Clinical Research Directory

Combined Effects of Swiss Ball Exercises and Diaphragmatic Breathing in Pregnant Females

30 to 60 percent of the pregnant females experience stress urinary incontinence depending on various factors like trimester, parity and body weight. Stress urinary incontinence is a common yet often underreported condition affecting pregnant women, characterized by involuntary leakage of urine during physical activities such as coughing, sneezing, or exercising. Stress urinary incontinence majorly occurs due to increased intra-abdominal pressure and weakened pelvic floor muscles which are further strained during pregnancy. Despite its impact on quality of life, awareness and management remains inadequate. Strengthening the pelvic floor muscles plays a critical role in managing stress urinary incontinence and Swiss ball exercises have emerged as an effective and low impact method to improve core stability and pelvic floor muscle strength. These exercises engage deep abdominal and pelvic muscles in a functional and dynamic way, potentially enhancing both physical and psychological well-being during pregnancy. . The study will be conducted as a randomized control trial involving females with stress urinary incontinence in Zia Hospital Lahore and Ittefaq Hospital Lahore. The study will be completed within 10 months of synopsis approval. A non-probability sampling technique will be employed and 42 patients will be enrolled after randomization. Participants will be divided into two groups. Group A will undergo a structured program involving Swiss ball exercises combined with diaphragmatic breathing. Group B will receive Swiss ball exercises without diaphragmatic breathing. Kegel exercises will be considered the baseline treatment. Outcome measures will include syptoms of stress urinary incontinence (using International Consultation Incontinence Questionnaire), pelvic floor muscle strength (assessed through standardized tools i.e. Modified Oxford Scale) and self-reported quality of life (using validated questionnaires i.e. King's Health Questionnaire). The data collected will be analyzed using IBM SPSS statistics version 25.

Use of Exercise Snacks to Improve Upper Body Fitness

This study will examine the effects of an upper-body resistance "exercise snack" (ES) protocol on upper-body strength, endurance, and power. Participants will be randomly assigned to one of three groups: a submaximal effort repeated throughout the exercise day ES group, a maximal effort performed once per exercise day ES group, and a control group that continues usual activity (Control: no resistance exercise). Both exercise groups will perform two exercises, push-ups and planks, three days per week. The submaximal repeated effort ES group (SMR\_ES) will perform approximately 33% of the maximal number of push-ups and maintain a plank position for 33% of maximal time, three times per day. The maximal once-per-day effort ES group (MO\_ES) will perform the maximal number of push-ups and maintain a plank position for maximal time, once per day. Therefore, both ES groups (SMR\_ES and MO\_ES) will perform the same weekly volume (repetitions and time) of both exercises across the six-week intervention period. Before and after the six-week intervention period, all participants will undergo testing to assess upper-body performance. Outcome measures will include push-up endurance (maximum repetitions), plank endurance (maximum time), push-up power (assessed using force plates), and maximal push strength (assessed using hand-held dynamometry). Pre- and post-intervention changes in outcomes will be compared among all three groups. If significant changes are identified, additional comparisons will be conducted between the SMR\_ES and Control groups, as well as between the SMR\_ES and MO\_ES groups. The primary aim of this study is to determine whether repeated submaximal efforts performed three times per day, three days per week, increase upper-body endurance, power, and strength compared to a control group performing no resistance exercise. The secondary aim is to determine whether submaximal efforts performed three times per day, three days per week, produce changes in upper-body strength, endurance, and power that are not different from maximal efforts performed once per day, three days per week. These aims address whether exercise distribution influences strength and power adaptations beyond total weekly volume. The findings may help inform time-efficient, lower subjective-effort resistance training strategies that can be implemented in educational, athletic, or general fitness settings.

Dose-Response Impact of Geranylgeraniol (GG) Supplementation on Muscle Health

This study will evaluate the effects of daily geranylgeraniol (GG) supplementation on muscular strength, body composition, and aerobic capacity in healthy, physically active men and women. Approximately 60 participants aged 30-60 years will be enrolled in a randomized, double-blind, placebo-controlled, parallel-group trial lasting 8 weeks. Participants will be assigned to receive either placebo, 150 mg GG, or 300 mg GG daily. Outcome measures will be assessed at baseline, week 4, and week 8 and include maximal strength (1RM bench press and leg press), fat-free mass, muscular endurance, aerobic capacity (VO2peak), and circulating biomarkers related to metabolism and health.

