learning environment for language development.
Keywords:
Intellectual Disability, Color Coding Approach, Traditional Approach.
24
Development of Assessment Tool for Diagnosis of Aphasia
Presenter: Saima Haider
Background:
Aphasia is an acquired language disorder needs proper assessment facing a serious problem in all
around the world having limited number of assessment tools few are standardized majority of
these are in English language that are not applicable for the people with other languages.
Similarly there was a great need for the development of a diagnostic tool of aphasia in Urdu
language.
Purpose:
The objective of the study was to design an assessment tool in Urdu for the diagnosis of aphasia
after stroke.
Study Design:
The study was analytical in nature.
Material and Method:
500 normal population and 60 patients of aphasia were included in the study from Ayub Medical
Complex Abbottabad and PEMA hospital Mansehra.
Result:
Results presented the mean score of normal group is 603.8.4 and standard deviation is 14.2 while
aphasic group obtain 191.7 mean score whereas standard deviation is 148.7 and significant value
of both group is .000, that indicates that results of current study are significant.
Conclusion:
The current study concluded mean scores and standard deviation of normal group and aphasic
group the results shows significance of study.
Keywords:
Language, aphasia, normal population, aphasic patients
25
Efficacy of Video Modeling Technique for Word Production in Children with
Intellectual Disability
Presenter: Sobia Taj
Background:
ID children present with delayed speech and language and in initial stages may not be able to
express their needs; this not only influences their quality of life but also affects their families. In
special education centers management strategies for these children are limited. Video modeling
will be a new intervention technique for these children to learn academics, communication and
adaptive skills.
Objective:
The objective of study was to determine the effectiveness of video modeling as therapeutic intervention with ID children, to provide evidence based facts of therapy in word production and to
increase the awareness of VM technique in acquiring speech.
Methodology:
The interventional study was conducted at a Govt. special education centre. Total 09 children with
intellectually disabled were selected between 8 to 11 years with mild to moderate level of severity
for word production. Total of 3 nouns were selected for video and three for flash cards and the
therapy provided for six weeks. In 25 min of session 4 days in week, each subject received both
interventions. Pre and post testing was carried on comparison in initiating word and number of
sessions the child took to acquire words in both techniques.
Results:
Data analysis was carried out using SPSS vs. 21. Paired sample t-test was used for pre and post
testing. The results of current study showed that the video modeling has significant effect in word
production. Data was computed and statistically analyzed and compared by paired sample test
with significant values of in trial 1 .02 in trial two .08 and in trial three .02
Conclusion:
The study concludes that video modeling has an important role for word production in ID
children and proved that this is a time-efficient and effective technique for ID children.
Keywords:
intellectually disable, verbal acquisition of speech, video modeling, dynamic assessment
26
How we learn: Learning Style Preferences of Riphah International University’s
Speech-Language Pathology students as per the VARK test
Presenter: Hajra Gull
Background:
To mark the advancement of Speech-Language Pathology (SLP) in Pakistan it is essential to
investigate in ways of refining Pakistani SLP educational programs. In particular, to cultivate
competency amongst SLP students, it is wise to recognize and define the learning styles whereby
Pakistani SLP student’s best acquire information ensuring that they are learning in the best
possible manner.
Objective:
This study was conducted to determine the preferred learning styles and the affect of semester
level and gender on the learning style preferences of SLP students at Riphah International
University, Pakistan. Do SLP students show a preference for a certain learning mode? Do the
variables of gender and semester affect the students’ learning style preferences?
Methodology:
A cross sectional study amongst Riphah’s SLP graduate students was conducted to identify their
preferred learning styles in accordance with the VARK test. A quantitative approach and
descriptive statistics were used to analyze the data collected from the VARK questionnaires in
order to explore the dominant learning style of SLP students and how the variables of gender and
semester affect the students’ learning style preferences.
Results:
The obtained data depicted a Multimodal dominancy (33%) out of all learning preferences.
Considering unimodal preferences, Read/Write modality (26.7%) was the most preferred and the
least preferred was the Visual modality (10%). Learning style preferences as a function of the
semester variable did not differ significantly. Learning style preferences as a function of the
gender variable could not be analyzed due to the great disparity between the numbers of male
and female students.
Conclusion:
Identifying and understanding learning style preferences aid educators and students to better
understand learning related to their professional field. Accommodating for students’ preferred
learning styles and working on their non-preferred learning styles is concluded to be in their best
interest. The students will become effective learners and problem solvers by the provision of
information from different sensory components as some will match their preferences and the
remaining will give them practice in their least preferred modalities.
27
Keywords: Speech & Language Pathology, VARK, Riphah
Evaluation of SLP Knowledge and Perception Regarding PECS with
Children on ASD in Twin Cities
Presenter: Saiqa Yasmin
Introduction:
Speech language pathologists (SLPs) in Pakistan have limited awareness and knowledge
regarding augmentative and alternative communication (AAC) and particularly picture exchange
communication system (PECS). Speech therapy is an emerging field in Pakistan and SLPs have
deficient knowledge of the beneficial effects of PECS training program to enhance the
communication of individuals on the autistic spectrum disorders (ASD). This study aimed to
investigate the knowledge and perspectives of SLP s regarding use of PECS with ASD.PECS can be
an effective program to help specific individuals with ASD to become functional communicators.
Decisions about the use of the PECS should be according to the needs of the individual emergent
communicator. There are several myths regarding the use of PECS and parents are reluctant to put
their child on the program.
Methods and Methodology:
It was a cross sectional survey, prospective in nature in which 35 SLPs were included. This study
was conducted on SLPs working with children on ASD in government and private hospitals,
clinical settings and special schools. Participants were selected from Rawalpindi and Islamabad
with minimum 1year post graduation experience.
