EFFECTS OF MULLIGAN ROTATIONAL MOVEMENT VERSUS MEDIAL GAPPING TECHNIQUE ON PAIN, RANGE OF MOTION AND DISABILITY IN PATIENTS WITH KNEE OSTEOARTHRITIS

Background and Aim: To compare the effects of mulligan rotational movement and medial gapping technique on pain, range of motion and disability in knee osteoarthritis patients. Methodology: This study was a Randomized Clinical Trial. The data was collected using a convenience sampling technique. Data was collected from Jinnah Hospital Lahore, from 15th December – 30th June 2022.36 subjects (males and females) were recruited in two groups. The first group received Mobilization with movement along with a conservative treatment protocol. The second group received the Medial gapping technique along with conservative treatment protocol. Each group was treated for four weeks in which three sessions per week were given. Numeric pain rating scale and the disability index were used as outcome measures. Data was analyzed through statistical package for the social sciences (SPSS) version 25. Results: Within-group comparison by paired t-test showed the p-value was significant <.05, indicating that both treatment was effective in improving symptoms. Between groups, comparison by independent t-test showed that Mulligan Mobilization Technique is more effective than the medial gapping technique in improving pain disability and quality of life. Conclusion: The study concluded that Mulligan Mobilization Technique provides more clinical benefits regarding pain, disability and range of motion in osteoarthritis patients than Medial Gapping Technique.

Neuropharmacological Studies on Memory Enhancing and Reinforcing Effects of Cns Stimulants in Rats Exposed to Unpredictable Repeated Stress

There is growing increase in the prevalence of depression and obesity. In addition there is growing need of cognitive enhancers. CNS stimulants seem to be effective alternative for all these therapies but are addictive. Apomoprhine, a D1/D2 agonist also produces CNS stimulant like effects. The present study is designed to monitor antidepressant and cognitive improving effects of apomorphine, methylphenidate and caffeine in rats exposed to unpredictable repeated stress. Antidepressant like effects was monitored as the ability of drug to reduce stress effects on locomotion in a familiar as well as novel environment. Reinforcing effects of drug were monitored as drug-induced behavioral sensitization and place preference in a CPP paradigm. Cognitive performance and drug-induced enhancement of learning and memory were monitored in a Morris Water Maze Test. Apomoprhine, methylphenidate and caffeine exhibit antidepressant like effects by producing hyperlocomtion and anorexia. Long term administration of moderate dose of apomorphine and low doses of methylphenidate and coffee produces sensitization and enhances CPP greater in stressed animals. However when apomorphine is experienced during the exposure of unpredictable repeated stress it suppresses stress effects and enhances locomotion, drug induced sensitization was also smaller. Single as well as repeated administration of low dose of methylphenidate enhances short term and long term memory whereas high dose enhances memory retention and produces sensitization and reinforcement. Coffee is also effective in reducing stress-induced cognitive impairment, but reinforcing when taken at high dose specially for stressful conditions. The present study shows that CNS stimulants such as methylphenidate and caffeine can reduce stress effects and may be useful for the treatment of depression. Apomorphine which also produces CNS stimulant like effects is also similarly effective. Moreover the present results tend to suggest that psychostimulant as well as apomorphine can improve cognitive performance and alleviate stress-induced memory impairment. Psychostimulant as well as apomorphine have addictive potential and should not be used for long term.