Journal Riphah College of Rehabilitation Sciences https://journals.riphah.edu.pk/index.php/jrcrs <p><strong>Issues</strong> : 4 Per year <strong><br />Print-ISSN:</strong> 2226-9215 <br /><strong>Electronic-ISSN: </strong>2410-888X <br /><strong>Chief Editor: </strong>Prof. Dr Asghar Khan <br /><strong>Editor: </strong>Prof. Dr Arshad Nawaz Malik <br /><strong>Managing Editor: </strong>Dr Iqbal Tariq<strong> <br /></strong><strong>Journal Website:</strong> <a href="http://jrcrs.riphah.edu.pk/">http://Jrcrs.riphah.edu.pk</a><br /><strong>Affiliation University website:</strong> <a href="https://www.riphah.edu.pk/">https://www.riphah.edu.pk/</a></p> <header class="kt-page-header"></header> en-US [email protected] (Managing editor JRCRS) [email protected] (Faizan Masood) Wed, 24 Sep 2025 07:08:41 +0000 OJS 3.2.1.4 http://blogs.law.harvard.edu/tech/rss 60 Motor Imagery can be Incorporated into a Stroke Rehabilitation Program. https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2750 <p><strong>Introduction:</strong></p> <p>The most common and widely recognized impairment caused by a stroke is motor and sensory impairment. This can be defined as a loss or limitation of muscle control, movement, mobility or sensual control. Motor and sensorial impairments after a stroke typically affect the control of movement in the arm and leg on one side of the body, and is seen in about 80% of patients. Approximately two-thirds of stroke survivors have initial mobility deficits, and more than 30% of survivors cannot walk independently six months after a stroke. After a stroke, a person may experience complete or partial damage to their senses, including those responsible for light touch, pain, temperature, proprioception, vibration, foot pressure, stereognosis, and two-point discrimination. Among patients with gait disturbances evaluated for stroke, most experience proprioception loss. Approximately 36-54% of stroke patients experience varying degrees of loss of joint position sense. Additionally, disturbances in touch, vision, and hearing are also observed. Loss of superficial sensation in the forefoot and loss of plantar pressure sensation can affect patients' ability to bear weight on their forefoot and cause problems with activities such as sitting up and walking.<sup>1, 2</sup></p> <p>Therefore, much of the focus of stroke rehabilitation, particularly the work of physiotherapists, is on recovering physical independence and functional ability during activities of daily living. The ultimate goal of therapy is commonly to improve sensorial integration, walking function and balance. During the rehabilitation process, therapeutic exercises and neurophysiological approaches are used to help patients regain motor function. For many years, fundamental neurophysiological approaches such as the Bobath Concept, Margaret Johnstone Approach, and Brunnstrom Technique have long been used in stroke rehabilitation to help patients achieve functional gains. In recent years, contemporary approaches such as Constraint-Induced Movement Therapy (CIMT), Virtual Rehabilitation (VR), robotic-assisted rehabilitation, task-focused training, Mirror Therapy, and PANat (Pro-Active Neurorehabilitation approach integrating air splints and other tools) have increasingly been preferred by physical therapists due to their evidence-based outcomes and adaptability to individual patient needs.<sup> 3, 4</sup></p> <p>Parallel to these developments, motor imagery strategies has also been preferred to accelerate neuroplasticity. Motor imagery (MI) is an increasingly popular and widely studied technique in stroke rehabilitation, particularly for improving motor function in patients with impaired movement. MI (motor imagery) is a technique that uses imagination to teach movement to individuals who have suffered a stroke. Based on the principles of mental practice, MI has also begun to be used in stroke rehabilitation in recent years. Two concepts frequently emerge when examining mental exercises. The first is movement observation (MO), and the second is motor imagery (MI). MI is defined as imagining a task without performing it. Movement observation (MO) is based on an individual watching a specific movement performed by a third person or played back from a video recording. Motor imagery (MI) is the conscious mental representation of a movement without physically performing it. MI is defined as the mental rehearsal or simulation of movement and is considered a dynamic cognitive process. Research using advanced brain imaging techniques has