Results:
Analysis of data was conducted by using 19.0 version of statistical package for social sciences.
Conclusion:
It is concluded from the study that regardless of the year of experience certain myths remain
dominant in the use of PECS and twenty percent SLP's are still reluctant to use PECS due to these
misconceptions.
Keywords:
Picture exchange communication system (PECS), Autistic spectrum disorder (ASD)
28
Evaluation of Phonological Assessment Practices By Speech and Language
Pathologists in Pakistan of Children with Suspected Speech Sound Difficulties
Presenter: Munaza Parveen
Introduction:
The present study examined phonological assessment practices of speech-language
pathologists(SLPs) in Pakistan for the identification of children with suspected speech sound
disorders (SSDs).Many children develop speech sounds with the passage of time but those who
fail to develop often need the services of SLPs in order to learn correct speech sounds. Speech
sound disorders may be subdivided into two primary types that are articulation disorders and
phonemic disorders (also called phonological disorders).Clinician’s assessment and analysis
choices are also influenced by many factors, such as severity level of SSD, determining eligibility
for special education and size of caseloads.
Objective:
To evaluate the phonological assessment practices conducted by speech-language pathologists
in Pakistan with the speech sound disorders.
Material And Methodology:
It was a cross sectional survey study, prospective in nature which included 32 SLPs working with
children in special education schools, government or private hospitals and clinical settings of
Rawalpindi, Islamabad and Lahore in Pakistan, through convenient sampling
technique.Phonological assessment questionnaire with sub-scales A, B, C, D and E were used for
data collection. Analysis of data was conducted by using version 20.0 of Statistical Package for
Social Sciences.
Results:
The results revealed that the data consisted of 32 total cases. The phonological component subscale C included 18 variables having 27 valid cases with a mean of 33.22, the phonological assessment timing sub-scale D included 3 variables with 30 valid cases having 10.06 mean score and the
standard tests for phonological assessment sub-scale E consisted of 11 variables with 31 valid
cases having 41.12 mean score.
Conclusion:
The present study concluded that SLPs do not follow proper assessment guidelines. It was also
concluded that SLPs do not conduct comprehensive phonological assessment including standard and non-standard assessment.
Keywords:
29
Phonology, phonological assessment, articulation, speech, speech sound disorder
NCRS
National Conference
Poster Presentation
Community Awareness of the Warning Signs, Symptoms and Risk Factors of
Stroke in Rawalpindi/Islamabad
Presenter: Nausheen Irum
Background and Aim:
Stroke is the most common cause of disability around the world and globally the second leading
cause of death. According to World Health Organization survey disability and death toll is higher
in developing countries. Health education is the only way to improve the health and to avoid the
risk of stroke. The aim of the present study is to determine the awareness regarding stroke
symptoms, warning signs and risk factors among the educated people of Rawalpindi/Islamabad.
Methods:
The population of the study was the educated class of Rawalpindi/Islamabad. The sampling was
consisted of 30 teachers and 200 students of 5 universities in Rawalpindi/Islamabad. A
questionnaire was designed to know the awareness of educated class of Rawalpindi/Islamabad
about stroke. The researcher visited the selected universities and got filled the questionnaire.
Results:
45% of the respondents were unable to recognize signs and were unaware of the risk factors and
signs causing stroke. 80% of the respondents did not know about a single reason behind stroke.
Conclusion:
The government should launchnational awareness programme/campaign regarding stroke and
precautionary measures to embattle with it and to make public aware of the signs and symptoms
and warning signs which may help in early identification of the problem and awareness of the risk
factors that may help in preventing the chances of stroke.
Keyword:
Health education, stroke, risk factors
30
Effect of Sleep Quality on Grades of University Students of Rawalpindi/Islamabad
Presenter: Anam Zafar
Co-author: Urooj Rafi, Aisha Shafqat
Background:
University students are prone to sleep disturbances due to university related stress, spending
more time on mobile/internet, studying through late night, various peer pressures and other
psychological stressors. Disturbed sleep can lead to poor grades among university students. The
objective of this study was to determine the effect of sleep quality on academic performance of
university level students across Rawalpindi/Islamabad.
Objectives:
To determine the effects of sleep disturbances on academic performance of university level
students across Rawalpindi/Islamabad.
Methodology:
This study is based on descriptive cross sectional survey and purposive non probability sampling
technique that collected by a structured questionnaire was circulated among under graduate
level students of 7 universities of Rawalpindi/Islamabad from August 2013 to December 2013.A
total of 250 students 200 students responds to all questions. The questionnaire was based on
Pittsburgh Sleep Quality Index along with relevant data about student’s age, gender, discipline
and cGPA/grades. The data obtained analyze by SPSS 17.
Result:
Majority of the students had moderately poor sleep quality (Global PSQI score=5).The 17.6% of
subjects scored 5 in PSQI and 14.8% of subjects scored 6 in PSQI. The majority scored from 3 to 8
on PSQI. However the students who scored high cGPAs (>3.5) had better sleep quality as compared to those who got cGPAs <3.5.
Conclusion:
University level students often tend to neglect their sleep quality due to multiple stressors and
social activities. Majority of the students having poor sleep quality and their grades might be
affected. Furthermore, the students who attaining good cGPAs (>3.5) had on an average good
sleep quality.
Keywords:
Sleep Quality, CGPA, Performance, PSQI, REM, NREM
31
To determine the preference and feedback of Patients about treatment in
physical therapy OPDs
Presenter: Ibadullah
The Purpose of Study:
Physical therapy is a renowned developing profession and improves notonly the functional status
but also enhances the quality of life in movement disorder population. Its main emphasis is
continues improvement of knowledge and skills. The main purpose of this study was to
determine the preference and feedback of Patients about treatment in physical therapy OPDs.
