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.

Exploring and Understanding the Culture of a ‘Moving’ School in the Context of Pakistan Through Critical Incident Analysis

Recently, culture has become the focus of many school improvement endeavours. Yet, only a few schools seem to be aware of the strong influence of culture on school improvement. Change in culture has been known to change a stuck school to a ‘moving’ school. To explore and understand the culture and its relationship with school improvement, this study was conducted in one of those ‘moving’ schools in Karachi, Pakistan. Within the qualitative paradigm, a neo research approach analysis of critical incidents was used. The incidents were identified through observations, and interpreted and classified through interviews, informal talk and discussions. Data was coded according to the research questions, regarding the values, beliefs, processes, and relationships that were reflected through these incidents and how they contributed to the school improvement efforts. Findings from the study showed that the school highly values and believes in students’ holistic development, shared leadership, life long learning and collaboration among all its members. The school believes that it is responsible not only for the academic development but also for the holistic development of students, specifically for developing disciplined and responsible individuals. The school believes that maximum involvement and collaboration among the stakeholders greatly contributes towards the successful implementation of the school improvement efforts. The school has a loose hierarchical structure, which follows a partially democratic and a partially autocratic culture. The on going school improvement efforts aim to move the school from conformity of authority to decentralization, from schooling to learning, from traditional school to a learning community and from individualism to collaboration. The findings from the study suggest a close but complex relationship between school culture and school improvement. The school’s vision, which comprises a mixture of all the values mentioned above, guided the school improvement efforts, which, in turn, started changing the existing culture. The initiatives started from within the school kept the stakeholders motivated and committed to accomplish their vision. During the process of initiation and implementation, the school continuously worked on mutual adaptation of the school culture. However, the initiatives are still considered as something new. To ensure sustainability, the school is engaged in activities like: eliminating competing and contradictory practices, establishing links with other change efforts, specifically to the curriculum and classroom teaching, and developing local facilitators for skills training.