revealed that brain regions responsible for planning, executing, and regulating movement become active during both physical movement and motor imagery. These structures include the premotor area, parietal lobe, basal ganglia, anterior cingulate cortex, and cerebellum. Motor imagery has several clinical applications in stroke rehabilitation, particularly in enhancing motor recovery. One of its most notable effects is improving motor function, particularly in recovering upper limb movements, which are often impaired after a stroke. When combined with physical therapy, motor imagery can also increase muscle strength by reinforcing the neural activation patterns associated with movement. It also supports brain reorganization by stimulating motor-related areas of the brain and promoting neuroplasticity, which is essential for recovery. After a stroke, the areas of the brain responsible for movement may be damaged. However, studies have shown that imagining movements activates the same brain regions as performing them. As a therapeutic approach, motor imagery is safe and cost-effective, making it accessible to a wide range of patients. Furthermore, it can be self-administered or guided by therapists and can be enhanced through the use of technology, enabling flexible, individualized rehabilitation programs. Systematic reviews and randomized controlled trials (RCTs) provide moderate evidence that motor imagery (MI) is effective in improving upper limb function, particularly in individuals recovering from subacute or chronic stroke. The therapeutic benefits are significantly enhanced when MI is combined with physical practice, as this integrated approach proves more effective than physical training alone. Optimal outcomes are typically achieved through regular and consistent practice, with sessions conducted three to five times per week, each lasting approximately 20 to 30 minutes. This structured routine supports the reinforcement of neural pathways involved in motor control and facilitates more meaningful functional recovery. The effectiveness of motor imagery in stroke rehabilitation largely depends on the patient's ability to accurately imagine movements, a skill that not all individuals possess or can easily develop. To ensure its success, proper training and assessment are necessary, often involving tools such as the Kinesthetic and Visual Imagery Questionnaire to evaluate a patient's imagery capabilities. It is also important to recognize that motor imagery is not a replacement for physical therapy; rather, it serves as a complementary approach that enhances the overall rehabilitation process when used alongside conventional therapeutic interventions.<sup>5,6,7 </sup>Therefore, motor imagery (MI) may facilitate the reorganization of motor networks in patients who have had a stroke by enhancing neural activation in specific cortical and subcortical regions, as well as modulating functional connectivity within motor-related pathways. It is thought that these neurophysiological changes contribute to improvements in motor function and overall recovery. <sup>8, 9</sup></p> <p><strong>Conclusion:</strong></p> <p>In summary, motor and sensory impairments are among the most common consequences of stroke, significantly affecting patients' mobility, independence, and quality of life. Traditional neurophysiological rehabilitation approaches have long aimed to restore functional movement, and recent advancements have introduced more dynamic and cognitively engaging strategies such as motor imagery (MI). MI offers a promising adjunct to conventional therapy by engaging the brain's motor networks through mental simulation of movement, thereby promoting neuroplasticity and functional recovery. Evidence from clinical research, including systematic reviews and randomized controlled trials, supports the use of MI—particularly when combined with physical practice—for improving upper limb function in individuals with subacute or chronic stroke. While the effectiveness of MI may vary depending on a patient's ability to mentally visualize movement, its accessibility, low cost, and adaptability make it a valuable tool in modern stroke rehabilitation. As part of a comprehensive, individualized rehabilitation plan, motor imagery has the potential to enhance recovery outcomes and contribute meaningfully to restoring patients' independence in daily activities. Motor imagery can be incorporated into the standard rehabilitation programme to enhance cognitive processes and target motor function in appropriate stroke cases. In this context, it is recommended that physical therapists increase their experience in this area and use this technique.