Methodology:
A descriptive cross-sectional survey was conducted with sample of 500 patients from different
hospitals of Pakistan. A self structured questionnaire was designed and for convenience of patient
it was also translated into Urdu language. The data was collected from October 2014 to March
2015.Data was analyzed using SPSS 20.
Results:
According to these results only 35.1 % patients are satisfied with physiotherapy treatment at
government hospitals and majority of the patients 64.9% want to taketreatment from private
clinics. The results indicate that 15.7% patients were private, 26.6 % Entitled, 26.2% Panel patients
and 31.5% patients were family members/friends.41.1% Patients visit OPD for less than one week
28.2% patient’s visit for more than one week and 76.6% take appointment before visit.67.7%
Patients had to wait for their session.26.6% patients received 40 minute session.61.7% patients
gave their complete history.57.7% Patients responded that the same physical therapist has given
the session.29.8% Physiotherapists are involved in giving treatment sessions to the patients
13.3% technicians, 10.5% assistants and 46.4% trainees.83.5% of patients responded that their
session just included electrotherapy.25% Patients did not get any relief. 20.6% patients got 50%
relief after 10 to 15 sessions and 27.8% got relief after 5 to 10 sessions.13.3 % sessions are given
by physiotherapy technicians, 10.5% by physiotherapy assistants’ and46.4%by physical therapy
trainees and 29.8% by professional physical therapist
Conclusion:
It is concluded that majority of the patients are not satisfied by the physical therapy treatment at
government hospitals and they prefer private clinics for treatment. The study also concludes that
government hospitals need to increase the number of qualified physiotherapist so that patients
receive proper protocols and treatment for their problems.
Keywords:
Perception, physiotherapists, physiotherapy OPDs, patient
32
Association of Maternal Obesity and Preeclampsia with Gestational Diabetes
Mellitus (GDM)
Presenter: Wardah Qazi
Background:
Women who are obese are considered at increased risk of developing Gestational Diabetes
Mellitus (GDM) and it is also a risk factor for developing high blood pressure and protein in the
urine after 20 weeks of pregnancy that is preeclampsia. GDM is a condition of maternal
hyperglycemia which is diagnosed only during pregnancy and overcome after pregnancy. It
results in various maternal and neonatal outcomes like oligohydramnios and Caeserean delivery
in mothers while macrosomia and obesity in children. As prevalence of GDM and Preeclampsia is
increasing in our population so we want to find the association between them and also their
association with maternal obesity.
Objective:
The main objective of the study was to evaluate the obesity level/BMI in GDM as compare to non
GDM mothers and also to calculate the association of Preeclampsia both in GDM and non GDM
mothers
Methodology:
It was a comparative Cross sectional survey conducted in Pakistan Railway Hospital from February
2015 to April 20,2015 on 60 gestational women divided into two groups of 30 gestational women
each, after their 20 weeks of pregnancy and between the age of 18 to 38. One group was having
GDM while other group not having GDM. Data was collected through Urine RE samples for Preeclampsia and BMI testing for obesity and analyzed using SPSS.
Results:
In GDM group, 5 (16.6%) out of 30 mothers were in the normal weight range, 16 (53.3%) found to
be overweight while 9(30%) were obese according to BMI table and no woman was found to be
under weight. In the second group of non GDM, 18(60%) mothers had a normal weight while
6(20%) were overweight and 6 (20%) were obese. Hence there are more over weight patients with
gestational diabetes but we also found obesity in mothers without GDM. On the other hand
5(16.66%) out of 30 mothers with GDM had Preeclapmsia while in mothers without GDM, 3 (10%)
out of 30 had positive preeclampsia. Hence there is no absolute association of preeclampsia with
GDM
Conclusion:
It is concluded that obese mothers are more at risk of developing GDM as compare to normal
weight mothers but its not an obvious and certain factor all time and we found that Preeclampsia
has less association with GDM. It is also prevalent in women without GDM.
33
Keywords: Gestational diabetes Mellitus, Maternal obesity, Preeclampsia, Body Mass Index
Physiotherapy Student's Attitude towards Physiotherapist - Patient Relationship
Presenter: Maryam Shabbir
Co-author: Faryal Aftab, Bilal Umar
Background:
The physiotherapist–patient relationship is very important for the treatment plan to succeed and
for the adherence of the patient to the plan. The undergraduate students need to learn the communication skills, so that they can be a good PT in the future. A cross-sectional survey was carried
out, assessing the students’ attitude toward physiotherapist-patient relationship, using the PPOS.
Objectives:
The objectives of this study were to explain and quantify the attitudes of physiotherapy students,
undergoing pre-clinical rotations, towards patient-centered approach, to measure the
association/statistical significance in these attitudes and demographic data and to determine the
factors associated with patient centered attitude.
Methodology:
This observational cross sectional study was done at department of physical therapy ANMC, UOL
and SAHS and was compiled at RCRS Lahore. Study was completed in 4 months after the approval
of synopsis. Non-probability, purposive sampling was used. Sample size was calculated to be of
215 students. Self-administered questionnaire consisting of validated 18-items, Patient Practitioner Orientation Scale (PPOS) was used to find out the attitude of physiotherapy students
towards physiotherapist-patient relationship.
Results:
The grand mean of all the 18- items of PPOS scale was 3.025 ± 0.46 SD. The mean of sharing item
was 3.08 ±0.62 SD, while the mean for caring items appeared to be 2.94±0.59 SD. The range of
total PPOS score was 3.42, maximum value being 4.68 and minimum 1.26. Females show more
patient centered approach with a value of 3.05 ± 0.55 SD than males having a value of 2.92 ± 0.45
SD. The mean of family in medical profession for PPOS has almost same values. The gender*year
interaction is not statistically significant because the P-value is greater than α i.e. 0.067. But the
gender and year individually have statistically significant difference as the P-values of both
variables are less than α. Gender (p = 0.04) and year (p = 0.02).
