Background: The disability and significant economic costs accredited to Low back pain (LBP) are likely to rise which is an essential problem in low and middle-income countries like Pakistan. The associated factors of LBP are age, sex, and race including physical activity, high spinal load, lifting, bending, and twisting occupations. The literature highlighted there is substantial differences in associated factors of LBP within available studies in developing countries. The objective is to investigate the association of demographic factors and lumbar range of motion with disability in patients with chronic low back. Methods: A baseline data analysis was performed as an analytical cross-sectional study among 150 patients with chronic low back in a randomized controlled trial with a duration from March 2020 and January 2021. After recording demographics, Modified-Modified Schober’s test was used to measure lumbar flexion and extension and Oswestry disability index for disability. After the descriptive analysis the continuous variables, age and pain were analyzed with Spearman’s correlation. Variables that were significant in bivariate analysis were then fitted in a multivariable linear regression. The Kruskal–Wallis test was used to analyze variations of disability in gender, marital status, work status, education level, and duration of pain. The p-value of 0.05 was significant. Results: The results showed a significant correlation between age and pain in sitting (rh=-0.189, p = 0.021 and rh = 0.788, p < 0.001) with the disability but no significant effects of age and pain in sitting (B=-0.124, p = 0.212 and B = 1.128, p = 0.082) on disability were found. The decrease in lumbar flexion and extension was found to increase disability (B=-6.018 and − 4.032 respectively with p < 0.001). Female gender (x2(1) = 15.477, p = < 0.001) and unmarried marital status (x2(1) = 4.539, p = 0.033) had more disability than male gender and married marital status, respectively. There was a significance between groups of the duration of pain regarding disability (x2 (2) = 70.905, p < 0.001). Age, education level, and work status showed no significance (p > 0.05). Conclusions: The female gender and unmarried marital status are associated with functional disability. Decreased lumbar range of motion accompanies more disability, while age, education level, and work status do not effect on disability.

Neck pain is a common musculoskeletal issue that has been seen as high in terms of disability. Muscle Energy Techniques (MET) are advanced soft tissue techniques to treat Mechanical Neck Pain (MNP). This study compares the Autogenic inhibition (AI) technique with the Reciprocal Inhibition (RI) technique providing conventional treatment to improve functional outcomes. A randomized control trial was conducted at Sindh Institute of Physical Medicine & Rehabilitation, Karachi, Pakistan from August 28, 2021, to December 31, 2021 among 20–50 years old patients with Moderate intensity MNP for more than 4 weeks and with limited Neck ROMs. The sample were divided randomly and allocated into two groups (groups 1 and 2). Group 1 and 2 received 12 sessions of AI and RI with Conventional therapy respectively. The randomization sheet was generated online from randomization.com for a sample size of 80 and two groups of study ‘AI’ and ‘RI’ with a ratio of 1:1 by an independent statistician. Pain (primary outcome), range of motion, and functional disability (secondary outcomes) were assessed through visual analog scale (VAS), Goniometer, and Neck disability index (NDI) at baseline, 1st, and last session respectively. Mean and standard deviation, frequency, and percentages were calculated. Chi-square test and independent t-test compare baseline characteristics. The Repeated Measure Two-Way ANOVA compared mean VAS, NDI, and ROM. The significant P-value was less than 0.05. The mean duration of neck pain was 8 weeks. There was a more significant (p < 0.001) improvement in pain (ES = 0.975), disability (ES = 0.887), neck ROMs; flexion (ES = 0.975), extension (ES = 0.965), right and left lateral flexion (ES = 0.949 and 0.951), and right and left rotation (ES = 0.966 and 0.975) in the AI group than the RI group at 12th session. The Autogenic Inhibition-MET is more beneficial than Reciprocal Inhibition-MET in improving Pain, Range of Motion, and Functional Disability in patients with Sub-Acute and Chronic Mechanical Neck Pain. Therefore, it is a beneficial technique to add with conventional neck pain therapy to get better treatment outcomes in MNP patients. Prospectively registered on ClincalTrials.Gov with ID: NCT05044078.

The purpose of this study was to determine the effects of bilateral asymmetrical limb proprioceptive neuromuscular facilitation (PNF) pattern exercises on lumbar multifidus (LM) activity, pain, disability, and lumbar range of motions (ROMs) compared to Swiss ball exercises in patients with chronic low back pain (CLBP). A randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan, between March 2020 and January 2021. A sample size of 150 patients with CLBP was randomized into 2 groups. Participants in the intervention group (n = 75) received bilateral asymmetrical limb PNF, while the comparison group (n = 75) received Swiss ball exercises. The scores of the visual analog scale, Oswestry Disability Index, Modified-Modified Schober's test, and percentage of the maximum voluntary contractions of LM (%MVC LM) through surface electromyography were recorded before and after 15 sessions of exercises. The Wilcoxon signed rank and Mann-Whitney U tests were employed for within-group and between-group comparisons of all outcomes, respectively. The considered level of significance was 0.05. The trial was registered with ClinicalTrials.gov (NCT04206137). Pain (in sitting, standing, and walking), disability on the Oswestry Disability Index, and left side %MVC LM were significantly improved (P < .001) in the PNF group compared to the comparison group except for right side %MVC LM and ROMs on the Modified-Modified Schober's test (P > .05). Bilateral asymmetrical limb PNF exercises showed improvement in pain, disability, and LM activity of patients with CLBP more than those who used Swiss ball exercises.

Background & Objective: Low back pain (LBP) is the foremost cause to hamper an individual

Objective: To determine the frequency of sleep disturbance among individual with chronic low back pain, and to explore the association between the two. Method: The cross-sectional study was conducted from January to March, 2017, at the Physiotherapy Department of the Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, and comprised patients of either gender aged 18-40 years with at least a three-month history of chronic low back pain.. Data was collected using insomnia severity index for sleep disturbance and Rolland Morris questionnaire for disability due to chronic low back pain. Data was analysed using SPSS 21. Result: Of the 110, patients 68(62%) were males. The overall mean age of the sample was 31.79 +/- 6.18 years. Mean functional disability score was 13.66+2.44, while 84(76.4%) had sleep disorder; 78(70.9%) having sub-threshold insomnia, and 6(5.5%) with clinical insomnia of moderate severity. There was a positive intermediate correlation between sleep disorder and functional disability (p<0.05). Conclusion: Frequency of sleep disturbance was high in patients with chronic low back pain. There was an intermediate positive correlation between the two.

Objective: To determine the frequency of hamstring tightness and its impact among patients with chronic neck and low-back pain. Method: The analytical, cross-sectional study was conducted at the outpatient department of the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, from September 10, 2021, to January 31, 2022, and comprised patients of either gender aged 18-40 years with non-specific cervical and lumbar pain for more than 3 months. The participants were divided into 2 groups. Group A included those with chronic neck pain and group B included participants with chronic low-back pain. Clinical assessment was done to measure hamstring tightness and pain by using the active knee extension test and the visual analogue scale, respectively. Data was analysed using SPSS 24. Results: Out of 104 participants, there were 52(50%) males and as many females. The overall mean age was 28.155.10years. There were 52(50%) subjects in each of the two groups. Hamstring tightness was found in 73(70.2%) subjects. Patients with chronic low-back pain reported more tightness of hamstring muscle 38(73.1%) than those with chronic neck pain 35(67.3%) (p>0.05). Conclusion: Hamstring tightness was frequent among patients with chronic neck pain and low-back pain though not significantly. Key Words: Lumbar, Muscle, Neck pain, Pain intensity.