Allied Medical Research Journal

Occupational Therapy in the Age of Artificial Intelligence: Preserving Human Occupation While Embracing Digital Innovation

Neelum Zehra — Thu, 30 Jul 2026 00:00:00 +0000

Artificial intelligence is transforming occupational therapy by enhancing assessment, intervention, and personalized care. While digital innovations improve efficiency and clinical decision-making, occupational therapists must preserve the profession's human-centered focus on meaningful occupation, empathy, and therapeutic relationships. Balancing technological advancement with holistic, client-centered practice ensures optimal outcomes and ethical healthcare delivery.

Comparative Effects of Mirror Therapy, Proprioceptive Neuromuscular Facilitation, and Constraint-Induced Movement Therapy on Upper Limb Motor Recovery in Stroke Survivors: A Three-Arm Randomized Controlled Trial

Thu, 30 Jul 2026 00:00:00 +0000

Background: The majority of stroke survivors have upper-limb weakness, which reduces their functional independence in the real world, but there is limited evidence from trials that directly compare upper-limb rehabilitation interventions. The study compared the efficacy of three types of therapies (Mirror Therapy (MT), Proprioceptive Neuromuscular Facilitation (PNF), and Constraint-Induced Movement Therapy (CIMT)) in restoring motor function of the affected upper limb after stroke, when combined with conventional physiotherapy.

Methods: This was a three-arm parallel-group trial of 90 adults with post-stroke upper-limb hemiparesis, with blinded outcome assessment. The participants were allocated in a 1:1:1 ratio to MT, PNF, or CIMT, each with conventional physiotherapy, 6 days per week. The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Modified Ashworth Scale (MAS), and grip strength were measured by a blinded assessor at baseline and at 12 weeks.

Results: All 90 participants completed the trial with significant improvements from baseline on all four measures (p<0.001). A between-group difference at week 12 emerged only for the ARAT (one-way ANOVA, F=9.335, p<0.001): CIMT scored higher than both MT (p=0.002) and PNF (p<0.001), whereas MT and PNF were statistically indistinguishable. FMA-UE, MAS, and grip strength showed no between-group differences.

Conclusion: All three interventions improved upper-limb function with CIMT showing the greatest benefit in task performance, as measured by the ARAT. When CIMT is not feasible, MT and PNF are effective alternatives. This highlights the need to tailor therapy choices to each patient’s goals and resources.

DOI: https://doi.org/10.59564/amrj/04.03/001

Incidence of Varicose Veins and Edema among Female Nurses in Islamabad: A Comparative Study

Adn Tahir Chaudry, Ameera Aamar, Mohammad Suleman, Muhammad Haroon — Thu, 30 Jul 2026 00:00:00 +0000

Background: Varicose veins (VV) and edema are common chronic venous disorders affecting quality of life. Female nurses are at greater risk because of long hours standing and pregnancy, but incidence data available on these conditions in Pakistan is scarce. This study was aimed to compare the incidence of VV and edema among female nurses in Islamabad and to identify associated risk factors.

Methods: This descriptive, comparative, and cross-sectional study recruited 356 female nurses from government, semi-government, and private hospitals in Islamabad, selected through stratified random sampling from a pool of 4297 female nurses. Information was obtained using a validated questionnaire covering demographic data, disease status, family history, pregnancy, and risk factors, with edema graded on a pitting scale and VV classification based on the CEAP system. Descriptive statistics and Chi-square test (p<0.05) were used for analysis in SPSS version 22.

Results: Among 356 nurses, 51 (14.35%) were unaffected. Of the remainder, edema alone was found in 161 (52.8%), VV alone in 52 (17.0%), and both conditions in 92 (30.2%). Prolonged standing (35.1% and 18.7% respectively) was the most common risk factor for both edema and VV. Significant associations with disease occurrence were found for pregnancy (χ²=12.046, p=0.017) and family history (χ²=19.123, p=0.004), with 45.9% of affected nurses not receiving treatment.

Conclusion: VV was found to be less frequent than edema in female nurses of Islamabad. Family history, pregnancy, and prolonged standing were identified as major risk factors, underscoring the importance of screening and ergonomic modifications for nurses.

DOI: https://doi.org/10.59564/amrj/04.03/002

The Efficacy of Instrument-Assisted Soft Tissue Mobilization as an Adjunct to Therapeutic Exercise in Knee Osteoarthritis: A Parallel-Group Randomized Clinical Trial

Faiza Kalsoom, Mehreen Ali, Khakshan Taveel , Rabbia Irshad, Zona Mehreen — Thu, 30 Jul 2026 00:00:00 +0000

Background: In adults over 40, knee osteoarthritis (OA) commonly causes pain and dysfunction, often associated with tight soft tissues, quadriceps weakness, and limited range of motion. While therapeutic exercise is the main non-surgical treatment, its effectiveness can be limited by myofascial restriction. This study aimed to assess the effectiveness and safety of Instrument-Assisted Soft Tissue Mobilization (IASTM) combined with the exercise program compared with exercise alone in reducing pain, knee range of motion, and function in individuals with knee OA.