Conclusion:
The total PPOS mean was high for female gender and early years of medical school. This showed
that the factors that were responsible for the patient-centered attitude of physiotherapy
students, these were female gender and early years of medical school. Male gender was found to
be associated with physiotherapist-centered approach irrespective of the year of medical school.
Keywords: Physiotherapist-patient relationship, physical therapy, PPOS
34
Frequency of Fine Motor Impairments in Patients with Guillain Barre Syndrome
Presenter: Yusra Nayab
Co-author: Muhammad Sikander Ghayas Khan, Ehsan Ullah
Introduction:
Guillian Barre Syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy
characterized by progressive symmetric ascending muscle weakness, paralysis, and hyporeflexia
with or without sensory or autonomic symptoms; however, variants involving the cranial nerves
or pure motor involvement are not uncommon. Muscles weakness or paralysis is the
characteristic features of GBS.
Objective:
To evaluate the frequency, type and severity of fine motor impairments in patients with
Guillian Barre Syndrome.
Material and Method:
A cross sectional survey was conducted through questionnaire and manual ability assessment
tool to find out the frequency, type and severity of fine motor impairments in patients with
GBS.The data was collected from Occupational Therapy Department of Pakistan Society of
Rehabilitation for Disabled (PSRD), Neuroward of Lahore General Hospital, Jinnah Hospital and
Children Hospital Lahore from July 2012 to December 2012.50 patients of 5-50 years old were
selected through purposive sample technique. Patients of GBS with other diseases were
excluded. The data was analysis with SPSS version 17.
Results:
According to the present study 5 (10%) patients were positive for gross motor impairments, 27
(54%) patientsfor fine motor impairments and 18 (36%) patients for both fine and gross motor
impairments. Among these impairments 28(56%) Grasping, 27(54%) Release, 41(82%) Pinching
and 23(46%) Reach. Autonomic system was involved in 30 out of 50 patients while 34 patients
also presented with signs of cranial nerve involvement.
Conclusion:
It is concluded that the patients with Guillain Barre Syndrome mostly have fine motor
impairments that affect activities of daily living (ADL’s).
Keywords:
Guillain Barre Syndrome, Occupational Therapy, Fine Motor Impairments, Manual Ability Assessment, Activity of Daily Livings
35
Epidemiological Survey on Prevalence of Musculoskeletal Injuries in
Elite Class Rugby Players of Pakistan
Presenter: Rashid Hafeez Nasir
Co-author: Syed Imtiaz Hussain Shah, Rabia Tabassum
Background:
Rugby is a very popular game around the globe and getting fame at the university, colleges and
schools levels of Pakistan as well in past decade. Rugby is full contact sports and players are
always at the risk of musculoskeletal injuries. The common are sprains and strains but these
ranges from simple abrasions to life threatening head injuries.
Objective:
To determine the prevalence of sports related musculoskeletal injuries in rugby players of Pakistan.
Methodology:
An epidemiological cross sectional survey was conducted in Pakistan Rugby Union. A selfdesigned, pre validated questionnaire was used to get the data from the 90 rugby players with
stratified random sampling. Data was collected through self-administered questionnaire from
January 2014 to June 2014 and analyzed with SPSS 16.
Results:
The sample of 90 players was equally distributed between forwards and backs. Mean age was
25.44± 5.607.Forwards having more BMI 30.66 ± 5.19 as compared to backs 26.30± 4.73. Point
prevalence of the rugby related injuries was 45.6%, six month prevalence was 55.6 %, One year
prevalence was 57.8% and Life time prevalence calculated was 70%. There are only 8% players
who practice for the rugby game for more than 60 hours per month.
Conclusion:
This study enlightens the quite high prevalence of injuries in rugby players. It also shows the
point, one month, six month and one year prevalence of rugby related sports injuries to the rugby
players which are quite higher.
Recommendations:
Future researchers are recommended to perform a case control studies to find out the risk factors
of the rugby related injuries so that the impact can be minimized.
Keywords:
Rugby Injuries, Rugby Athletes, Rugby Trauma, Sports Injuries in Rugby Players
36
Prevalence and Severity of Temporomandibular Disorders in Undergraduates of
Khyber Medical University: A Cross Sectional Study
Presenter: Hajra Mukhtar
Background:
Temporomandibular disorder (TMD) is a musculoskeletal condition that affects the
temporomandibular joint (TMJ), myofascial and sensorial structures of the face and the
stomatognathic system resulting in pain, functional limitations and disability. Epidemiological
studies have determined different prevalence of TMD signs and symptoms in basically all of the
investigated populations and age groups. TMD is an important public health problem. It affects
approximately 5-12% of the population and is known to be the second most common
musculoskeletal condition (after chronic low backache) which causes pain and disability.
Amongst the Physiotherapy specialties, the area of orthopedics that is applied to TMD is
extending in knowledge and developing new therapies and approaches. Therefore, it is necessary
for a physiotherapist to be aware of the epidemiology of the disorder. The public interest in oral
health is growing which has increased the demand for the treatment of TMD; therefore it is
essential to have epidemiological data in order to evaluate the proportion and distribution of
TMDs in general population.
Objective:
The objective of this study was to investigate the prevalence and severity of temporomandibular
disorders (TMDs) in undergraduates of Khyber Medical University.
Materials and Methods:
In the following cross-sectional study, 260 students officially registered in Khyber Medical
University, with an age range 17-27 years, were taken as a sample. Prevalence and severity of TMD
was determined using ‘Fonseca anamnestic questionnaire’. Chi-square test was used to evaluate
the data, between TMD severity and gender.