</p> <p><strong>References:</strong></p> <ol> <li>Comino-Suárez, Comino-Suárez J, et al. Transcranial direct current stimulation combined with robotic therapy for upper and lower limb function after stroke: A systematic review and meta-analysis of randomized control trials. J Neuroeng Rehabil. 2021;18(1):148.</li> <li>Tanamachi K, Kuwahara W, Okawada M, Sasaki S, Kaneko F. Relationship between resting-state functional connectivity and change in motor function after motor imagery intervention in patients with stroke: A scoping review. J Neuroeng Rehabil. 2023;20(1):159.</li> <li>Mehrholz J, Thomas S, Kugler J, Pohl M. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2018;10:CD006185.</li> <li>PANat Concept. PRO-Active Neurorehabilitation integrating air splints and therapy tools. 2022. Available from: https://www.panat.info/</li> <li>Prasomsri J, Sakai K, Ikeda Y. Effectiveness of motor imagery on physical function in patients with stroke: A systematic review. Mot Control. 2024;28(4):442–63.</li> <li>Taube W, Gruber M, Beck S, Faist M, Gollhofer A, Leukel C. Cortical and spinal adaptations induced by balance training: Correlation between stance stability and corticospinal excitability. Acta Physiol (Oxf). 2015;213(1):1–12.</li> <li>Kho ME, Duffett M, Willison DJ, Cook DJ, Brouwers MC. The CONSORT statement: A guideline for reporting randomized trials in rehabilitation research. Arch Phys Med Rehabil. 2014;95(8):1451–8.</li> <li>Zhang W, Li W, Liu X, Zhao Q, Gao M, Li Z, et al. Examining the effectiveness of motor imagery combined with non-invasive brain stimulation for upper limb recovery in stroke patients: A systematic review and meta-analysis of randomized clinical trials. J Neuroeng Rehabil. 2024;21(1):209.</li> <li>Yazgan EA, Kara Kaya B, Tiryaki P, Atlı E, Cavlak U. Effectiveness of motor imagery and action observation in parameters of sport performance: A systematic review. Percept Mot Skills. 2025 Jul 14.</li> </ol> <p> </p> <p> </p> Uğur Cavlak Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2750 Wed, 24 Sep 2025 00:00:00 +0000 Comparing Neuromuscular Training and Closed Chain Exercises in Athletes with Ankle Sprains: Efficacy in Pain Reduction, Joint Mobility, Balance, And Functional Disability: A Randomized Control Trial https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2574 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> Ankle sprains are one of the most common musculoskeletal injuries in athletes and are caused mainly by inversion during dynamic movement, change of direction, and jump. The injuries predominantly affect the lateral ligament complex, with emphasis on the anterior talofibular ligament</p> <p><strong>Objective:</strong> To determine the effects of neuromuscular training versus closed kinetic exercise on pain, range of motion, balance, and function in athletes with ankle sprain.</p> <p><strong>Methodology:</strong> This RCT compared Neuromuscular training (NMT) to Closed Chain exercises (CKC) in 40 athletes with acute grade I-II ankle sprains. Participants were randomly assigned to the group that got either CKC exercises (n=20) or neuromuscular training (n=20), 3×/week for 4 weeks. Outcomes measured were pain (Numerical Pain Rating Scale NPRS), range of motion (goniometer), balance (Star Excursion Balance Test), and function (Functional Ankle Ability Measure FAAM), with statistical analyses performed using t-tests (p&lt;0.05). (CTR: NCT06198270</p> <p><strong>Results:</strong> Statistically significant improvement occurred in pain, balance, ROM, and function for 2 groups (p&lt;0.001). Pain reduction was better in the KT group (1.3±0.17 vs. 3.6±0.67), along with superior ROM gains on dorsiflexion (3.7°±1.8° vs. 2.5°±1.4°), on plantarflexion (6.8°±2.4° vs. 3.7°±2.2°), balance (20.6cm±3.7cm vs. 11.7cm±3.0cm SEBT), and function (16.9%±3.4% vs. 5.5%±1.7% FAAM-S) compared with the CKC group (all p&lt;0.001). Hence, neuromuscular training was more effective than CKC exercises for some clinical variables.</p> <p><strong>Conclusion:</strong> Given that both therapies brought great improvements in pain, ROM, balance, and functional outcomes, those patients undergoing neuromuscular training were, in fact, more effective than the other groups, especially in improving balance and functional activities.