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.

Us Policy in Indian Ocean:

The Indian Ocean has attained significance as center stage of world politics in current century. The regions of Asia Pacific & Atlantic were the main theatres of warfare generally in World Wars and specifically in cold war .Asia has emerged as epicenter of global politics in current timeframe. Indian Ocean politics has greatly affected the US policy in post-cold war and post 9/11 period due to growing Chinese and Indian interests and presence in the region. This triangular relationship between US, China and India has great implications on regional balance of power and especially on Pakistan. The main purpose of this study is to analyze the United States Policy in the Indian Ocean during post-cold war period from year 1990 to 2014. A comprehensive research has been done to determine the implications of US approach on Pakistan’s foreign and maritime policy. Although qualitative in nature but content analysis method has been adopted for research. Analytical, historical and descriptive approach has been employed to understand strategic moves from different angles. Apart from relevant primary data i.e. official reports and documents, interviews from naval officers and experts have been effectuated in order to fathom the expert view and to ample the study vision. It has been concluded that US reframed its policy through offensive realist perspective especially in Iraq and Afghanistan. United States approach was to subjugate Pakistan through coercive diplomacy in post- cold war and post 9/11 period. US have revised its Cooperative Security Strategy of 2007 as Cooperative security Strategy for 21 century in 2012: Forward, Engaged, Ready; it has shifted its focus to Asia Pacific after declaration of Asia Pivot policy. Pakistan had no other option except to look towards China in order to counter balance the growing Indo-US synergy in the Indian Ocean. US inclination towards India has turned into a challenge for Pakistan’s foreign and maritime policy makers. The need of the hour is to re-visit maritime and foreign policy of Pakistan keeping in view changing dynamics of Indian Ocean geopolitics.