Naureen Tassadaq’s research while affiliated with Foundation University Islamabad and other places

Objective: To explore the association of knee pain intensity with demographics, body mass index, daily sleep hours and comorbidities in overweight people. Study Design: Cross-sectional study. Place and Duration of Study: Different Clinics of Wazirabad City, Pakistan, from Oct 2020 to May 2021. Methodology: People with knee pain for >1 month and a body mass index of ≥25 kg/m2 were included and questioned regarding variables of interest. The pain was graded according to the Numerical Rating Scale. Results: Of 335 individuals (mean age: 31±7 years), 189(56.4%) were males, and 199(59.4%) were married. The mean systolicand diastolic blood pressures were 124.4±7.9 mmHg and 85.3±7.2 mmHg, respectively. The mean sleep hours were 7±0.8 hours,while the mean body mass index was 30.1±2 kg/m2. The mean pain score was 2.8±1. Pain intensity had a significant positive correlation with age (p<0.001), body mass index (p=0.041), systolic and diastolic blood pressures (p<0.001 each). Similarly, pain intensity was significantly higher in people who were married (p<0.001) or had diabetes mellitus or hypertension (p<0.001 each). Conclusion: Knee pain intensity increases with age, body mass index, and systolic and diastolic blood pressure, and it decreases with increasing sleep hours.

Smartphone applications (apps) that utilize embedded inertial sensors have the potential to provide valid and reliable estimations of different balance and gait parameters in older adults with mild balance impairment. This study aimed to assess the reliability, validity, and sensitivity of the Gait&Balance smartphone application (G&B App) for measuring gait and balance in a sample of middle- to older-aged adults with mild balance impairment in Pakistan. Community-dwelling adults over 50 years of age (N = 83, 50 female, range 50–75 years) with a Berg Balance Scale (BBS) score between 46/56 and 54/56 were included in the study. Data collection involved securing a smartphone to the participant’s lumbosacral spine. Participants performed six standardized balance tasks, including four quiet stance tasks and two gait tasks (walking looking straight ahead and walking with head turns). The G&B App collected accelerometry data during these tasks, and the tasks were repeated twice to assess test-retest reliability. The tasks in quiet stance were also recorded with a force plate, a gold-standard technology for measuring postural sway. Additionally, participants completed three clinical measures, the BBS, the Functional Reach Test (FRT), and the Timed Up and Go Test (TUG). Test-retest reliability within the same session was determined using intraclass correlation coefficients (ICCs) and the standard error of measurement (SEM). Validity was evaluated by correlating the G&B App outcomes against both the force plate data and the clinical measures using Pearson’s product-moment correlation coefficients. To assess the G&B App’s sensitivity to differences in balance across tasks and repetitions, one-way repeated measures analyses of variance (ANOVAs) were conducted. During quiet stance, the app demonstrated moderate reliability for steadiness on firm (ICC = 0.72) and compliant surfaces (ICC = 0.75) with eyes closed. For gait tasks, the G&B App indicated moderate to excellent reliability when walking looking straight ahead for gait symmetry (ICC = 0.65), walking speed (ICC = 0.93), step length (ICC = 0.94), and step time (ICC = 0.84). The TUG correlated with app measures under both gait conditions for walking speed (r −0.70 and 0.67), step length (r −0.56 and −0.58), and step time (r 0.58 and 0.50). The BBS correlated with app measures of walking speed under both gait conditions (r 0.55 and 0.51) and step length when walking with head turns (r = 0.53). Force plate measures of total distance wandered showed adequate to excellent correlations with G&B App measures of steadiness. Notably, G&B App measures of walking speed, gait symmetry, step length, and step time, were sensitive to detecting differences in performance between standard walking and the more difficult task of walking with head turns. This study demonstrates the G&B App’s potential as a reliable and valid tool for assessing some gait and balance parameters in middle-to-older age adults, with promise for application in low-income countries like Pakistan. The app’s accessibility and accuracy could enhance healthcare services and support preventive measures related to fall risk.