</p> <p><strong>Keywords:</strong> Athletes, Closed Kinetic Chain Exercise, Functional Disability, Neuromuscular Training</p> Aamir Gul Memon, Suriyakala Perumal Chandran, Abdul Hameed, Shahzaib Saleem, Ali Sheraz Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2574 Wed, 24 Sep 2025 00:00:00 +0000 Comparison of Kinesiology Taping and Instrument Assisted Soft Tissue Mobilization in Cervicogenic Headache: A Randomized Clinical Trial https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2408 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> Cervicogenic headache is a common condition caused by issue in the cervical spine, leading to chronic head pain. Various treatments exist, including kinesiology Taping and Instrument Assisted Soft Tissue Mobilization, but there is limited evidence comparing their effectiveness. <br /><strong>Objective:</strong> In this study, the effects of instrument-assisted soft tissue mobilization and kinesiology taping on pain severity, range of motion, and functional status in individuals with cervicogenic headache were compared. <br /><strong>Methodology:</strong> In the physiotherapy department of Healing Hands Institute, Mega Medical Complex, Rawalpindi, 36 participants with clinically diagnosed cervicogenic headache, headache, and stiffness in the neck, positive flexion rotation test with restriction of 6-10 degrees unilateral headache, aged 30-44 years, were divided into two equal groups for a <br />clinical experiment that was randomized. While Group B received conventional therapy together with Instrument Assisted Soft Tissue Mobilizations (IASTM), Group A received conventional treatment along with Kinesiology Taping. Using a non-probability purposeful sampling approach, data was gathered at baseline and the fourth week to measure the <br />indicator using the Numeric Pain Rating Scale, Neck Disability Index, and Bubble Inclinometer. SPSS version 22 was used for data analysis. (CTR : NCT05474612) <br /><strong>Results:</strong> At 4 weeks of intervention, both groups A and B saw substantial improvements in disability, range of motion, and discomfort (p &lt; 0.05). Although there were no statistically significant differences in cervical flexion, extension, left lateral flexion, or left rotation (p &gt; 0.05), between-group analysis revealed statistically significant differences in NPRS, NDI, <br />cervical right rotation, and cervical right lateral flexion (p &lt; 0.05). In the case of within-group comparisons, all measures showed statistically significant changes (p &lt; 0.05). <br /><strong>Conclusion:</strong> The study concludes that the use of both instrument-assisted soft tissue mobilization and kinesiology taping has been successful in improving range of motion and lowering pain and impairment. However, Group B (Instrument Assisted Soft Tissue Mobilization) had a more notable improvement. <br /><strong>Keywords:</strong> Cervical Atlas, Cervicogenic Headache, Headache Unilateral, Mobilization, Range of Motion.</p> Sana Javaid , Zainab Noor Qazi, Muhammad Ansar, Mahnoor Zia Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2408 Wed, 24 Sep 2025 00:00:00 +0000 Immediate Effects of Taping on Patellofemoral Pain Syndrome in Outpatient Physical Therapy Patients at Rehman Medical Institute, Peshawar – Pre-Post Interventional Study https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2551 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> Patellofemoral pain syndrome (PFPS) is one of the most common reasons for the development of knee joint pain usually over the anterior aspect and causes deterioration of the cartilage in between the superiorly lying patella and underneath femur. PFPS contributes to approximately 15-45% of diagnosed cases of knee pain among US population.</p> <p><strong>Objective:</strong> The objectives of this study were to evaluate immediate effects of taping on pain in patients with Patellofemoral Pain Syndrome and to determine the difference in responses according to gender, BMI, and the type of taping technique used.</p> <p><strong>Methodology:</strong> A total of 32 participants were recruited in this pre-post-interventional study. The participants were asked to descend a stair of 8-inch height before and after the application of tape and were asked to rate their pain from 1 to 10 while differences were recorded and analyzed.</p> <p><strong>Results:</strong> The results of the study indicated a statistically significant reduction in pain following the intervention, (p&lt;0.05) with a post-intervention mean value of 3.5±1.7. There was no significant difference between based on the tapping technique. A significant difference between the BMI groups was observed, with individuals with normal BMI responding effectively towards treatment. There was no significant difference between the two gender groups, meaning that both genders respond equally towards treatment.