EMS Combined With Resistance Training in Weight Lifters

The purpose of this randomized controlled trial is to determine the effects of Electrical Muscle Stimulation (EMS) combined with resistance training on muscle mass, muscular strength, body composition, and power in trained weightlifters. Participants will be randomly allocated into two groups: one receiving resistance training alone and the other receiving EMS combined with resistance training. The intervention will be conducted for eight weeks, and outcome measures will be assessed at baseline, mid-intervention (4 weeks), and post-intervention (8 weeks). The findings of this study may provide evidence regarding the additional benefits of EMS when combined with conventional resistance training programs in enhancing muscular performance among trained athletes.

Different Drop Height Plyometric Training in Soccer Players

This randomized controlled trial aims to determine the effects of different drop height plyometric training protocols on lower limb explosive strength, anaerobic power, and change of direction (COD) performance in soccer players. A total of 56 competitive soccer players aged 18-30 years will be randomly allocated into three intervention groups using sealed envelope randomization: low drop height (30 cm), moderate drop height (45 cm), and high drop height (60 cm) plyometric training groups. Participants will undergo supervised plyometric training three times per week for six weeks. Outcome measures including Vertical Jump Test, Running-Based Anaerobic Sprint Test (RAST), and T-Test Agility Test will be assessed at baseline and post-intervention. Statistical analysis will be performed using SPSS version 25 to determine within-group and between-group differences.

L-serine and Strength Training in the Elderly

This study investigates whether taking the amino acid L-serine, either alone or in combination with targeted strength training, can have a positive effect on mental performance, brain function, and physical fitness in older people. Healthy, independent women and men aged 65 to 85 are eligible to participate. Participants will be randomly assigned to one of three groups: placebo, L-serine, or L-serine combined with strength training. Cognitive tests, physical performance tests, and blood and brain tests will be conducted over a period of 48 weeks. The aim is to gain a better understanding of how nutrition and exercise can contribute to healthy aging.

Menstrual Cycle and Women's Performance

This study examines how different phases of the menstrual cycle are associated with selected performance and musculoskeletal parameters in physically active women aged 18-35 years. Participants will track their menstrual cycle using a mobile app for approximately 2 months and attend 3 laboratory visits scheduled to specific cycle phases. At each visit, participants will complete non-invasive assessments including lower-limb strength/performance testing, musculoskeletal measurements (muscle and tendon properties), body composition assessment, and symptom-related questionnaires. The goal is to improve understanding of physiological variability across the menstrual cycle and support evidence-based planning of training, testing, and clinical practice in women.

Impact of Digital Muscle Strength on Activity in Tech-Addicted University Students

Results from muscle strength assessment methods commonly used in physiotherapy can vary due to their lack of objective results and their reliance on the individual's muscle strength. Digital muscle testing devices provide objective results because they provide numerical data based on the resistance applied by the individual performing the measurement. These data can objectively identify weakness in specific muscles or muscle groups that may occur due to decreased physical activity levels in university students, and they will also be useful in developing an individualized exercise program.

Lower-Limb Muscle Mass and Cardiovascular and Muscular Performance in Males and Females

The aim of this study will be to examine the relationship between leg muscle mass and muscle strength, aerobic capacity, anaerobic power, and jumping performance in young adults. In addition, these physical performance measures will be compared between male and female participants. Recreationally active young adults will be recruited to participate in the study. Body weight and leg muscle mass will be assessed using a body composition analyzer. Participants will perform isokinetic and isometric leg strength tests, an aerobic fitness test (VO₂max), an anaerobic power test (Wingate), and a countermovement jump (CMJ) test. This study aims to improve the understanding of the effects of leg muscle mass on physical performance and to identify possible differences between males and females. The findings are expected to contribute to exercise prescription, performance assessment, and future research in sports and health sciences.

