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Background: Hamstring is the two joint muscles originating from the ischium and inserting on the tibia and fibula and skeletal structures are connected with the myokinetic chains in the body, change in the length of muscle fibers might lead to alteration in the biomechanics of the skeletal structures and might alter tibial torsion. On the other hand, increase in the obesity also imposes stress on the body structures which might lead to change in the kinematics of the joint. Study also aims to find correlation between hamstring tightness, waist hip ratio with tibial torsion. Method: This was an observational study, including 125 participants aged between 18 to 21 having internal or external tibial torsion and BMI between 23 to 29.9. The participants were evaluated for the hamstring tightness and waist hip ratio. Results: Study found significant correlation at 5% level with linear association between internal tibial torsion and hamstring tightness for both right and left side (p

Background and Objective: Literature suggests spinal mobilization with arm movement (SMWAM) individually is effective in treating cervical radiculopathy. There is paucity of literature on myokinetic stretching technique (MST) and evidence which compare MST and SMWAM. The aim of the present study was to evaluate the effect of MST and SMWAM on range of motion (ROM), pain, functional disability, and grip strength in subjects with cervical radiculopathy. Materials and Methods: A randomized clinical trial with thirty two subjects diagnosed with cervical radiculopathy were included in the study and randomly divided into two groups of 16 subjects each where, Group A received MST and Group B received Mulligan's SMWAM along with the conventional treatment. Outcome measures were assessed on the 1st day preintervention and 6th day postintervention where pain intensity was assessed using visual analog scale, ROM using universal goniometer, grip strength using hand dynamometer, and functional performance using neck disability. Results: Within group analysis showed pain relief, improvement in ROM, and reduced disability which was statistically significant in both the groups (P Conclusion: The study concluded that MST and SMWAM are equally effective in relieving pain, improving ROM, and functional disability in subjects with cervical radiculopathy.

Background and Objective: Trigger points in the myofascial system form the major reason for pain and tenderness in nonspecific low back pain (NSLBP). These points can be treated using manual therapy techniques such as integrated neuromuscular inhibition technique (INIT). Due to lack in the literature about its effect in NSLBP condition, the present study was undertaken to evaluate the effects of INIT on trigger points in patients with NSLBP. Materials and Methods: Forty-four patients with NSLBP were randomly assigned to either of the two study groups using envelope method. Group A (n = 22) was treated with stretching and strengthening exercises, whereas Group B (n = 22) was treated with INIT. Both the groups received hot moist pack and therapeutic ultrasound as common treatment. Five consecutive sessions of intervention were given over 5 days. Outcome measures in terms of pain pressure threshold (quadratus lumborum [QL] and erector spinae [ES]), lumbar range of motion (ROM), and disability were measured at baseline and end of the fifth session of treatment. Results: The within-group analysis showed a reduction in pain, improved ROM, and disability in both the study groups (P 0.05). Conclusion: The present study concluded that INIT is superior to stretching and strengthening exercises in reducing trigger point tenderness and better functionality in patients with nonspecific low back pain.

Background: Pelvic crossed syndrome (PCS) is a common predisposing factor of low back pain. If left untreated, PCS could result in various spinal and lower-limb pathologies which would hinder an individual's functional abilities and affect their quality of life. Aims: The study aimed to evaluate the effect of sciatic nerve neurodynamic sustained natural apophyseal glides (SNAGs) along with a stretching-strengthening protocol on individuals with symptomatic PCS. Settings and Design: This study was conducted in a tertiary care center; this was a randomized controlled trial. Materials and Methods: Forty-two individuals were randomly allocated to control group (conventional physical therapy) and experimental group (sciatic nerve neurodynamic SNAGs along with conventional physical therapy) using envelope method. The outcome measures – pressure pain threshold, degree of lumbar lordosis, modified Thomas test, finger-to-floor test, and Modified Oswestry Disability Questionnaire (MODQ) were obtained from the participants on day 1 and posttreatment on day 6, respectively. Both the groups received the treatment for 45 min per session for 6 consecutive days. Statistical Analysis Used: Parametric dependent t-test was applied through R software 3.5.1. Results: Intragroup analysis revealed statistically significant changes in all outcome measures in both the groups. Statistically significant changes were observed in the intergroup analysis of all the outcome measures (P Conclusion: Sciatic nerve neurodynamic SNAGS when given along with conventional therapy resulted in significant and superior improvement as compared to conventional therapy alone in patients with symptomatic PCS in terms of pain sensitivity and flexibility.

Introduction: Quadriceps is one of the strongest muscle of the body that is required for knee mobility. Quadriceps plays a crucial role in many daily activities such as walking, twisting, running, jumping, and controlling the movement of knee. Since it’s a two joint muscle, they tend to become very to tight leading to imbalance, which can give rise to a number of postural problems and common musculoskeletal disorder causing pain in the knee joint. It could be acute, subacute and chronic in its clinical presentation. Hence strengthening of quadriceps femoris is necessary. Materials and Methods: a total of 90 participants within age of 21 to 29 years and BMI 19.9 to 24.9 having no neurological, cardiopulmonary and musculoskeletal disease were selected. Results: of the total 90 subjects, the mean age of the participants in group A 21.67±0.88 the mean age of participants in group B was 22.23±1.33 and the mean age of participants in the group C was 22.03±1.27. The result showed high significance in the group B. Conclusion: Study showed increase in the quadriceps muscle strength in group B.