</p> <p><strong>Conclusion:</strong> The results of this study show that short-term taping can significantly reduce knee pain in PFPS via sensory input, with BMI influencing pain relief, while gender and taping technique show no significant impact.</p> <p><strong>Keywords:</strong> Taping, Spider Taping, McConnell’s Taping, Tibial Internal Rotation Taping, Patella Femoral Pain Syndrome</p> Rehana Nayab, Mariyam Kifayat, Shehla Nasir, Farrakh Tariq, Faizan Gohar, Bilal Khan Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2551 Wed, 24 Sep 2025 00:00:00 +0000 The Participation of Persons with Disabilities on the Labor Market in Zimbabwe. A Case of Glenview 1, Riverside, Harare - A Qualitative Research https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2496 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> This study explored the factors affecting the participation of persons with disabilities in the labour market in Zimbabwe. Persons with disabilities continue to face stigma and discrimination in their participation in labour market despite the availability of robust social policy and programs in Zimbabwe. The study therefore aims to establish pathways towards promoting their inclusion in labour market.</p> <p><strong>Objective: </strong> The main objective of the study was to identify the socio-economic factors hindering the participation of persons with disabilities in the labour market and to establish strategies to ensure increased participation of persons with disabilities in the labour market.</p> <p><strong>Methodology:</strong> A qualitative research approach was employed, utilizing a phenomenological research design to capture the lived experiences of persons with disabilities. Purposive sampling, was used to select a total of 13 participants with varying disabilities, as well as 3 key informants. The study conducted semi structured interviews of approximately 45-60 minutes each with 15 open-ended questions and focus group discussions with 8-10 participants gathering insights from persons with disabilities. Additionally, key informant interviews were conducted with individuals possessing specialized knowledge on the area of study.</p> <p><strong>Results:</strong> from the study were analyzed using a thematic data analysis. The researcher obtained consent from participants before their involvement in the study. All participants were assured of full confidentiality, with the understanding that no information would be revealed without their consent. The study found that attitudinal and physical barriers are major factors affecting the participation of persons with disabilities in the labour market. Additionally, resource constraints were found to limit the capacity of communities and employers from accommodating persons with disabilities in the workplace. The study further established that measures to improve participation include vocational training and the establishment of a quota system.</p> <p><strong>Conclusion:</strong> The study recommended among other efforts, the continuous improvement of existing disability-friendly policies and the repeated raising of awareness on the need to include persons with disabilities in the labour market through effective implementation of reasonable accommodations among other efforts.</p> <p><strong>Keywords:</strong> Disability, Labour Market, Persons with disabilities and Zimbabwe.</p> Tafadzwanashe James Magavude, Lakidzani Polite N Moyo, Edwin Ndhlovu, Given Shamiso Kabayahwaro Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2496 Wed, 24 Sep 2025 00:00:00 +0000 Association between Smartphone Screen Time and Cervicogenic Headache Severity in Young Adults, a Cervical Flexion-Rotation Test-Based: A Cross-Sectional Study https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2526 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> With increased use of smartphones, extended screen time is associated with musculoskeletal disorders such as cervicogenic headaches. Poor postures and forward head posture can cause cervical spine dysfunction and result in headache. Young adults, especially students, are highly susceptible because of overuse of smartphones. The prevalence and severity of cervicogenic headaches in this population need to be identified for early treatment and prevention.