ROLE OF KINESIOPHOBIA ON PAIN, DISABILITY AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW

Background and Aim: The majority of people suffered with low back pain (LBP) at least once during their lifetime. As such, LBP is a highly prevalent and costly condition. People respond inappropriately as a result of current or possible risks and establish defensive habits (for example, hyper-vigilance) that aim at avoiding new injuries. A continued reconciling of studies which provide various answers for the same issue will be necessary for treatment decisions. This study is performed to conclude the function of Kinesiophobia and check it on   Pain, Disability and Quality of Life in Patients that are suffering from Chronic Low Back Pain: A Systematic Review. Methodology: A Systematic Review has been conducted. Secondary data collected from Electronic database including PubMed, Medline and Cochrain Library from inception to 2010. Total 554 Article found out of which 10 articles included in the study after excluding the duplicate article, Quality screening through Pedro Scale, and article don’t fulfilling the inclusion criteria of the study. Review completed within 9 months after approval of synopsis. Results: According to this Review total Sample size was 554 with mean Sample size 130±90, mean Age 46±5 years, Mean of Pain Intensity (VAS 0-10) 6.12±1.5, mean Pain Duration 30±14, mean Kinesiophobia Measures (Tampa Scale of Kinesiophobia 0-68) 37±6.5, mean Disability (Oswestry Disability Index 0-100%) 56±27, mean Quality of Life (SF 36 0-100) 39.17±15.197.  Conclusion: TSK scores showed a statistically significant correlation with Pain, Disability, education level, and SF-36 QOL. As the education level decreases, kinesiophobia scores increase and as kinesiophobia scores increase, Level of disability increases and the quality of life decreases. Patients with kinesiophobia presented greater pain intensity, a greater fear of movement and of performing physical activities and it was also associated with worse quality of life.

Ethnobotanical Potential of Medicinal Shrubs in Socioeconomic Uplift of Cholistan Rangeland Dwellers

Rangelands are usually managed for their capability to support livestock but their other plant related benefits are nearly overlooked. Rangelands undoubtedly play an important role in the livelihood of nomadic pastoral communities by supporting their livestock. Wild plants in the rangelands supply food stuff, medicine and fuelwood to the local communities. This study was designed to assess the contribution (ethnobotanical potential) of medicinal shrubs of Cholistan rangeland in socioeconomic uplift of local dwellers. Methodology for conducting this research was consisted of structured and unstructured phases. In unstructured stage, field visits were made and plant specimens were collected. Household surveys were conducted to collect ethnobotanical and socioeconomic information from the inhabitants of sixteen villages. Ethnobotanical data were also collected from medicinal plant experts/traditional herb healers by individual interviews by using well prepared separate questionnaires. Seven most common medicinal shrubs e.g. Calotropis procera, Calligonum polygonoides, Haloxylon recurvum, Capparis decidua, Ziziphus nummularia, Haloxylon salincornicum, and Aerva javanica were selected from the area for ethnobotanical studies. The results revealed that shrubs were usually used as fuelwood and some for fruits, wood (for making parts of agricultural tools), washing cloth and performing religious rituals. Local dwellers used these shrubs in curing thirty diseases but the herbal medicine practitioners enlisted fifty two different diseases cured by these plants in different combinations. For instance, Calotropis procera was used in maximum number of diseases while Capparis decidua and Ziziphus nummularia have more multiple uses. But some uses of these shrubs as medicine were first time recorded during this study. The density/availability of Haloxylon recurvum and Ziziphus nummularia is decreasing in the area due to three major factors i.e over exploitation (over grazing etc.), uncertain rain and agriculture expansion. These selected shrubs has role in socioeconomics of the local people (93.8 %) by providing fodder to livestock (20.9 %), as firewood (23.8 %) and as home remedy (21.3 %). Most of the respondents were of the view that the sale of these shrubs as medicine had great potential which could be enhanced to manifold by installing proper medicinal plant processing units at the local level. This will create more income generating sources in the area. Further, most of the medicinal shrubs are being used in the area only as fuelwood. Local dwellers are familiar with unique medicinal uses and recipes of these shrubs for different ailments. But they are not utilizing them completely. These shrubs were collected from the study area and analyzed in the laboratory for determining different nutritive quality parameters like %N [maximum in Aerva javanica (5.22%)], % crude protein [maximum in Aerva javanica (32.5%)], % CF [maximum in the stem bark of Ziziphus nummularia (39.49%)], % Ash [maximum in Aerva javanica (33.49%)], % EEF [maximum in leaves of Calotropis procera (7.61%)], % P [maximum in the roots of Calligonum polygonoides (0.062%)], % K [maximum in Haloxylon recurvum (4.51%)] and % NFE [maximum in the flower of Capparis decidua (69.46%)]. Secondary metabolites like total phenolic [maximum in the fruits of Ziziphus nummularia (4.12 mg/0.1gm)], Total flavonoids [maximum in stem bark of Ziziphus nummularia (0.48 mg/0.1gm)] and Alkaloids [maximum in Aerva javanica (0.17 mg/0.5gm) were also recorded. Presence of secondary metabolites testified the medicinal role of these selected shrubs.