This study aimed to assess the effects of exercise interventions of more than 8 weeks on thyroid function in adults with hypothyroidism through a systematic review and meta-analysis of randomized controlled trials. The PEDro, WOS, PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched for relevant articles, which then underwent standardised screening, data extraction, and bias risk assessment. A total of seven randomised controlled trials (n = 7) were included, predominantly examining 12 weeks of exercise therapy. A meta-analysis was conducted using data extracted from the included studies. Standardised mean differences were calculated for thyroid-stimulating hormone levels, and heterogeneity was assessed using the I² statistic. The certainty of evidence was evaluated using the GRADE approach. Statistically significant reductions in thyroid stimulating hormone (TSH) levels (SMD: -3.254; 95 % CI: -3.937 to -2.572; p < 0.001) and increases in thyroxine (T4) level (SMD: 1.315; 95 % CI: 0.263-2.367; p = 0.015) were noted in exercise intervention groups as compared to control groups. Heterogeneity was moderate (I² = 65.93 %, p = 0.019) and no publication bias was detected. In addition, based on GRADE assessment, the certainty of evidence was rated as moderate for the TSH outcome and very low for the T4 outcome. Findings from seven randomised controlled trials support the integration of long-term exercise as a non-pharmacological adjunct in the management of hypothyroidism. Exercise interventions, alongside conventional treatment, appear to improve thyroid function by reducing TSH and increasing T4 levels.

Background: Exercise therapy can potentially relieve symptoms and improve functional status of the knee osteoarthritis population. Despite the proved practical benefits, there is no standard, comprehensive physiotherapeutic protocol available targeting the physical and physiological impairment cluster associated with disease. Osteoarthritis is a whole joint disease, affecting joint cartilage, ligaments, menisci and joint associated muscles, from variable pathophysiological processes. Hence, there is a need to develop a physiotherapy protocol to address the multi-structural physical, physiological and functional impairments associated with the disease. Objective: The objective of the present study is to evaluate the efficacy of designed, therapist supervised, patient education, progressive resistance exercises, passive stretching exercises, soft tissue manipulation, muscle energy technique, Maitland mobilization, aerobic exercise, and neuromuscular training physiotherapy protocol on pain, disability, balance, and physical functional performance in knee osteoarthritis patients. Methodology: The preliminary study was conducted on a (n = 60) sample of convenience. The samples were randomly allocated into two study groups, intervention, and control group. The control group was advised on a basic home program. On the other hand, the treatment of the intervention group was designed with a therapist supervised Physiotherapy Protocol. The outcome variables studied were the Visual Analogue Scale, Modified WOMAC Scale, Timed Up and Go Test, Functional Reach Test, 40 m Fast Paced Walk Test, Stair Climb Test, 30 s Chair Stand Test. Results: The results of the study revealed a significant improvement among most of the studied outcome measures in the intervention group, hence the designed supervised physiotherapy protocol was found effective in relieving multiple physiological impairments associated with this whole joint disease.

The purpose of the present study was to compare the effect of sciatic nerve mobilisation on muscle flexibility among diabetic and non-diabetic sedentary individuals. The study was a pre-post experimental-group design. A sample of 40 sedentary subjects was assigned into two groups; Group A (diabetics: 10 males and 10 females) and Group B (non-diabetics: 10 males and 10 females). Both groups were tested for hamstring and calf flexibility following which sciatic nerve mobilisation was given to the most affected lower limb in terms of reduced hamstring and calf flexibility. Hamstring flexibility was checked by active knee extension test and calf flexibility was checked with the distance-to-wall technique using a tape measure. It was a two-week program in which subjects were given sciatic nerve mobilisation using sliders technique after which flexibility was checked. Three sessions per week were given for two weeks and muscle flexibility of hamstring and calf was measured after the intervention. The present study findings reveal that sciatic nerve mobilisation by sliders technique when given to diabetic and non-diabetic groups of sedentary individuals for two weeks, enhance patient outcomes in both the groups in terms of increase in hamstring and calf flexibility, but results were more significant in non-diabetic individuals as compared to diabetic individuals. In conclusion, sciatic nerve mobilisation resulted in an increase of muscle flexibility of hamstring and calf muscles in both groups.

Chronic neck pain is a prevalent condition affecting a substantial portion of the population globally. Pressure pain threshold (PPT) evaluation using algometers offers a quantifiable and potentially reliable tool for pain assessment. However, its test-retest reliability, particularly using the Wagner algometer, requires further validation in this population. To assess the test-retest reliability of the Wagner algometer for measuring PPT in patients with chronic neck pain. A total of 100 patients with chronic neck pain underwent PPT assessment using the Wagner algometer at two time points across four muscle sites: right and left upper trapezius, and right and left levator scapulae. Intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated. ICC values indicated good to excellent reliability: right trapezius (0.98), left trapezius (1.00), right levator scapulae (0.88), and left levator scapulae (0.99). SEM ranged from 0 to 0.26, and MDC from 0 to 0.73. Bland-Altman plots confirmed high agreement without proportional bias. The Wagner algometer demonstrates excellent test-retest reliability for measuring PPT in chronic neck pain patients and may serve as a consistent tool for clinical pain assessment and outcome tracking when tested under required conditions.