</p> <p><strong>Objective:</strong> To determine the association between smartphone screen time and cervicogenic headache severity in young adults.</p> <p><strong>Methodology:</strong> This cross-sectional study was conducted on Doctor of Physical Therapy (DPT) students (n=175) using a non-probability convenience sampling technique. Participants included both male and female DPT students aged 18–25 years with more than three hours of daily smartphone screen time, while individuals with systemic diseases, whiplash injuries, psychiatric illnesses, or a history of cervical spine tumors were excluded. Cervicogenic headache severity was assessed using the Numeric Pain Rating Scale (NPRS), and cervical spine dysfunction was evaluated through the Cervical Flexion-Rotation Test (FRT).</p> <p><strong>Results:</strong> Of the 175 participants, 137 tested positive and 39 tested negatives on the Flexion Rotation Test (FRT). According to the NPRS (Numeric Pain Rating Scale), 35.4% of participants reported mild pain, 55.4% had moderate pain, and 9.1% experienced severe pain. Screen time and Cervicogenic Headache CGH pain severity were statistically significantly correlated, with a chi-square test value of 63.742 and a p-value of &lt;0.001.</p> <p><strong>Conclusion:</strong> The majority of students experienced cervicogenic headaches associated with excessive smartphone use. Moreover, a statistically significant association was found between increased screen time and higher cervicogenic headache severity (χ² = 63.742, p &lt;0.001), indicating that prolonged smartphone use may contribute to increased headache intensity in young adults.</p> <p><strong>Keywords:</strong> Cervicogenic Headache, Smartphone Addiction, Screen Time, Young Adult</p> <p> </p> Jannat Arshad, Somia Faisal, Nabeela Safdar, Sahar Aslam, Mishal Farwa Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2526 Wed, 24 Sep 2025 00:00:00 +0000 Knee Joint Proprioception in Weight Bearing and Non-Weight Bearing Position in Arthroscopic Assisted Anterior Cruciate Ligament Reconstruction: A Cross-Sectional Study https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2382 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> Proprioception is the body's ability of sensing the position, movement, and alignment of its joints and limbs. The ACL is rich in proprioceptive fibers, an injury to this ligament, impairs knee function and neuromuscular control, leading to poor coordination. Incorporating proprioception assessment and training in ACL rehabilitation is essential for restoring function and preventing future injuries.</p> <p><strong>Objective:</strong> To determine knee joint proprioception in loaded and unloaded position among patients after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction.</p> <p><strong>Methodology:</strong> A descriptive cross-sectional study was conducted at Ghurki Trust and Teaching Hospital (GTTH), targeting patients who had undergone surgical reconstruction of anterior cruciate ligament. The total study duration was six months, covering the period from June 2023 to December 2023. Using a non-probability purposive sampling technique, a total of 74 participants meeting the inclusion criteria were selected. A goniometer was utilized to evaluate joint position sense in both loaded and unloaded positions. The data was entered and analyzed using SPSS version 22.</p> <p><strong>Results:</strong> The result showed that the mean age of participants was 27.79 ± 5.03. Knee flexion in weight bearing position was 30 degrees and maximum range was 44 degree with mean of 34.89 ± 4.21 whereas minimum knee flexion in non-weight bearing was 30 degree and maximum was 45 degree with mean of 33.68 ± 4.35.</p> <p><strong>Conclusion:</strong> Statistically significant difference was found in knee joint proprioception between loaded and unloaded position among patient of ACL reconstruction.</p> <p><strong>Keywords:</strong> Anterior Cruciate Ligament, Knee Joint, Proprioception, Weight-Bearing</p> Yamna Mazher, Marwa Muslim, Hassan Shahid Dar, Mahrukh Asif, Muhammad Tariq Shafi Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2382 Wed, 24 Sep 2025 00:00:00 +0000 Anxiety and Depression among Primary Caregivers of Male versus Female Children with Cerebral Palsy: A Cross-Sectional Comparative Study in Karachi, Pakistan https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2323 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> Cerebral palsy (CP) is a neurological disorder that impacts movement, posture, and muscle tone due to brain damage in fetal development, infancy, or early childhood.