Methods: This is a parallel-group randomized trial with participant blinding, conducted over 12 months at two centers: Physio Care Center, Gujarat, and SK Physio OPD, Islamabad. Fifty patients with knee OA (Kellgren-Lawrence grade II-III) were randomly assigned to Group A (exercise + IASTM) or Group B (exercise only), with 25 patients in each group. All patients received 3 sessions per week for 6 weeks and were assessed at baseline and at 6 weeks using the Visual Analog Scale, Goniometry, and WOMAC index respectively.

Results: Both groups demonstrated improvement, with Group A (exercise + IASTM) demonstrating more pain reduction, knee flexion improvement, and residual effects compared to Group B (exercise only). All results in Group A were p<0.01 compared with Group B, which reduced extension deficits and showed better WOMAC scores.

Conclusion: The findings revealed that combining IASTM with therapeutic exercise yielded greater improvements in pain, knee mobility, and function than exercise alone in knee OA, making it a valuable complementary tool for traditional knee rehabilitation.

DOI: https://doi.org/10.59564/amrj/04.03/003

Frequency of Cervicogenic Headaches symptoms among Bankers of Islamabad: A Cross-sectional Study

Khaleel Ur Rehman, Eeman Malik, Mahpara Ali — Thu, 30 Jul 2026 00:00:00 +0000

Background: Cervicogenic headache (CGH) is a secondary headache associated with disorders of the cervical spine. Poor and sustained posture, particularly during prolonged desk work and use of electronic devices, may contribute to musculoskeletal pain, reduced cervical mobility, sleep disturbances, and fatigue. Bankers are frequently exposed to these occupational risk factors. This study aimed to determine the frequency and severity of CGH symptoms among bankers working in Islamabad.

Methods: A cross-sectional descriptive study was conducted among 61 bankers aged 25–60 years working in banks in Islamabad. Participants were recruited using convenience sampling. Data were collected from July 2025 to January 2026 using the Visual Analog Scale (VAS) to assess pain intensity and the Wiley-Blackwell Cervicogenic Headache Diagnostic Criteria Questionnaire. The questionnaire was used to assess factors associated with CGH and was not intended as a substitute for a comprehensive clinical diagnosis. Data were analyzed using frequencies and percentages in SPSS version 23.

Results: CGH was identified in 20 of 61 participants, indicating a prevalence of 32.7%. Among those meeting the criteria for CGH, 10% reported mild pain, 65% reported moderate pain, and 25% reported severe pain. Moderate pain was therefore the most frequently reported intensity.

Conclusion: A notable proportion of bankers reported symptoms consistent with CGH, with moderate pain being the predominant severity. These findings highlight the importance of workplace ergonomics, posture awareness, and preventive strategies to reduce occupational risk factors associated with CGH among desk-based professionals.

DOI: https://doi.org/10.59564/amrj/04.03/004

The Impact of DBT-Based Mindfulness Training on Cognitive Performance Among University Students: A Pre-Post Stroop Test Study

Shumaila Atif, Sheeba Farhan, Rabika Shoukat, Sara Jehangir — Thu, 30 Jul 2026 00:00:00 +0000

Background: Mindfulness is increasingly used to support cognitive and emotional functioning in high-stress academic settings. Dialectical Behavior Therapy (DBT) combines mindfulness with distress tolerance, cognitive flexibility, and emotion regulation skills that may strengthen attentional control. However, controlled evidence using objective cognitive measures remains limited in South Asian university populations.

Methods: A one-group pre-test–post-test design was used with 50 undergraduate students (aged 18–25 years) purposively recruited from a Pakistani university. Participants completed the Stroop Color and Word Test (SCWT) before and after a structured six-session DBT-based mindfulness training program covering core mindfulness, distress tolerance, cognitive flexibility, and stress-management skills. Pre- and post-intervention scores on nine SCWT indices were compared using paired-samples t-tests.

Results: Word-reading time fell significantly, from 15.19±5.19 to 12.89±3.93 seconds (t(49)=2.691, p=0.010), as did letter-reading time, from 32.38±10.07 to 26.10±9.33 seconds (t(49)=3.596, p=0.001), and letter-reading errors, from 0.74±0.99 to 0.40±0.78 (t(49)=2.084, p=0.042). Color-naming time, the remaining error scores, and all three interference (conflict) scores showed no significant change (all p>0.05).

Conclusion: A brief DBT-based mindfulness program improved basic processing speed and selective attention but left higher-order executive control and interference resolution largely unchanged. The training is a feasible, low-cost way to strengthen foundational attentional processes in university students. However, longer or more intensive programs may be needed to affect more complex executive functions.

DOI: https://doi.org/10.59564/amrj/04.03/005

Comparative Effects of Dry Needling and Kinesio Taping as Adjuncts to Strength Training on Pain, Functional Mobility, and Quality of Life in Patients with Knee Osteoarthritis: A Three-Arm Randomized Controlled Trial

Thu, 30 Jul 2026 00:00:00 +0000

Background: Knee osteoarthritis (OA) is the most prevalent form of OA contributing to around 60% of all the cases globally. Strength training is the recommended first-line non-drug treatment, but evidence comparing it with adjunctive therapies such as dry needling and Kinesio taping is yet to be explored.

