ABSTRACT
Musculoskeletal disorders pose a significant global health burden with a substantial impact on individuals and healthcare systems. Graded Motor Imagery (GMI) is a novel and emerging approach in musculoskeletal rehabilitation based on the principles of neuroplasticity. This literature review aimed to evaluate the available evidence for the efficacy of GMI in diverse musculoskeletal pathologies. GMI is a multicomponent rehabilitation strategy that includes laterality recognition, motor imagery, and mirror therapy. It is hypothesized that the overall GMI program aims to create neural adaptations, reduce pain, and reduce disability. This review evaluated the effects of GMI from Randomized Controlled Trials on pain reduction, pain-related disability, strength, physical function, and fear of movement.
Keywords: Graded Motor Imagery (GMI), Neuroplasticity, Musculoskeletal rehabilitation, Pain reduction, Randomized Controlled Trials (RCTs).

ABSTRACT
Thoracic outlet syndrome (TOS), a challenging clinical scenario, arises from neurovascular compression within the thoracic outlet, resulting in upper extremity symptoms. This case study examines the effectiveness of the static opener technique, a conservative physical therapy approach targeting postural anomalies and muscle imbalances that contribute to TOS. A 45-year-old female office worker with persistent upper extremity pain, numbness, and weakness underwent a five-week intervention using the static opener method. Pre- and post-treatment objective assessments included pain intensity (Visual Analog Scale), numbness/tingling severity (Numeric Rating Scale), upper extremity strength (Manual Muscle Testing), and functional status (Disabilities of the Arm, Shoulder, and Hand questionnaire). The patient experienced a 50% reduction in pain intensity, a 57% reduction in numbness/tingling severity, improvement from 3/5 to 4/5 in upper extremity strength, and a 38% reduction in functional disability (as measured by the DASH score). The patient reported satisfaction with symptom relief and improved daily function. These findings suggest that the static opener technique may be a promising adjunctive therapy for managing TOS symptoms, and further research is needed to validate its effectiveness in larger, controlled studies.
Keywords: Thoracic outlet syndrome, postural anomalies, tingling, opener technique, physical therapy.

ABSTRACT
Purpose of the Study: To evaluate the reliability of a modified digital dynamometer for assessing the strength of the Flexor Hallucis Longus muscle (FHL) through maximum voluntary isometric contraction (MVIC). Relevance: The device is easier to handle, portable, and more cost-effective than any other similar device to measure maximum voluntary isometric contraction. Participants: A total of 50 healthy subjects aged 18-30 were randomly recruited. Methods and Analysis: Subjects were seated in a high sitting position on the chair. A 4 mm board was placed under the sole except the toes. Participants were instructed to flex their great toe through a rope assembly attached to the modified digital dynamometer which was placed on a stable surface. The device measured the great toe flexor muscle strength in kilograms. The values were recorded independently by three observers and later values were converted into Newton. Result: The device shows excellent inter-rater reliability with an r value of 0.97, relative to FHL muscle strength. Conclusion: The tool is reliable in evaluating muscle strength through maximum voluntary contraction of the Flexor hallucis longus muscle, contributing to its potential use in clinical or research settings.
Keywords: Flexor hallucis longus muscle, muscle strength tool, modified digital dynamometer, maximum voluntary isometric contraction.

ABSTRACT
This case study examines the effectiveness of knee braces in aiding people with cerebral palsy (CP) in standing. The study focuses on a young boy with CP who struggled with standing due to muscle weakness and stiffness. Custom knee braces were prescribed and fitted as part of the operation to provide external support and stability to the knee joints. The child’s standing abilities were assessed before and after the braces were put on. Results showed that the child’s standing ability and functional independence significantly improved after using knee braces. This improved knee joint stability and alignment allowed the child to engage more actively in everyday activities and social interactions, resulting in a more regulated and prolonged standing posture. The study underscores the importance of customized therapies and individualized evaluation for optimal functional results in CP patients.
Keywords: Knee braces, cerebral palsy, spasticity, knee contracture, rehabilitation, neurodevelopment disorder, standing abilities.

ABSTRACT
Background: Dysmenorrhea (menstrual cramps) is a common gynecological condition with painful menstruation as its main symptom. It negatively influences women’s quality of life and hampers their productivity and activities. While the exact etiology is unknown, increased prostaglandin levels and myofascial trigger points are thought to play a role. This study investigated the effectiveness of combining sacral release technique, a myofascial release therapy, with conventional physiotherapy for treating dysmenorrhea symptoms. Methods: A 23-year-old woman with clinically diagnosed primary dysmenorrhea was treated with a rehabilitation protocol consisting of sacral release technique, deep breathing exercises, and static stretching over the course of her menstrual period. Outcomes were measured pre- and post-intervention using the Numerical Pain Rating Scale (NPRS) and Menstrual Distress Questionnaire (MEDI-Q). Results: Subsequently after the intervention all outcome indices indicated significant improvement for the patient. NPRS scores reduced from 6 to 4 indicating less pain intensity while broad MEDI-Q total score went down from 64 to 39 signifying improved menstrual symptoms along with distress due to periods in addition to over-all quality regarding daily living associated with menses. Conclusion: In Conclusion, combining sacral release technique, and traditional physiotherapy methods of deep breathing and stretching were effective in alleviating symptoms of woman during menstrual flow, reducing pain and improving quality of life for the mentioned patient. These findings indicate that having a sacral release along with other modalities may become another intervention in treating dysmenorrhea.
Keywords: Dysmenorrhea, sacral release technique, Pain Management, conventional physiotherapy, case study.