</p> <p><strong>Objective:</strong> To compare anxiety and depression among primary caregivers of male versus female children with cerebral palsy.</p> <p><strong>Methodology:</strong> This cross-sectional comparative study was carried out between February 2020 and March 2021 with the caregivers of CP-inflicted children admitted at a rehabilitation center in Karachi, Pakistan. Among 46 approached caregivers, only 30 (75%) voluntarily participated in the study. Group 1 encompassed caregivers of male CP-inflicted patients (n=19) and group 2 encompassed caregivers of female CP-inflicted patients (n=11). Data on physical characteristics and additional impairments accompanying CP was gathered whereas face-to-face meetings were arranged with primary caregivers to gather data for sociodemographic questionnaire and Hospital anxiety depression scale (HADS).</p> <p><strong>Results:</strong> No significant differences were observed in the two groups concerning the physical characteristics of CP cases and sociodemographic characteristics of caregivers. Compared to the caregivers of female CP children, caregivers of male CP children had significantly higher anxiety (7.09±1.64; 8.42±1.6, p=0.044), depression (5.90±1.8; 8.10±1.88, p=0.004) and total HADS scores (6.50±1.79; 8.26±1.75, p=0.006).</p> <p><strong>Conclusion:</strong> Caregivers of male CP children were more prone to anxiety and depression problems. There was no significant correlation found between the sociodemographic profile of the caregivers and the characteristics of CP with the gender of CP children.</p> <p><strong>Keywords:</strong> Anxiety; Caregivers; Cerebral Palsy; Children; Depression; Pakistan</p> Ammara Rafique Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2323 Wed, 24 Sep 2025 00:00:00 +0000 Perception of Undergraduate Rehabilitation and Nursing Students of Khyber Medical University, Peshawar, Pakistan, Regarding an Effective Teacher: A Cross-sectional Study https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2506 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> Effective teaching is crucial in medical education, where instructor’s performance and personality attributes significantly impact student learning.</p> <p><strong>Objective:</strong> The objective of the study was to identify the perception of students of Khyber Medical University (KMU) regarding teachers' most and least effective attributes.</p> <p><strong>Methodology:</strong> A cross-sectional survey of 288 undergraduate students was conducted in constituent institutes of KMU, Peshawar. Undergraduate students of any gender from the 2nd year to the final year were allowed in this survey after taking their written informed consent. One-way ANOVA and Tukey test were used to identify the differences among institutes.</p> <p><strong>Results:</strong> Performance attributes (M=4.39 ± 0.48) were more important than personality attributes (M=4.29 ± 0.53) to the students. The top 3 performance items were: Expert on the subject, facilitation of students’ learning and desire to promote students’ learning. The top 3 personality items were: Helpful, punctual and good communication skills. Uniform marking and not being strict/showing leniency were the least valued.</p> <p><strong>Conclusion:</strong> Performance attributes were found to be more important than personality. However, there were some highly endorsed personality attributes, which show that students want their learning needs to be met and desire some personality attributes which make a teacher effective.</p> <p><strong>Keywords:</strong> Perception, Clinical Competence, Students, Faculty, Teaching, Personality</p> Sapna Ali Khan, Uzma Amin , Hoor Bakht , Haider Darain , Hazrat Bilal, Aamna Bibi Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2506 Wed, 24 Sep 2025 00:00:00 +0000 Level of perceived stress among undergraduate physiotherapy students with primary dysmenorrhea in Sialkot, Pakistan – A Cross Sectional Study https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2463 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> Menstrual pain often caused by prostaglandins, triggering uterine contractions is named as Primary Dysmenorrhea. Perceived stress is stated as an individual’s subjective assessment of the degree to which they feel overwhelmed or unable to cope with the demands of life.</p> <p><strong>Objective:</strong> To determine the level of perceived stress among undergraduate physiotherapy female students with primary dysmenorrhea in Sialkot, Pakistan.