Islamabad

Researchers are evaluating whether measuring blood flow in the common carotid artery with bedside Doppler ultrasound can accurately identify fluid responsiveness in adults with sepsis who are on mechanical ventilation. The study compares this method to cardiac output measurements obtained by transthoracic echocardiography, a commonly used non-invasive technique. The goal is to find a faster, simpler bedside tool to guide fluid resuscitation in critically ill patients. Participants will undergo ultrasound assessments before and during a passive leg raising maneuver, which temporarily increases blood return to the heart to simulate a fluid challenge without giving fluids immediately. Blood flow in the carotid artery and cardiac output will be measured at baseline and during the maneuver. If the participant meets criteria for fluid responsiveness, they will receive a 500 mL intravenous crystalloid fluid bolus, followed by reassessment. During the study, participants will have bedside Doppler ultrasound and echocardiographic measurements, along with routine monitoring of vital signs and organ function. The main outcome is how accurately carotid artery blood flow predicts fluid responsiveness compared to cardiac output. Researchers will also assess the ease, speed, and reliability of carotid ultrasound in this setting. Data will be carefully reviewed and analyzed to determine diagnostic performance and clinical usefulness.

Researchers are evaluating the effects of Action Observation Therapy AOT on balance and mobility in children with spastic cerebral palsy aged 5 to 12 years. This randomized controlled trial compares functional performance outcomes between children receiving training with AOT and those receiving similar training without action observation, aiming to determine the therapys impact on physical function. The study uses established assessment tools like the Modified Ashworth Scale, GMFCS, Pediatric Balance Scale, and GMFM-88 to measure progress. Participants are randomly assigned to one of two groups. One group receives AOT-based mobility and balance exercises combined with conventional therapy including lower limb stretching and strengthening. These exercises involve various stances such as sitting, standing, and turning with fun activities like reaching for objects, tower building, and taking turns. The other group receives the same balance and mobility exercises and conventional therapy but without the action observation component. Both groups undergo training designed to improve functional mobility and balance. Childrens functional performance will be assessed at baseline and after 8 weeks of intervention to measure static balance, dynamic balance, and mobility. Researchers will monitor changes using the specified scales to evaluate outcomes. The study involves multiple assessments to track progress and compare the effectiveness of training with and without action observation, ensuring a comprehensive understanding of the therapys effects on cerebral palsy management.

Researchers are evaluating the added effects of combining coherent breathing with aerobic exercise compared to aerobic exercise alone in adults aged 30 to 65 with stage 1 hypertension. This randomized controlled trial aims to assess whether coherent breathing can provide additional benefits in managing raised blood pressure and improving quality of life, offering an affordable, non-drug option especially useful in low-resource settings. Participants will be randomly assigned to one of two groups one group will perform aerobic exercises along with simple breathing exercises, while the other group will perform aerobic exercises combined with coherent breathing techniques. Both groups will follow a 4-week program with 5 sessions per week, including warm-up, brisk walking, stepper, static cycling, and cool down, with the breathing exercises lasting about 10 minutes per session. During the study, researchers will monitor heart rate, blood pressure, respiratory rate, rate pressure product, and oxygen saturation at the start, after 2 weeks, and at the end of the 4 weeks. Quality of life will be measured using the MINICHAL questionnaire. Data will be analyzed using SPSS software. The total participation duration is 4 weeks, with regular assessments to understand the impact of the interventions.

Chronic Obstructive Pulmonary Disease COPD is a progressive and irreversible lung condition marked by persistent airflow limitation causing breathlessness and reduced ability to function. Pulmonary rehabilitation is a key treatment to lessen breathlessness and improve functional capacity. This research investigates whether adding the box breathing technique to a short-term pulmonary rehabilitation program provides extra benefits for patients with COPD. Participants will be randomly assigned to one of two groups. One group will receive short-term pulmonary rehabilitation plus pharmacological treatment, with physiotherapist-supervised sessions twice a week for three weeks. The other group will receive the same care plus daily box breathing exercises alongside the supervised rehabilitation sessions. Participants in the box breathing group will keep a home diary to track their practice. During the study, researchers will assess breathlessness and functional capacity over three weeks. Participants will attend supervised exercise sessions including warm-ups, aerobic and strength training, breathing exercises, and cool-downs. The study aims to measure changes in dyspnea and functional ability to understand the additional effects of box breathing on COPD management.