Objective: To construct a scale for measurement of rumination among traumatic amputees while utilizing a Pakistani cohort. Methodology: This was the first part of a scale development and validation study carried out from February 2018 to March 2019 including amputees from multiple centers. We carried out thematic analysis of lived experiences and perspectives on complex phenomenon on 30 amputees and generated an item pool. Seven experts first evaluated the item pool and then Content Validity Ratio (CVR) was calculated. Item reduction analysis was carried out while recruiting 50 amputees using Cronbach's alpha evaluation. Factorial Validity and Internal Consistency of the scale was determined on evaluating 200 amputees through Exploratory Factor Analysis (EFA). Results: The CVR ≥ 0.99 and pilot study indices were the criterion for item inclusion. Items were selected for the scale measuring rumination. This scale comprised of three sub scales, each having value of Cronbach's alpha as 0.90, 0.87, and 0.89. To establish factorial validity, EFA identified three-factor solution and all three emerged factors had Eigen values > 3. Six items, each for three factors, accounted for almost 44% of the total variance. Conclusion: Rumination Scale for Traumatic Amputees is a new scale developed in Urdu for the measurement of rumination among traumatic amputees in Pakistan.

Obesity as depicted by changes in the body composition is considered a global epidemic of the 21st century, predisposing to cardiometabolic diseases. This analytical cross-sectional study evaluated body composition parameters in both genders and conducted an obesity analysis of healthy adult Pakistani population. Using non-probability purposive sampling technique, data was collected from 205 healthy adults (aged 18-45 years), who had not been participating in any structured exercise or dietary regime over the last six months. Body composition was assessed using bioelectrical impedance analyser. For data analysis, descriptive statistics, Mann-Whitney U-test and one-sample T-test were applied. The mean body mass index was 24.3±4.93 kg/m2. Body composition components which were significantly higher in males included soft lean mass, fat-free mass index, skeletal muscle mass index and bone mineral content, whereas females had significantly higher percentage of body fat (PBF), visceral fat area and fat mass index (p<0.05). ---Continue

Objective: To study the efficacy of radiofrequency ablation for treating pain in patients with advanced knee osteoarthritis. Study Design: Quasi-experimental study. Place and Duration of Study: Pain Clinic of Armed Forces Institute of Rehabilitation Medicine Rawalpindi, from Sep 2019 to Feb 2020. Methodology: Patients of more than 50 years of age, with grade III and IV Kellgren-Lawrence grades of knee osteoarthritis and at least a score of 4 for three months on the numerical rating scale were included in the study. Measurements were taken on the numerical rating scale and Western Ontario and McMaster universities osteoarthritis index before and four weeks after fluoroscopy-guided radiofrequency ablation of three genicular nerves around the knee joint. Results: Fifty patients (mean age: 62 ± 6.5 years) were included in the study. The median numerical rating scale scores before and after intervention were 9 (Interquartile range: 7-10) and 5 (Interquartile range: 2-8), respectively (p<0.001). The mean Western Ontario and McMaster universities osteoarthritis index scores before and after intervention were 76.7 ± 13.4 and 50.3 ± 18, respectively (p<0.001). No complications were reported. The reduction in numerical rating scale, Western Ontario and McMaster universities osteoarthritis index scores after the intervention were significantly better in females than in males (p=0.023 and p=0.012 respectively); however, no significant change was observed for the right and left knee or grades of knee osteoarthritis (p>0.05). Conclusion: Radiofrequency ablation of genicular nerves around the knee joint significantly improves pain, stiffness and body function in patients with advanced knee osteoarthritis and results are better in women.

Objective: To determine the added benefits of short-term glucosamine and chondroitin sulfate supplementation in combination with manual therapy and resistance exercise training in the management of knee osteoarthritis. Methods: A parallel-design, double-blind randomised controlled trial was conducted from January to September 2020 at the Foundation University Institute of Rehabilitation Sciences and Fauji Foundation Hospital, Rawalpindi, Pakistan, and comprised of knee osteoarthritis patients of either gender having radiological evidence of grade III or less on Kellgren classification. The subjects were randomly allocated to active comparator group A and experimental group B. Both the groups received manual therapy and resistance exercise training, while group B additionally received glucosamine and chondroitin sulfate supplementation for 4 weeks. Study outcomes included pain, function, quality of life, range of motion, strength, fall risk, skeletal muscle mass, visceral fat area, body fat, intracellular water ratio, and segmental lean and fat mass. Data was analysed using SPSS 21. Results: Of the 24 subjects, there were 12(50%) in each of the two groups. Each groups had 9(75%) males and 3(25%) females. In terms knee osteoarthritis grade, there was no significant difference between the groups (p=1.00). No significant differences were observed in any of the outcome measures neither at 2 weeks, nor at 4 weeks post-intervention between the groups (p>0.05) except for percentage change in segmental lean mass of the right leg at 2nd week and of the left leg at 4th week (p<0.05). Conclusions: Manual therapy and resistance exercise training are effective in the management of knee osteoarthritis, however, glucosamine and chondroitin sulfate supplementation for 4 weeks showed no additional benefits. Clinical trial number: NCT04654871. https://www.clinicaltrials.gov/ct2/show/NCT04654871.

