ASSESSMENT OF LOWER LIMB MUSCLE STRENGTH IN ATHLETES BY USING HAND-HELD DYNAMOMETER: A RELIABILITY STUDY

Background and Aims: Muscle strength is the key area to measure the functional status of an individual. Different tools and techniques has been used to detect strength differences and deficits. Hand- held dynamometer is one of the most affordable and handy tools used for this purpose. This study was designed to determine intra-rater reliability of hand- held dynamometer to measure muscle strength in different muscle groups of lower extremity of young athletes. It will further explore the reliability of hand- held dynamometer. Methodology: In this cross- sectional study young players of squash and badminton in the age group of 18-26 years were selected. The participants were recruited by non- probability convenience sampling technique. The strength of major muscle groups of lower limb was measured by a single male tester twice with gap through isometric make test of dynamometer. The intra-class correlation coefficient was then calculated for two readings of each muscle group by using SPSS version 21. Results: The intra- class correlation coefficient showed good to excellent reliability. The hip abductors, hip adductors, hip extensors of left side, knee flexors and knee extensors showed excellent reliability. Whereas, hip flexors, ankle plantar- flexors and dorsi-flexors of both sides showed excellent reliability at 95 % confidence interval. Conclusion: The isometric make test of dynamometer is a reliable tool for the objectification of strength of lower limb in   young players participating in squash and badminton.

An Exploration of Multi Level Barriers to Neonatal Hearing Screening Nhs in Islamabad, Pakistan

Hearing impairment (HI) in children is globally prevalent and neonatal hearing screening (NHS) programs detect hearing loss(HL) in newborns at the earliest stage for early intervention leading towards rehabilitation. Such NHS programs have been established in the developed countries since decades and are also being implemented in many developing countries except Pakistan. Initiationof NHS programs is not the priority of the health policy makers and except for the Government of Sindh the federal nor any of the provincial governments have legislated on NHS.The present study is based upon the perceptions of parents of hearing impaired (HI) children in the special schools and hospitals and puts forward the proposition that although HI children are suffering and eventually placing a financial and economic burden ,with its negative societal impact affecting the speech and language development and compromising on the quality of life of the HI child , no initiative has been taken by the federal government to address the lack of NHS in Pakistan.Interviews were conducted with the health policy makers and hospital administrators. The barriers to NHS comprise of policy, legislative and operational barriers and the priority accorded to NHS is at the lowest rung of the health care agenda in Pakistan. What is perceived to be lacking in the initiation, planning and implementation of any NHS program in Pakistan is that there is not enough priority accorded to it perhaps as it is not sensationalised in the electronic and press media to catch the attention of the policy makers. As HI is not a visible disability it is not perceived to be a serious public health issue amongst the public. The international health organizations have not put their weight and technical assistance nor voiced any support for initiating of NHS in Pakistan.Hence the health policy makers do not feel any compulsion to adhere to international declarations and conventions on NHS. The non existence of NHSand late detection of HI in Pakistan costs deeply in economic and financial terms to the state and individuals as well in the long term. Data about the prevalence of HL is available to some extent but admittedly there is paucity of research on NHS and the concerned health authorities have not advocated any research in the public sector.