Benign Paroxysmal Positional Vertigo BPPV is a common cause of recurrent vertigo that affects about 2.4% of people during their lifetime, especially older adults. It causes brief episodes of vertigo, dizziness, and imbalance that can reduce quality of life. Although maneuvers to reposition the inner ear crystals are effective, BPPV often recurs, so this study is evaluating if adding Brandt-Daroff exercises to the GANS Maneuver can further reduce dizziness and improve quality of life in patients with BPPV. Participants will be randomly assigned to one of two groups one group will receive the GANS Maneuver alone, while the other will receive the GANS Maneuver combined with Brandt-Daroff exercises. The intervention lasts six weeks, with supervised GANS Maneuver sessions held twice weekly, each including three repetitions. Those in the combined group will also perform Brandt-Daroff exercises at home twice daily. The total supervised GANS sessions will be 12, and the Brandt-Daroff exercises will be done 36 times at home during the study. During the study, dizziness and quality of life will be assessed using the Dizziness Handicap Inventory Scale DHI and the Vestibular Activities and Participation VAP Scale at the start and after six weeks of treatment. Participants will attend regular supervised sessions for assessment and treatment. Data will be analyzed to see if adding Brandt-Daroff exercises improves outcomes compared to GANS Maneuver alone. The study is conducted over one year with ethical approval and careful monitoring of participants.

Mild Cognitive Impairment MCI is a condition marked by noticeable declines in cognitive abilities like memory, attention, and executive function, which can reduce independence and quality of life in older adults. This research compares the effects of immersive Virtual Reality VR 360-degree videos combined with aerobic exercises versus aerobic exercises alone on improving these cognitive functions in elderly individuals with MCI. The study focuses on assessing global cognition, attention, and executive function using tools like the Montreal Cognitive Assessment MoCA and Trail Making Test TMT. Participants will be randomly assigned to one of two groups one receiving a 6-week program combining immersive VR 360-degree videos with chair-based aerobic exercises, starting at 15-minute sessions twice weekly and increasing to 25 minutes, and the other performing chair-based aerobic exercises alone with the same duration and frequency. The VR content includes various stimulating environments such as forests, wildlife, and space, with added memory recall tasks after each session. The aerobic exercises consist of upper and lower limb movements performed while seated. Throughout the study, participants aged 60 and older with MoCA scores between 18 and 25 who can perform daily activities independently will be evaluated at the start, mid-point 3 weeks, and end 6 weeks using cognitive tests. The research team will monitor changes in cognitive function and attention, aiming to understand how these interventions affect mental abilities. The trial will run for one year and is conducted as a single-blinded randomized controlled trial.

Researchers are studying patients with subacute stroke to evaluate the additional effects of kinesio taping combined with conventional physical therapy on upper limb function, range of motion, and spasticity. This randomized control trial aims to determine whether adding kinesio taping provides significant improvements compared to physical therapy alone. The study is conducted in rehabilitation settings and includes adults aged 40 to 65 years with a history of diagnosed stroke and moderate spasticity. Participants are divided into two groups. The experimental group receives kinesio taping three times per week along with physical therapy exercises including passive and active range of motion ROM, PNF stretching, D1 flexion and extension movements, and resistance training with a medium resistance band from weeks 3 to 6. The control group receives the same physical therapy regimen but without kinesio taping. Treatments last 30 minutes on alternate days over six weeks. During the study, participants upper limb spasticity and function are assessed at baseline, week 3, and week 6 using the Modified Ashworth Scale and the Wolf Motor Function Test. Range of motion is measured with a goniometer for shoulder, elbow, and wrist joints. Data collection includes demographic information and questionnaires. The study monitors outcomes throughout the six-week treatment period to analyze differences between groups.