Objective: To evaluate the functional status of Pakistani patients with non-cancerous end-stage liver disease selected for liver transplant and to compare results acquired through various assessment tools. Methods: The study was conducted at the Rehabilitation Medicine Department, Shifa International Hospital Islamabad, Pakistan, from August 2017 to November 2019 and comprised end-stage liver disease patients of either gender who had been selected for liver transplant. Assessment tools included the Six-Minute Walk Distance, Eastern Cooperative Oncology Group Performance Status and Modified Borg Dyspnoea Scale across age, gender, ethnicity, primary aetiology, and Model for end-stage liver disease score. Data were analysed using SPSS 20. Results: Of 172 patients, 143(83%) were males; 99(58%) hailed from the Punjab province; and 118(71%) had hepatitis C as the most common aetiology. The overall mean age was 46.1±10.5 years (range: 14-70 years). The mean Six-Minute Walk Distance was 291.9±67.2m. Model for end-stage liver disease score had a significant inverse correlation with Six-Minute Walk Distance (p<0.01) and a significant positive correlation with Modified Borg Dyspnoea Scale (p=0.02) and Eastern Cooperative Oncology Group Performance Status scores (p<0.01). Age and ethnicity had no correlation with the variables (p>0.05). Conclusions: The Six-Minute Walk Distance was significantly low. The Model for end-stage liver disease score was inversely correlated with Six-Minute Walk Distance score, and positively correlated with Eastern Cooperative Oncology Group Performance Status and Modified Borg Dyspnoea Scale scores.

Pakistan is one of the only three countries in the world with an enduring poliovirus transmission, making poliomyelitis an important health concern for Pakistan. Paralytic scoliosis is a common musculoskeletal dysfunction associated with poliomyelitis. To determine the occurrence of paralytic scoliosis a cross-sectional study was conducted at Fauji Foundation Hospital, Rawalpindi from 2015 to 2018. All patients with poliomyelitis reporting to the hospital were included, whereas patients with scoliosis but no poliomyelitis were excluded. Cobb’s angle was used to determine the severity of scoliotic curves. Pearson correlation was used to determine the correlation of Cobb’s angle with age and Independent T-test was used to determine the difference in terms of gender. Confidence interval was kept at 95%. A total of 51 patients with poliomyelitis were included in the study with a mean age of 28.58±15.07 years.

Objective: To compare the efficacy of subacromial and posterior approach glenohumeral joint injections using triamcinolone acetonide in cases of primary adhesive capsulitis. Study Design: Quasi-experimental study. Place and Duration of Study: Pain Clinics of Armed Forces Institute of Rehabilitation Medicine Rawalpindi and Combined Military Hospital Jhelum, from May to Nov 2014 and from Jan to Jul 2019 respectively. Methodology: We included patients with primary adhesive capsulitis in stage 1 and 2. The pain, measured by Numeric Rating Scale and range of motion of the affected joint measured through goniometer before and four weeks after the injection were the study parameters. A 40-mg injection of triamcinolone acetonide was given blindly into the affected shoulder joint through subacromial injection in 45 patients (group A) and posterior glenohumeral injection in 43 patients (group B). Results: Each group had a significant reduction in mean pain score after four weeks of treatment (p<0.001) and a significant increase in range of motion in flexion, abduction, internal, and external rotation after treatment (p<0.001). The mean reduction in pain score for group B was significantly greater than the mean pain reduction for group A (p<0.001). The mean increase in flexion and internal rotation was significantly greater in group B, compared to group A (p=0.003 and p<0.001, respectively). Conclusions: The posterior glenohumeral injection of triamcinolone acetonide when compared with subacromial injection, was significantly more effective in reducing pain, and improving range of motion especially in flexion and internal rotation in patients with primary adhesive capsulitis.