Results: It was found that out of 260 students, 105 students (40.4%) were TMD-free, 114 students
(43.8%) were with mild TMD, 30 students (11.5 %) with moderate form of TMD while 11 students
(4.2%) were having severe TMD.
Conclusion:
Signs and symptoms of TMD were present even in student population. Thorough clinical assessments with standardized test are necessary for the early diagnostic process.
Keywords:
Prevalence, temporomandibular disorders, undergraduates, non-patient population
37
Learning Style Preferences of Physical Therapy Students in Lahore
Presenter: Eisha Amin
Co-authors: Mah Rukh Badar, Saifa Zia
Background:
There is important role of educational institutions to provide optimal environment for learning
and utilizing different teaching methodologies. Physical therapists are important part of health
care system. Their practical/ clinical work demands extensive level of academic and clinical
training. Students’ learning style and preferences have an essential place in learning process.
Learning can be highly enhanced if students know their learning style and use respective
strategies.
Objective of Study:
To investigate the preferences of learning style insecond year physical therapy students and their
association to gender and past academic performance.
Methods:
A cross sectional survey was conducted in two institutions from January to April 2015. Sample
size of 170 students was taken with convenience sampling technique. The data collection tool
(questionnaire) used was comprised of Demographics and 16-item standardized Visual, Auditory,
Read/ Write and Kinesthetic (VARK), available as open access. The questionnaire was distributed
as handouts.
Results:
Most of the students (86%) found to have multimodal learning style. However, among single
modal learning styles, most common was aural/audio (62%) after second most common
kinesthetic (31%). There found no significant difference with respect to gender, however, having
past high grades in first year physical therapy Education, were those with multimodal learning
style (p=0.026).
Conclusion:
Study showed that preferred learning styles were aural and kinesthetic. Students with
multimodal learning style showed better performance than single modal. So it’s recommended to
include variety of teaching strategies to provide versatile learning styles.
Keywords:
VARK, Physical Therapy Students, Learning Preferences, Learning Style
38
Quality of Life Issues in Older Adults Suffering From Parkinson’s Disease
Presenter: Nadia Hussain
Introduction:
Parkinson's disease is a progressive disorder of the nervous system that affects your movement. It
develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But
while a tremor may be the most well-known sign of Parkinson's disease, the disorder also
commonly causes stiffness or slowing of movement. The present study indicates that older adults
suffering from Parkinson’s disease finds difficulty in performing their activities of daily living.
Objective:
The purpose of this study was to describe confidence in geriatrics with Parkinson’s disease and to
suggest them occupational therapy, physical therapy with psychotherapy so they can do activities of daily living independently.
Methodology:
A cross-sectional survey with sample of 35 older adults suffering from parkinson’s disease was
conducted. The standard tool functional independence measure has been used to measure the
independency level.
Results:
Present study indicates people suffering from parkinson’s disease have badly affected quality of
life. They were not able to perform activities of daily life independently. They can’t eat, bathe and
speech properly and need assistance. Results clearly demonstrate that parkinson’s disease affects
quality of life in older adults.
Conclussion:
It was concluded that standardized self-report scales such as the Functional Independence
Measure may well be used effectively to screen level of dependency of older adults suffering from
parkinson’s disease.
Keywords:
Parkinson’s disease, Functional Independence Measure, Activities of Daily Living
39
Common Health Problems in Office Executives; A Cross Sectional Study
Presenter: Zahra Jabeen
Co-author: Bila Umer, Sikandar Ghayas Khan
Background:
Office executives represent upper middle and higher class comprised of chief executives and
managers in both public and private sectors. Their stressed nature of job may make them prone
to many medical and health issues including physical issues. It is expected that they may know
different diseases but would not aware of current problems and their origins such as life style and
poor ergonomics.
Objectives:
To find out top most prevalent health problems in office executives and aware them their
solutions.
Methodology:
Bankers and Office workers were surveyed in Lahore, through sampling of convenience taking
sample size of 80 Office Executives. Inclusion criteria were age more than 30 years and experience
more than 5 years. Executive officers doing field job were excluded. Data were collected through
validated questionnaire for this purpose used previously.
Results:
Male and female ratio was 97.4 and 2.6 percent respectively, mean experience 8.2 and Mean BMI
was 31 in males and 27 in females. Out of 80 patients, Respiratory problems were 56%,
psychosocial 87%, GIT 34%, Hypertension 64% and musculoskeletal problems reported were
62%.among the musculoskeletal problems back pain was found most common.
Conclusion:
Study found most of executives suffering health issues, some of which are high in severity.
Psychosocial problems found were more than any other issue. There is need to educate them
regarding healthy life style and good work ergonomics.
Keywords:
Psychosocial, Health Problems, Musculoskeletal, Office Executives
40
The Satisfaction of Students of Doctor of Physical Therapy and their Future Retention
Presenter: Misbah Amanat
Co-author: Bilal Umer, Zahra Jabeen
Background:
Physical Therapy has emerged as one of integral health profession in past century worldwide. In
recent years, degree is updated to five-year program of Doctor of Physical Therapy (DPT) making
it an independent, autonomous in patient management, resulting in a huge student influx.
However, lack of public awareness and infra-structure, has created confusion in students to
continue it as profession.
Objectives:
The purpose of study was to find out satisfaction level of students of Doctor of Physical Therapy
and their future retention.
Methodology:
A cross sectional survey conducted in two universities using validated questionnaire
Convenience sampling technique was used. The percentages and frequencies were extracted and
Chi-square test was used to find association between different variables.
