EFFECTS OF RELAXING MUSIC THERAPY ALONG WITH TASK-ORIENTED TRAINING OF LOWER LIMB ON BALANCE AND FUNCTIONAL INDEPENDENCE IN PATIENTS WITH CHRONIC STROKE: A RANDOMIZED CLINICAL TRIAL

Background of the Study: To compare the effects of relaxing music therapy with task-oriented training of lower limbs on the balance and functional status in patients with chronic stroke. Methodology: This randomized clinical trial was conducted in three outpatient physiotherapy clinics in Lahore, Pakistan. A sample of 76 participants with chronic stroke, aged 40-60 years, and on assistance walking, were recruited through a purposive sampling technique. Individuals who had physical impairments and visual or hearing deficits were not included in the study. Group A received task-oriented training with routine physical therapy while Group B received Music therapy additionally. Three sessions on alternate days per week for eight weeks were given. Balance and functional independence were the outcome variables measured using the Berg Balance Scale and Functional Independence Measure respectively. Mann-Whitney U test and Friedman ANOVA were applied for between-group and within-group differences respectively. P-value was significant at ≤0.05. Results: The mean age of participants was 54.05 ± 3.64 years, the majority i.e., 55 (72.4%) were male, 46 (60.5%) had ischemic stroke and 53 (69.7%) were presented with left-sided weakness. A statistically significant difference was observed among both groups in balance (p =.000) and functional independence (p=0.000). The within-group difference was also significant for balance (p=0.000) and functional independence (p=0.000). Conclusion: The integration of relaxing music therapy, task-oriented training, and routine physiotherapy is effective in improving balance and functional independence in chronic stroke patients.

Nature of Engagement of Secondary School Leaders in Curriculum Planning and Decision Making in the Mountainous Rural Areas of Pakistan

Teachers and students in Pakistan are perceived as consumers of the 'given' curriculum and have little role in the development of it. As a result, policy directives and actions to improve quality of education in Pakistan have been mainly 'top-down' and geared towards improving the ‘given knowledge’ transfer capability of teachers. Blind to teachers' agency to develop powerful curriculum in school, these efforts from outside school have mostly failed in achieving the aims of students' meaningful learning as espoused in the national curriculum of Pakistan. The quality of education, thus, can significantly be improved if change is initiated from within school. Be it the case, a series of questions needs to be answered. Who are in school that are so important for students' meaningful learning? How are they important for students' meaningful learning? What do they do to achieve that end? How and why do they do what they do to reach that end? How could they be helped to do better what they currently do in schools in order to facilitate students' meaningful learning? These are some of the questions that this research study with its focus on engagement of secondary school teachers and students in Chitral district in curriculum planning and decision making has attempted to answer. Hence, adopting a mixed methods research approach, this thesis outlines the nature (what, how, and why) of engagement of secondary school teachers and students (school leaders) in the four dimensions of curriculum planning and decision making at school level and provides a framework to improve their engagement for enhanced students' meaningful learning. These dimensions are (a) objectives of teaching and learning, (b) content to be taught, (c) learning opportunities, and (d) mode of presentation and response. Quantitative data were collected from 401 teachers in 89 secondary schools through a questionnaire survey and qualitative data were generated in the selected two case study schools through interviews, focus group discussions, observations, and field notes. The findings of this study are important with respect to the notion of school leaders as curriculum planners and decision makers at school level. The results show that school leaders are not just implementers of curriculum through teaching textbooks in the classroom. Rather, empirical findings have illustrated that school leaders exercise their personal agency to adapt and enrich nationally developed curriculum in order to serve the meaningful learning purpose of the students. All findings of data analysis are in