Diabetic Peripheral Neuropathy DPN is a common problem in people with type 2 diabetes, causing symptoms like pain, numbness, and balance difficulties. These issues can lead to falls, foot ulcers, and lower quality of life. Current treatments mainly focus on symptom management, so this study aims to evaluate if adding Neural Mobilization NM to balance training can further improve pain, balance, and quality of life in people with DPN. The trial is a randomized controlled study involving 32 patients aged 50 to 75 years. Participants will be randomly assigned to one of two groups for six weeks one group will receive Neural Mobilization combined with balance training plus standard care, while the other group will receive balance training alone along with standard care. Each group will have two 30-minute sessions per week. The NM protocol includes hot packs, TENS, nerve sliding and tensioning techniques, and various balance exercises that increase in difficulty over time. The balance training group receives similar physical therapy without the neural mobilization techniques. Throughout the study, participants will undergo assessments at the beginning and end of the six-week treatment period. Researchers will measure pain levels using the Numeric Pain Rating Scale, balance using the Berg Balance Scale, and quality of life with the Norfolk Quality of Life-Diabetic Neuropathy questionnaire. Data will be analyzed to determine if adding Neural Mobilization offers additional benefits. Ethical approval has been obtained, and participants will provide informed consent before joining.

Hypertension, or high blood pressure, occurs when the pressure in blood vessels is too high, defined by the Joint National Committee 8 JNC 8 as systolic blood pressure of 140 mmHg or higher and diastolic pressure of 90 mmHg or higher. This research aims to study the combined effects of Pilates breathing, diaphragmatic breathing, and moderate intensity continuous cycling training on blood pressure, chest expansion, lung function, and quality of life in patients with hypertension. The study involves 45 participants divided into three groups to compare these interventions. The study includes three groups one group performs cycling combined with Pilates breathing, another with diaphragmatic breathing, and a third group performs cycling only. All groups engage in moderate-intensity continuous cycling training at 60-79% of maximum heart rate, three times a week for six weeks, with each session lasting 20-35 minutes. Pilates breathing focuses on controlled lateral rib cage expansion and core engagement, while diaphragmatic breathing emphasizes deep abdominal breathing with slow, controlled breaths. Both breathing exercises are performed for 10-15 minutes per session, three times weekly, alongside cycling. Participants will be assessed before and after the six-week intervention for blood pressure, chest expansion, pulmonary function using spirometry, and quality of life through a questionnaire. Heart rate and oxygen saturation will be monitored during sessions, with continuous vital monitoring during cycling. The study uses validated tools like a sphygmomanometer, spirometer, pulse oximeter, and MINICHAL questionnaire to measure outcomes. Participants will complete 18 sessions total, including warm-up and cool-down exercises, with data analyzed using statistical software to evaluate the combined effects of these breathing techniques with cycling on hypertensive patients.

Researchers are studying pre-hypertension, defined by systolic blood pressure between 120-139 mmHg or diastolic blood pressure between 80-89 mmHg, to see if combining breathing exercises with moderate treadmill training improves blood pressure, chest expansion, lung function, and quality of life. This randomized controlled trial involves adults aged 20 to 55 who are sedentary and diagnosed with prehypertension. The study aims to evaluate the additional effects of pilates breathing and diaphragmatic breathing when added to treadmill exercise. Participants will be randomly assigned to one of three groups treadmill training with pilates breathing, treadmill training with diaphragmatic breathing, or treadmill training alone. The treadmill sessions follow a moderate-intensity continuous training protocol at 55-70% of maximum heart rate, lasting 20-35 minutes, three times per week for six weeks. Breathing exercises last 10-15 minutes per session and are performed alongside treadmill training for the two breathing groups. During the study, participants will complete assessments before and after the six-week intervention to measure blood pressure, chest expansion, pulmonary function, and quality of life. Researchers will monitor progress and analyze data to determine the effects of the combined interventions. The total participation duration is six weeks, with evaluations to compare changes in these health outcomes across the three groups.