Results:
Total 103 respondents responded. Most were around age 19 years and middle socioeconomic
class. Strong association found between students’ awareness with field Vs satisfaction level. Most
satisfied reported predictors were assessment system 70% (71), physical therapy field 86% ( 89),
qualified faculty 95% (98), practical learning period 72%(74) and admission criteria 60% found
satisfied. Recreational activities and scholarship opportunities by universities were neutrally satisfied. 98% respondents (101) preferred to complete the degree in same institute and to continue
physiotherapy profession in future.
Conclusion:
The students of this profession found satisfied about most predictors included such as faculty
competency and qualification; field itself, assessment system, and practical training period and
admission criteria. Students found well aware and satisfied and expected to continue
physiotherapy as profession.
Keywords:
student satisfaction, student retention, doctor of physical therapy
41
NCRS
National Conference
Poster
Frequency of Voice Disorders among Teachers and Associated Risk Factors
Presenter: Anam Yaqoob
Background:
The voice is an important work tool for communication. In fact; a job can be classified based on its
demand regarding voice quality and vocal load. In teachers’ work, the voice assumes an outstanding importance, influencing their relationship with students and among their partners. Voice
disorder is defined as the disorder involving both physical and functional aspects of voice,
suggesting that a voice disorder may be present when there are problems with the structure and
function of the larynx, or both. Teachers’ voice is an important resource to gain respect, attention
and make work more interesting.
Objective:
To determine the prevalence of voice disorders in teachers.
This was across sectional survey conducted at different school of Punjab during October 2012 to
March 2013. The questionnaire was designed as a data collection tool through literature review
and expert opinion in order to collect the views from the 100 school teachers by simply asking
some questions to them by the researcher regarding their voice quality. The data was analyzed
through SPSS software version-17.
Results:
The results indicated that 54(54%) were female and 46(46%) were male. Data suggested 23(23%)
had less than 10 years teaching experience, 52(52%) had 11 to 20 years, 19(19%) had 21 to 30
years and 6% responded that their teaching tenor is between 31to 40. Data suggested that significant impact of allergens, among them 84(84%) were exposure to dustiness, 30(30%) to chemical
substance, 22(22.0%) to air conditioning, 42(42%) were using cigarettes and tobacco and 3(3%)
were habitual of alcohol consumption. Out of 100 subjects, 54(54%) were diagnosed with voice
disorders.
Conclusion:
The findings concluded that the teachers are more prone to contract voice disorders, due to lack
of education about maintenance of vocal health, furthermore, many other factors were observed
to be not only etiological factors for voice disorders but they were also aggregating the symptoms and severity of already existing voice disorders. Increased ratio of voice disorders among
teachers can be avoided by just educating them about the vocal hygiene measures for maintaining their vocal heath.
Keywords: Vocal cords, Voice, Voice quality
42
Frequency of Social Phobia in People Who Stutter
Presenter: Madiha Maqsud
Co-author: Sikandar Ghayas Khan, Sumaira Nawaz Malik, Nayab Iftikhar
Introduction:
Stuttering is very common speech problem. The interrupted flow of speech and struggled
behavior of speech seriously affects the social life of the people who stutter (PWS).Most of time
social phobia prevents them for oral communication and it can adversely affect the social
functioning and emotional state of the person.
Objective:
To investigate the presence of social phobia in people who stutter.
Methodology:
Cross sectional survey was conducted by using convenient sampling technique. Spence Children
Anxiety Scale (SCAS) was used to find the frequency of social phobia among people who stutter,
Spence Children Anxiety Scale (SCAS) is a standardized tool which was applied on 50 individual
who stutter. The percentage of response was calculated and interpreted with complete detail
with the help of SPSS 16.
Results:
Results showed that out of 50 individuals, 20 individuals scored 0 to 6, while 19 fell between 6 to
12 and score for remaining 11 individual was between 112 to 18.
Conclusion:
Social phobia or social anxiety is mostly associated with other disorders; one of those co
morbidities is stuttering. Most of the people who stammer falls under mid score range for social
phobia. It is critical that patient receive an accurate diagnosis and appropriate treatment. A dead
speech melody may be the result of social anxiety.
Keywords:
Stuttering, Social phobia, frequency
43
Effectiveness of the use of Hearing Aid vs Cochlear Implant for Children with
Profound Defenses
Presenter: Faiza Jabeen
Background:
The research problem of the study is to explore the effectiveness of the use of hearing aid for
children with profound deafness. Different companies claim that their specific hearing aids give
appropriate results in terms of listening and also developing speech in children diagnosed with
profound deafness. The current study was conducted to ascertain the effectiveness of new
intervention in Pakistan like cochlear implant for profoundly deaf children in comparison to
hearing aids.
Objective:
To obtain evidence through comparison of cochlear implant and hearing aid users’ treatment
results and establishes the most useful medium for auditory, speech and language development
for children with profound hearing impairment.
Methodology:
The study was comparative analytical. Protocol included selection of 40 children with sensory
neural profound deafness, 20 with the hearing aid and 20 with cochlear implant. All the children
were taking auditory verbal therapy (speech therapy) for the duration of minimum six month.
Data was collected by conducting interview of parents of these 40 children using the Meaningful
Auditory Integration Scale (MAIS) and the Meaningful Use of Speech Scale (MUSS).Each parent
was interviewed in individual session of 45 minutes.
Results:
The higher MAIS scores were significantly associated with higher MUSS scores suggesting that
children fitted with cochlear implant has better functional hearing and were also better in using
spontaneous speech to communicate as compare to the hearing aid user group.
Conclusion:
The study indicated on the basis of results of parental responses, that the hearing aids and
cochlear implants both give significantly different results for profoundly hearing impaired
children. According to the parental report children with cochlear implant displayed better results
in terms of development of speech and language in comparison with children using hearing aids.
Cochlear implant is a better recommendation for children with profound deafness.