ABSTRACT
In order to evaluate and comprehend how different types of Gullian-Barre Syndrome respond to physiotherapy rehabilitation. The routine, evaluation, check, and diagnosis of the several treatments being utilized to treat this illness form the basis of the case study. The patient received immunoglobin and a monoclonal antibody treatment, among other medications, to see if their condition improved. This research mentions a number of conditions, such as respiratory failure, limb weakness, and limb strength. Professional physiotherapy techniques, a balanced and coordination program, virtual reality technologies, and breathing exercises were used to enhance their ADLs. This study aims to investigate different physiotherapy approaches and different forms of Guillain-Barre syndrome variation, with a focus on the most advantageous and successful approach. Based on this examination, it was determined that the patient treatment is effective in allowing patients to return to their usual routines. The use of contemporary physiotherapy approaches improves patient outcomes.
Keywords: Guillain-Barre syndrome, rehabilitation, physical treatment, limb strength, and weakness.

ABSTRACT
Background and purpose: Identifying the patient’s response to the muscle energy technique procedure is the aim of this case study.
Methods: This case study consists of the publications that were released between 2005 and 2022. The PubMed, the Web of Sciences, and Google Scholar search engines were used to locate the evidence. This case study was conducted using the Muscle Energy Technique.
Results: This case studies reveal how the Muscle Energy Technique has helped the health of those who are having carpel tunnel syndrome. I did a case study of several articles that provided evidence of the benefit of problems for patients having Carpel Tunnel Syndrome, including systematic reviews, randomized controlled trials, and case studies.
Conclusion: According to this research, muscle energy technique and continuous passive motion can be an efficient treatment plan for increasing wrist joint range of motion as it can improve range of motion, develop muscular strength, and improve gripping training by reducing other issues.
Keywords: Carpel tunnel syndrome, muscle energy technique, physiotherapy, wrist movements, median nerve.

ABSTRACT
Background and purpose: This literature review objective is to appraise the outcome of the Impact of blood flow restriction training as a supplemental rehabilitation technique for chronic ankle instability patients.
Methods: This literature review constitutes the articles which were published in 2017-2023. The evidence search was performed on Google Scholar, PubMed, Web of Science, Pedro database and Cochrane Library.
Results: According to 20 studies included in our review shows that BFR training has been useful in increasing muscle strength and hypertrophy; there was increased production of ATP in muscle mitochondria & Increased VO2 max along with other neuro-myogenic factors, which indicate increased adaptations post-injury.
Conclusion: This literature review, according to selective studies, demonstrates that the addition of BFR in conventional rehabilitation resulted in increased muscle adaptations like strength and hypertrophy, along with increased balance and tissue remodelling and decreased pain perception, which could be beneficial in the treatment of ankle dysfunction.
Keywords: Blood Flow Restriction Training, Occlusion Training, KAATSU Training, Chronic Ankle Instability, Muscle Adaptations.
Keywords: Colles Fracture, Muscle Energy Technique (MET), Muscle Stimulator (MS), Physiotherapy Rehabilitation, Home Based Rehabilitation.

ABSTRACT
Objective: This case study aims to assess the efficacy of Muscle Energy Technique (MET) and Muscle Stimulator (MS) in managing post-Colles fracture complications.
Methods: A systematic review of literature published between 2008 and 2023 was conducted utilizing PubMed, Web of Science, and Google Scholar databases. The study focused on investigating the effects of MET and MS in post-Colles fracture rehabilitation.
Results: The review revealed significant evidence demonstrating the positive impact of MET and MS on improving the health outcomes of individuals suffering from complications following Colles fractures. Various publications, including systematic reviews, randomized control trials, and case studies, highlighted the benefits of these interventions in reducing post-fracture complications.
Conclusion: The findings suggest that MET and MS can effectively enhance range of motion, increase muscle strength, and alleviate complications associated with post-Colles fractures. Implementing these modalities as part of a comprehensive treatment protocol can help mitigate stiffness and improve overall rehabilitation outcomes.
Keywords: Colles Fracture, Muscle Energy Technique (MET), Muscle Stimulator (MS), Physiotherapy Rehabilitation, Home Based Rehabilitation.

ABSTRACT
Background: A common degenerative joint condition called osteoarthritis (OA) is marked by increasing loss of cartilage, joint discomfort, and reduced function. Treatment plans for knee OA usually combine pharmacological and non-pharmacological measures. The potential benefits of manual and adjuvant therapy in controlling symptoms of OA have drawn interest among non-pharmacological techniques.
Objective: This review of the literature intends to assess the impact of manual therapy and complementary therapies on knee OA. The main goals were to determine how effectively manual therapies and adjuvant therapies work to improve pain, function, and quality of life in people with knee OA.
Methodology: A deliberate research of electronic databases such as PubMed, Cochrane Library, and Embase was carried out to pinpoint appropriate RCTs that were released from 2018 onwards.
Result: Fifteen RCTs in all that met the inclusion criteria were found during the review. These studies’ findings imply that manual therapies can significantly enhance pain alleviation, physical function, and patient-reported outcomes for people with osteoarthritis in their knees, either when used alone or in conjunction with adjunctive therapies.
Conclusion: The use of manual and adjuvant therapy to address the symptoms of osteoarthritis in the knee shows potential. However, more investigation is necessary to determine the best course of action and the long-term effectiveness of manual and complementary therapy in the management of knee osteoarthritis. This includes large-scale RCTs with extended follow-up periods.
Keywords: Knee Osteoarthritis, Manual Therapy, Adjuvant Therapy, Pain, Mobilisation.