ASSOCIATION OF PECTORALIS MINOR MUSCLE LENGTH AND SHOULDER RANGE OF MOTION AMONG INDIVIDUALS WITH AND WITH OUT SHOULDER PAIN

Background and Aim: To evaluate the association of pectoralis minor muscle length and the shoulder range of motion with and without shoulder pain. Methodology: A sample of 214 participants with and without shoulder pain were enrolled in an analytical cross sectional study at Institute of physical medicine and rehabilitation, Dow University of health sciences, Karachi.  Questionnaire was provided to all participants after taking consent. Individuals were categorized into two equal groups i.e. one with and the other without pain). Shoulder active ranges were measured with universal goniometer and pectoralis minor length with measuring tape. Statistical Package of Social Sciences version 21 was used for data analysis. The descriptive variables were assessed for frequencies and percentages. Continuous variables were shown with mean and standard deviations and were correlated with bivariate correlation test. Considered significant was 0.05 p value. Results: Females were 176(82.2%) and males were 38 (17.8%). Mean ± SD of age, weight, height, and BMI were 26.82 ±7.50, 58.45 ±12.11, 160.59 ± 12.43, and 22.18 ±3.78 respectively. The pain intensity negatively correlated with shoulder range of motions (rs = -0.307 to -0.775, p< 0.05) except medial rotation.  Significant difference (p< 0.05) is found for length of pectoralis minor and range of motion between groups. There was also weak positive correlation between pectoralis minor index and shoulder lateral rotation (rs =0.215; p = 0.003). Conclusion: The shoulder pain affects shoulder joint range of motion and pectoralis minor length. Decreased pectoralis minor muscle length accompanies limited shoulder range of motion except, medial rotation.

Psychopathology, Cognitive and Adjustment Problems in Women Burn Survivors

The objective of the present study is two folds. The first purpose of the study was the development and validation of scale of adjustment for adults in the national language of Pakistan i.e. Urdu and to estimate its reliability and validity. The second purpose of this research was to investigate the psychopathology, cognitive and adjustment problems in women burn survivors. In the first phase of this study, Scale of Adjustment for Adults (SAA) was developed and validated into Urdu language. In this process after the stages of item pool generation and expert evaluation the significance of the items was assessed in a sample of 100 adults’ age above 19 years in the pilot study. The results of correlation in the test retest administration of the pilot study retained 84 items. Exploratory and Confirmatory Factor Analysis supported the criteria of Adjustment disorder with specifiers of depression, anxiety and conduct disturbance and Aaron Beck model that include cognitive, behavioral and physiological reactions of individuals. The CFI value was .90 with the p-value of .00 that is less than .05. The results indicated a significant model fit with appropriate model fit indices. The SAA demonstrated high reliability (.938) at .01 level of significance. To estimate the convergent validity of the Scale of Adjustment for Adults (SAA) 93 adults selected from the city of Gujrat, Pakistan by using the convenient sampling technique. The convergent validity of the SAA was demonstrated via significant correlation (.626 at the 0.01 alpha level) with screening scale for adjustment disorders: Short form (Boer, Bachem & Maercker, 2014). The divergent validity of the SAA demonstrated no correlation (.058 at the 0.01 alpha level) with Coping Styles Scale in Urdu version developed in Pakistan (Zaman, 2015).The indigenous scale of SAA has found to be a reliable, valid and worth using instrument to assess adjustment of adult. In the second phase of study, research was conducted to explore the psychopathology, cognitive and adjustment problems in women burn survivors. The women burn survivors were assessed. To evaluate the predictive relationship of Post-Traumatic Stress Disorder (PTSD), cognitive and adjustment problems 200 women burn survivors age above 19 years were examined. The following standardized tools were used for data collection as abbreviated Post-Traumatic Stress Disorder PTSD Checklist Civilian Version in Urdu (Lang et al., 2012), Montreal Cognitive Assessment Urdu version (Evans & Raiz, 2010) and Scale of Adjustment for Adults developed in the study. The linear regression analysis was applied to analyze hypotheses which indicate PTSD would be a significant predictor of cognitive problems, sub domains of cognitive problems, adjustment problems and sub domains of adjustment problems in women burn survivors’ age above19 years. Results reflected a significant predictive relationship of PTSD with cognitive problems [R²=.206; F (1, 198) = 51.213, p<.01], with Visuospatial and executive functioning [R²=.107 F (1, 198) = 23.780, p<.01], with naming [R²=.089 F (1, 198) = 19.426, p<.01], with attention [R²=.087 F (1, 198) = 18.797, p<.01], with language [R²=.039 F (1, 198) = 8.101, p<.05], with abstraction [R²=.066 F (1, 198) = 14.041, p<.01], with delayed recall [R²=.112 F (1, 198) = 24.959, p<.01], and with orientation [R²=.080 F (1, 198) = 17.256, p<.01]. Results also reflected significant predictive relationship of PTSD with overall adjustment problems [R²=.437; F (1, 198) = 177.589, p<.01], with depression [R²=.377 F (1, 198) = 119.731, p<.01], with anxiety [R²=.402 F (1, 198) = 133.235, p<.01], and with conduct disturbance [R²=.306 F (1, 198) = 87.145, p<.01]. These findings may have implication in the future intervention and prevention procedure for women burn survivors with PTSD symptoms and related cognitive and adjustment problems.