Keywords:
Profound Hearing Impairment, Hearing Aid, Cochlear Implant, MAIS, MUSS
44
NCRS
National Conference
Prosthetic & Orthotic
Poster
Frequency of Congenital Anomalies of the Extremities
Presenter: Anam Razzaq
Background:
The study of frequency of congenital anomalies of upper and lower limbs has been conducted in
Benazir Bhutto hospital Rawalpindi by me. This study determined the frequencies of different
congenital deformities like congenital talipesequinovarus, congenital dysplasia of hip,
metatarsus adductus, club hand etc. The study also determined the most affected gender of
those deformities. This study included all the patients reported in orthopedic ward, orthopaedic
rehabilitation institute, paediatrics department and gyaenacology department of Benazir Bhutto
hospital Rawalpindi during whole one year.
Objective:
To analyze the retrospective data for the congenital deformities of limbs in Benazir Bhutto
hospital, Rawalpindi and to analyze the retrospective data to find out the male to female ratio of
each deformity. Further to analyze the retrospective data to find out the most common side
involved in each deformity.
Methodology:
All the data of patients reported with deformities during 2013 was collected. All the required data
was recorded on specially designed Performa. And all necessary details regarding deformity and
patient were recorded. I recorded the data of 82 patients presented with different congenital
deformities.
Results:
This study shows the frequencies of all the deformities as: 78% for club foot, 12.2% for cdh, 2.4%
for metatarsus adductus, 6.1% for calcaneovalgus and 1.2% for club hand. So this study shows
that most common congenital deformity reported in 2013 was club foot or CTEV as it has highest
percentage. And the percentage of deformities is higher in males than females; it means more no.
of males reported with different congenital deformities. And the most common affected limb is
lower limb and the deformities occur more bilaterally.
Conclusion:
This study should be done in other hospitals as well to see the percentages of the congenital
deformities. This study shows that CTEV has highest percentage and males are more prone to
deformities. These deformities can create hurdles in the life of many people if left untreated so
there should be proper check up and treatment of new borns for congenital deformities, and
should be given proper treatment to prevent these deformities. Unfortunately many
departments like gynaecology and paediatric deparments don’t check and take proper account
of the newborns for their congenital anomalies due to which their treatment becomes much
more difficult.
Keywords:
CTEV, Club foot, CDH, metatarsal adductus, calcaneo valgus
45
Functional Outcome of Colle’s Fracture Brace in the Treatment of Colle’s Fracture After
Removal of Circumferential Pop Cast at 2 Weeks
Presenter: Neelam Nadeem
Background:
A colle’s fracture is a fracture in a forearm of the distal radius with displacement of hand and wrist
is dorsally. It was defined in 1814 by an Irish surgeon and an anatomist, Abraham Colles. He based
his classification on clinical examination alone because radiography had not yet been invented.
Despite his limitation, his description of a fracture itself is quite accurate. Due to shape of the
resultant forearm the fracture is sometime referred as a “dinner fork” or “baynet” deformity. Colles
himself described that the fracture is above the carpel extremity of radius about an inch and a
half(38mm).It is caused by people falling on to hard surfaces with outstretched arm. Colles is a
common fracture in people having osteoporosis secondry only to vertebral fracture. The age
distribution for injuries to the distal radius is typically bimodal with peaks in 5-14year age group
and in elderly patients older than 60.Most colles fracture occur in elderly females with a male-tofemale ratio 1 to 4.
Objective:
The main objective of the study is to find the functional outcome of colles fracture brace in
management of colles fracture after the plaster was removed.
Methodology:
It was descriptive study in Benazir Bhutto hospital, Rawalpindi. Study period comprised of 6 to 8
months. All the patients with colles fracture were included who came for brace treatment
according to the inclusive and exclusive criteria and initial treated by POP plaster. The variables
which were considered included Pain, Disability, ROM, stiffness at wrist joint before and after 2 to
4 weeks of follow up.
Results:
The data was analyzed using SPSS 16. The variable which were considered was stiffness in
(mild,moderate,severe) whereas pain,disability,ROM according to “DEMERIT’S SCORE” it was
categorize as Excellent,Good,Fair,Poor.The variable was expressed in percentage and Mean SD. At
4 weeks of brace treatment only mild stiffness were seen in 75% of cases whereas moderate cases
was 25%.Pain at 4weeks of brace treatment, Excellent cases was 55% and Good 45% with Mean
SD 0.90.Disability at 4weeks Excellent cases 30% whereas Good were 60%,Fair 10% with Mean SD
1.6.ROM at 4weeks Excellent cases was 40% and good 50% whereas fair were 10% with Mean SD
1.4 according to DEMERIT’S SCORE.By comparsion of Pain, Disability, ROM the pain management
were excellent where as disability an ROM consider in good after brace treatment.
Conclusion:
The study indicates that Colles fracture brace is a better option for the treatment of colles fracture
with a high success rate because after 4 weeks of brace usage pain management was excellent,
Disability reduction and ROM were good only the mild stiffness remained.
Keywords:
ROM (Range of motion), disability, colles.
46
Role of mother’s smoking to cause CTEV
Presenter: Amir Shahzad
Background:
Club foot or CTEV (Congenital Talipes Equino-Varus) is one of the deformities of the lower limb
that is most prevalent. Many epidemiological studies is being held to know the cause, even
though it is concluded that genetic and environmental factors play central role to cause the
disorder but exact cause is still remains unknown. Outcomes of epidemiological studies
particularly role of mother smoking to cause the CTEV, were to insure / investigate in Pakistan.
Aims and Objectives:
To evaluate the causes and role of maternal’s smoking to cause of CTEV.
Methodology:
The Study design was a Questionnaire survey (descriptive) and conducted at PRSP, Peshawar from
April 11 to May 30, 2014. The inclusion criteria was club feet and paternal smoking, and exclusion
criteria was more than the age of 12 months and TEV’s. All the information were collected by the
subject parents. The data were analyzed using SPSS 20.