Methods: This study was a single-masked, three-arm RCT conducted at the Physio Care Center, Gujrat, from November 2024 to December 2025. Fifty participants aged 45 to 65 with knee OA and a Visual Analog Scale pain score ≥7 were randomly assigned to one of three groups: dry needling plus strength training (n=17), Kinesio taping plus strength training (n=17), or strength training alone (n=16), all conducted three times weekly for six weeks. Pain, mobility, and quality of life were assessed at baseline and week 6 by a blinded assessor.

Results: All groups showed significant improvements (p<0.001). One-way ANOVA revealed significant differences among groups for pain (p=0.010), mobility (p=0.003), and quality of life (p<0.001). Dry needling plus strength training resulted in significantly greater improvements than strength training alone (p≤0.006), whereas Kinesio taping showed no significant advantage over strength training alone.

Conclusion: Adding dry needling to strength training yields significantly greater short-term gains in pain, mobility, and quality of life than strength training alone in knee osteoarthritis, whereas the added benefit of Kinesio taping is smaller and less certain. Larger, sham-controlled, multicenter trials with longer follow-up are warranted.

DOI: https://doi.org/10.59564/amrj/04.03/006

Elemental Profile of Postoperative Infected Wound Exudates in Hospitalized Surgical Patients: A Cross-Sectional Study at People’s Medical College Hospital, Nawabshah

Thu, 30 Jul 2026 00:00:00 +0000

Background: Pyogenic infections following surgery are important contributors to post-surgical morbidity and may be related to surgical site and biochemical properties of wound exudates. Pus elemental profiling can give information on the wound microenvironment which can direct individual clinical interventions.

Methods: The study design was analytical cross-sectional with 370 consecutive patients (aged 15-80 years) who had infected postoperative wounds in Peoples Medical College Hospital, Nawabshah, Pakistan, between June 2023 and July 2025. Six gastrointestinal surgical sites were aseptically collected pus/wound-exudates. In the wet digestion, sodium, potassium, magnesium, calcium, zinc, copper and chromium were measured in triplicate by inductively coupled plasma optical emission spectrometry. One-way analysis of variance and independent student’s t-test were used to test the differences by surgical site and age, respectively, and by sex.

Results: The sample comprised 181 males (48.92%) and 189 females (51.08%); 115 patients (31.08%) were aged 61–80 years. Concentrations differed among surgical sites for sodium (p=0.002), magnesium (p=0.001), zinc (p=0.002), copper (p=0.003), and chromium (p=0.004), but not potassium (p=0.104) or calcium (p=0.103). Gut-cancer exudates showed the highest sodium (140.00±7.30 mmol/L), copper (24.00±1.65 µmol/L), and chromium (14.50±1.30 µmol/L). All seven elements were found to be different among the age groups (p=0.001–0.003), all elements except potassium were different by sex.

Conclusion: The work highlights the increased level of sodium, calcium, copper and chromium in the samples of the gut cancer and increased magnesium and zinc in the exudates from the colon and stomach. Significant higher contents of sodium, calcium, copper and chromium are in exudates of females while in males, magnesium and zinc are higher. Sodium, potassium, copper and zinc levels are higher in 61-80 years age group than in other age groups.

DOI: https://doi.org/10.59564/amrj/04.03/007

Hybrid Ensemble Learning for Multi-Class Chest X-Ray Classification Using Deep CNN

Thu, 30 Jul 2026 00:00:00 +0000

Background: COVID-19, pneumonia, and TB (tuberculosis) are still the big killers of people suffering from chest disease and continue to be a serious health challenge globally. A timely diagnosis leads to timely treatment and improved patient outcomes. Chest X-ray (CXR) imaging is widely used for diagnostic purposes due to its speed, low cost, and availability in most healthcare facilities. Manual reading of CXR images is, however, challenging because of the similarity in the presentation of radiographic features across various chest diseases.

Methods: This research introduces a hybrid ensemble learning approach to classify chest X-ray images into four classes—Normal, COVID-19, Pneumonia, and Tuberculosis. Three Deep CNN network models, namely Xception, AlexNet, and EfficientNet-B0, were used for deep feature extraction. Additionally, texture features of the images were extracted using Gabor filters. The deep and texture features were combined and classified using logistic regression and a stacking ensemble learning approach. A publicly available chest X-ray image database containing 7,135 X-rays was used, with six-fold stratified cross-validation to assess the proposed approach.

Results: The ensemble models outperformed the individual CNN models. The Average Ensemble produced the best results with an accuracy of 91.18%, an Average Precision (AP) of 96.75%, and an Area Under the ROC Curve (AUC) of 98.87%. The proposed model performs well across all four disease classes. It exhibited high sensitivity in detecting Tuberculosis with considerable stability in classifying Normal, COVID-19, and Pneumonia.

Conclusion: The proposed framework demonstrates the effectiveness of integrating deep learning features, Gabor texture features, and ensemble learning for improved chest X-ray image classification. This can help computer-assisted diagnostics systems and aid medical workers in identifying chest diseases early.

DOI: https://doi.org/10.59564/amrj/04.03/008