A 33 year old male patient presented to the department with the complains of pain and inability to bend and straighten the left knee since 1 month. The pain was present during Knee flexion and extension. Tenderness was present over medial knee joint line. Patient had a history of twisting his left leg and a third degree Anterior cruciate ligament tear for which he had underwent reconstruction surgery with autogenous bone-patellar tendon-bone graft after which he had been referred for Physiotherapy. During Physiotherapy treatment he was given Cryotherapy, Range of motion exercises, continuous passive movement exercises, followed by Anterior Tibiofemoral glides.strengthening exercises were given as home program.12 sessions of treatment were given and good reduction in pain and improvement in range of motion was observed in the last session. The purpose of this case report is to present the positive effects of mobilization techniques in the early post-op phases of rehabilitation on the subjects who underwent ACL reconstruction surgery.

Objective: Neck pain is commonly seen in back of neck and between the bases of neck to shoulder mainly indicates the involvement of upper trapezius muscle. About two third of people will experience neck pain at some point in their lives. It is important to identify the most effective therapeutic modality in the management of Acute Trapezitis. Thus the objective of the present study was to compare the effect of Ilex paraguariensis commonly known as Biofreeze gel by using Therapeutic Ultrasound and Diclofenac sodium gel using Therapeutic Ultrasound and find out which is more effective in the treatment of Acute Trapezitis. Study Design: A Randomized clinical trial. Outcome Measure: Visual analog scale (VAS),Neck disability index (NDI) and Universal Goniometer. Materials & Method: 30 Subjects clinically diagnosed with Acute Trapezitis were randomly assigned into two groups. Group A received Phonophoresis using Biofreeze gel and Group B received Phonophoresis using Diclofenac sodium gel along with exercises once daily for a total of 5 sessions. Results: Results for VAS scores suggested that both the groups showed improvement and were statistically significant with p-value 0.0006 and 0.0007 respectively, when compared in between groups, Group A had better outcome in relation to Group B. The pre and post-interventional mean and S.D. values of NDI scores of A and B groups also showed statistical significant difference when on comparing within and between groups with a p-value 0.0329. The results for Cervical range of motion suggested that there was no much significant difference in between group analysis, but have showed that group B had better improvement than group A with p-value 0.8316. Conclusion: The study concluded that both Biofreeze gel and diclofenac sodium gel are equally effective in Acute Trapezitis, but when compared for the better outcome, Biofreeze gel was proved to be more effective than Diclofenal sodium gel.

Background and Purpose: Lateral epicondylitis ("tennis elbow") is a common entity. Several nonoperative interventions, with varying success rates, have been described. The aim of this study was to compare the effectiveness of 2 protocols for the management of lateral epicondylitis: (1) manipulation of the wrist and (2) ultrasound, friction massage, and muscle stretching and strengthening exercises. Design: A Randomized Clinical Study. Subjects and Method: Ten subjects with a history and examination results consistent with lateral epicondylitis participated in the study. The subjects were randomly assigned to either a group that received manipulation of the wrist (group 1) or a group that received ultrasound, friction massage, and muscle stretching and strengthening exercises (group 2). Follow-up was at 3 weeks. The primary outcome measure was a global measure of improvement, as assessed on a 10-point scale. Analysis was performed using independent t tests, Mann-Whitney U tests, and Fisher exact tests. Results: Differences were found for 2 outcome measures: success rate and decrease in pain at 3 week. Both findings indicated manipulation was more effective than the other protocol. After 3 weeks of intervention, the success rate in group 1 was 62%, as compared with 20% in group 2. Also, improvement in pain as measured on a 10-point numeric scale was 5.2 (+ 2.4) in group 1, as compared with 3.2 (+ 2.1) in group 2. Conclusion: Manipulation of the wrist appeared to be more effective than ultrasound, friction massage, and muscle stretching and strengthening exercises for the management of lateral epicondylitis when there was a short-term follow-up.

Background: Burns are one of the most painful type of trauma and pain management for this type of injury is a well documented problem in all aspects or recovery. Specifically pain control is common obstacle limiting physiotherapy treatments. Hence progressive muscle relaxation & visual imagery can be used as an intervention to improve patient's compliance during the physical therapy interventions. Objective: To study the effect of progressive muscle relaxation & visual imagery on perceived pain during range of motion exercises and levels of anxiety and depression in patients with 20% to 50% of superficial to deep burns. Design: Randomized control trial. Methodology: 10 subjects with burns were randomly assigned to two groups. The Group A as the control group & Group B as the intervention group. Group A continued with conventional treatment & the Group B were given progressive muscle relaxation along with the conventional treatment. Main outcome measures: visual analogue scale, hospital anxiety & depression scale (HADS). Results: The mean pre-treatment VAS score for subjects in group B was 5.9 which reduced to 4.5 post treatment. The paired t-test which was statistically significant (P-value: 0.0007).The unpaired t-test of which was statistically significant( p-value. 0.0022) for anxiety & depression scores. The mean pretreatment anxiety level in subjects in group B was 12.6 i.e. abnormal which reduced to 8.8 i.e. borderline abnormal post treatment where as the mean pretreatment depression score was 12.8 i.e. abnormal which reduced to 9.6 i.e. borderline abnormal. Conclusion: The results of the present study indicate that there was a statistically significant reduction in perceived levels of pain and in anxiety and depression during range of motion the exercises for subjects with burns receiving progressive muscle relaxation & visual imagery intervention as compared with those subjects who had not received progressive muscle relaxation & visual imagery intervention.