Results:
Sample size was 107 consisting of 84% male and 16 % female. Minimum age of participants was
1 months and maximum age was 24 month. Mean age was 8.22± 6.10. Mostly mother of affected
child was illiterate and belonged to rural area of KPK. 78% parents married within the family while
22% parents married outside the family. Study contained 65 % participants were bilateral and
35% were unilateral. Minimum fathers’ age was 18 years and maximum father’s age was 53 years.
Mean fathers’ age was 30.48 (±5.60). Minimum mother’s age was 18 years and maximum age was
48 years. Mean age was 26.41 (±5.20). 18 participants were having affected siblings in which at
least 1 and utmost 2 siblings were present. There was not any participant whose mother did
smoking but there was 47 participants whose father did smoking during pregnancy. There were
only 5 children who had neuromuscular disorder.
Discussion:
Two variable has high concordance with other studies i-e gender was male and CTEV with bilateral. This study showed the positive family history likewise previous studies. This study showed
complete difference that there was not any mother who did smoking. During pregnancy but
many studies stated that mothers’ smoking important role to cause CTEV.
Conclusion:
A huge of participant’s mother was illiterate. Participants were affected more bilaterally as
compared to unilaterally. Ratio of male was higher than the female. The few participant has the
positive family history. It has clearly showed that parental smoking may cause the defect but
present study didn’t take any of club feet whose mother did smoking during the pregnancy.
48
Keywords:
Causes, maternal smoking, club foot.
Non-Operative Treatment of Tibial Fracture with Orthotic Intervention
Presenter: Amina Jamil
Co-authors: Laaraib Nawaz, Saroosh Bilal
Background:
PTB fracture brace is used to transfer weight from fractured tibial shaft to patella. It is used
postoperatively.
Objective:
To access the outcomes in non-operative patients, alignment of fractured Tibia, shear forces
applied to Tibia due to fracture brace.
Methodology:
10 patients were selected in retrospective study with fracture through tibia. In this study two
groups were designed as 1: (fracture through tibial shaft) and other group as 2: (fracture through
proximal end). They were prescribed with PTB (patellar tendon bearing) fracture brace 24 hours
daily.
Results:
In group 1 patients it was quiet good to allow union in time. Also it was effective to reside
swelling, edema, prevent atrophy and did not restrict range of motion. While in group 2 patients
it was unable to correct in time because it was difficult to stabilize the proximal segment. Rate of
PTB orthosis effects on tibial fracture was greater in tibial shaft fracture than in proximal tibial
fracture (70% vs. 20% respectively).
Conclusions:
If PTB fracture brace is prescribed for tibial shaft fracture it is effective enough to unite the bone
in time while for proximal end it is not that much effective, only weight is relieved.
Keywords:
Tibial shaft fracture brace, tibial pleatue fracture
49
Malalignment of Ankle-foot Orthosis & its Relative Effects on Body
Presenter: Laraib Nawaz
Background:
AFO is used to stabilize or immobilize, support and protect the structural integrity of ankle and
foot region. Congruency between anatomical and mechanical joint is most crucial and attention
demanding objective to be achieved. Normal ankle axis is assumed to be essentially horizontal at
the level of distal tip of medial malleolei and 25 degrees of external rotation in frontal plane.
Objectives:
To check out commonest mistake done in aligning AFO and its relative effects on limb
Method:
Retrospective study was performed on 10 patients using AFO in Rehabilitation center MAYO
hospital, Lahore. To analyze the effects of malalignment their behavior was compared. Two
groups were designed as 1: (n=5) AFO was anterioraly malaligned and 2: (5) AFO was posteriorly
malaligned. They were asked to wear orthosis to analyze the effects of malalignment their behavior was compared.
Results:
In AFO malaligned anteriorly calf band moves proximally in dorsiflexion & vice versa. And
opposite was true for posterior malalignment. Rate of anterior malgingment effects was same as
posterior malalignment effects of AFO (50% vs. 50% respectively)
Conclusion:
When there is in congruency there will be undue forces on the limb due to relative motion of calf
band.
Keywords:
In-congruency effects on limb, AFO
50
Effectiveness of Boston Brace in treating Scoliosis
Presenter: Saroosh Bilal
Co-authors: Amina Jamil & Laaraib Nawaz
Background:
Boston brace is an externally applied device which is used in treatment of scoliosis. It covers area
under the arms and around the rib cage, lower spine and pelvic region in order to prevent
progression of scoliosis.
Objectives:
The aim of study was to check out either the Boston brace could efficiently arrest the scoliotic
curve.
Methods:
20 patients were selected in a retrospective study with Cobb’s angle between 35-45 degrees.20
patients were treated with Boston brace with scoliotic curves developed at the angle of 35-45
degrees. Two groups were designed: group 1(n=10) skeletally immature patients and group 2:
(n=10) skeletally mature patients. They were asked to wear the brace for minimum of 0-18hours
per day.
Results:
In group 1, patients Boston brace effectively correct the curve in rest of the patients only
progression was arrested. In group 2 it was effective enough to accommodate the deformity. Rate
of effectiveness of Boston brace was greater in skeletally immature patients than in skeletally
mature patients (75% vs. 20% respectively).
Conclusion:
Above studies shows that if Boston brace was wore for 0-18 hours daily it is effective to treat
scoliotic curve in skeletally immature patients and only accommodate in mature patients.
Keywords:
Orthotic intervention of scoliosis, Boston brace.
51
Volume.04, Issue.02 | July - December 2014 | ISSN 2226-9215
JRCRS
Journal Riphah College
of Rehabilitation Sciences
riphah international university
riphah
international
university

PDF - Riphah International University

Transcription

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