</p> <p><strong>Methodology: </strong> This Cross-sectional study included 232 females with primary dysmenorrhea, selected using Simple non-random sampling technique. Inclusion criteria was age (18-25 years), women with normal menstrual cycle lasting between 21 to 35 days, low back pain that begins one day before the menstrual cycle and lasts for 6-12 hours after the start of menstrual cycle, and leads to 3 days of bleeding in last 3 menstrual cycles whereas polycystic ovarian syndrome (PCOS), amenorrhea, use of oral contraceptives, use of intrauterine devices, pregnancy and secondary dysmenorrhea were excluded from the study. The outcome measuring tool was Perceived Stress Scale (PSS-10). The data was analyzed using SPSS software 22 and interpreted as frequencies and percentages.</p> <p><strong>Results:</strong> Out of 232 participants the mean age was (21.34± S.D 1.49 years). The majority of the participants were unmarried (N=206, 88.8%). Most of the participants (N=138, 59.5%) had normal Body Mass Index, (N=131, 56.5%) had healthy diet with maximum sleep duration of 12 hours. Most of the participants had 3-5 days of menstrual bleeding (N=188, 81.0%), moderate menstrual flow (N=182, 78.4%), 21-35 days of menstrual cycle length (N=169, 72.8%) and menarche at the age of 13 years (N=57, 24.6%). The Participant’s mean score of perceived stress scale was (22.10± S.D 5.92).</p> <p><strong>Conclusion:</strong> The study concluded that students with primary dysmenorrhea had moderate level of perceived stress.</p> <p><strong>Keywords:</strong> Menarche, Primary Dysmenorrhea, Perceived Stress</p> Kainat Shahbaz, Esha Ali, Maham Shahbaz, Iqra Tul Hussain Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2463 Wed, 24 Sep 2025 00:00:00 +0000 Frequency of Shoulder and Elbow Overuse Injuries and its Association with Risk Factors among Overhead Athletes in Peshawar, Pakistan https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2441 <p><strong>Abstract:</strong></p> <p><strong>Background:</strong> In sports that involve overhead movements, the overuse injuries occurs due to the repetitive exertion of force in an arc overhead exerts significant stress on the shoulder and elbow joints.</p> <p><strong>Objective:</strong> To find out the frequency of shoulder and elbow overuse injuries among overhead athletes and the association of frequency with associated factors such as age, gender, sport, years of experience and weekly playing hours.</p> <p><strong>Methodology:</strong> This cross-sectional study was conducted at Peshawar Sports Complex and Hayatabad Sports Complex, Peshawar from July to October 2024. A total of 132 athletes of ages between 18-40 years were included in this study. Data was collected through Oslo Sports Trauma Centre Overuse Injury Questionnaire from the athletes. Data was analyzed using Statistical Package for Social Sciences version 27.0 to create graphs and tables. Chi square test was used for statistical analysis to find the association between overuse injuries and its risk factors.</p> <p><strong>Results:</strong> A total of 132 athletes were part of this study. The frequency of shoulder overuse injuries was 17.4% while the frequency of elbow overuse injuries was 5.3%. Most of the affected athletes were between the ages of 18-25 years. There was no significant association between the frequency of shoulder and elbow overuse injuries and its risk factors.</p> <p><strong>Conclusion:</strong> This study concluded that statistically, the overuse injuries do not show significant association with the factors such as age, gender, sport, years of experience and weekly training hours.</p> <p><strong>Keywords:</strong> Elbow Injuries, Overhead Athletes, Overuse Injuries, Shoulder Injuries</p> Muneeb Hassan, Shehla Ali, Muhammad Kamal Sardar Ali, Abid Ali, Firas Ahmad Copyright (c) 2025 All Articles are made available under a Creative Commons &quot;Attribution-NonCommercial 4.0 International&quot; license. (https://creativecommons.org/licenses/by-nc/4.0/). Copyrights on any open access article published by Journal Riphah college of Rehabilitation Science (JRCRS) are retained by the author(s). Authors retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means; provided the article is correctly cited. JRCRS does not allow commercial use of the articles published. All articles published represent the view of the authors and do not reflect the official policy of JRCRS. https://creativecommons.org/licenses/by-nc/4.0 https://journals.riphah.edu.pk/index.php/jrcrs/article/view/2441 Wed, 24 Sep 2025 00:00:00 +0000