Resistance Training Adaptations and Caffeine Intake

This randomized, double-blind, placebo-controlled crossover trial investigates the effects of three different caffeine supplementation strategies on resistance training-induced adaptations in 180 caffeine-naive, inactive young adult males. Participants will undergo two 4-week supervised resistance training programs separated by a 2-week washout/crossover period. The three caffeine strategies are: (1) constant daily low-moderate dosing (3 mg/kg/day), (2) gradually escalating dose (3 to 6 mg/kg across weeks), and (3) training-day-only caffeine (3 mg/kg/day). Primary outcomes include non-invasive measures of integrated anabolism and hypertrophy (D2O-derived plasma proteomic fractional synthesis rate, DXA muscle volume) and strength metrics. Secondary outcomes include hormonal responses (insulin, cortisol, testosterone, IGF-1), sleep/recovery parameters, and adverse effects.

Applicability of Tissue Flossing for Blood Flow Restriction in the Upper Limb: Reliability and Performance Analysis

Blood flow restriction (BFR) is a widely studied technique that combines low-intensity exercise with vascular occlusion, resulting in muscular benefits. However, its application is challenging due to methodological variations and equipment costs. Tissue Flossing (TF) appears as an affordable alternative, but lacks solid scientific evidence.

Effect of Cross-Education in Blood Flow Restriction Resistance Training on Lower Limbs in Older Women

Unilateral resistance training has been shown to promote strength adaptations in the directly trained limb and also improve strength in the contralateral limb, a phenomenon known as cross-education (CE), with more pronounced effects observed in high-load training. However, high-load resistance training may be unfeasible for older adults. Blood flow restriction (BFR) training emerges as a low-load alternative that reduces joint stress, is easy to apply, and has low cost. Although there is already evidence showing significant effects of CE during resistance training with BFR, gaps remain regarding its applicability in older adults. This study aims to evaluate the effects of CE in resistance training with BFR on the lower limbs of older women.

Frailty and Muscle Strength Tests in Older Adults Undergoing Major Surgery

The goal of this observational study is to learn if simple tests for frailty and muscle strength can help predict which older adults (age 65 and older) are at higher risk for problems after major abdominal surgery. The main questions it aims to answer are: * Do measures of frailty and muscle strength, taken before surgery, predict complications after surgery? * Can these tests be easily done during a routine pre-surgical visit? Participants will: * Complete brief tests measuring muscle strength, breathing strength, physical function, nutrition status, body composition, and memory during a regular pre-surgical clinic appointment. * Allow researchers to review their medical records 30 and 90 days after surgery to identify any complications or health problems.

Ankle Isometric Strength and Proprioception in Young Ice Hockey Players

This observational cross-sectional study aims to profile ankle isometric strength and proprioception in 9-10-year-old junior ice hockey players and to compare these outcomes and limb symmetry indices with age-matched non-athlete children. Ankle isometric muscle strength is assessed using a handheld dynamometer, and ankle proprioception is evaluated using a digital inclinometer. Measurements are performed bilaterally for dominant and non-dominant limbs. Group comparisons and limb symmetry analyses are conducted to identify potential neuromuscular differences related to sports participation.

The Efficacy of a Technology-Assisted Block Training Program on Cognitive Function, Hand Dexterity, and Grip Strength in Community-Dwelling Older Adults: A Mixed-Methods Research

Block-building activities represent a promising tool for enhancing cognitive and hand function in older adults. When integrated with technological support, they offer personalized training advantages; however, their comprehensive effectiveness requires empirical validation. This study aimed to develop and evaluate a "Technology-Assisted Block Training Program" to explore its effects on cognitive function, hand grip strength, dexterity, and quality of life among community-dwelling older adults, while examining participants' subjective experiences.

Comparative Effects Of Exergaming And Otago Exercise On Anticipatory Postural Control And Sensory Integration In Older Adults

This study explores whether non-immersive, interactive Exergaming using Xbox Kinect can go beyond conventional exercise by actively training the brain and body to react faster, balance smarter, and move more confidently. Through dynamic games like Reflex Ridge and 20,000 Leaks, we aim to stimulate internal perturbations and real-time Sensory Integration, something Otago doesn't directly target. In this randomized controlled trial, 36 older adults (aged 55+) will be assigned to either the Exergaming or Otago group. Both groups will receive 6 weeks of supervised balance training (3x/week, 30 mins/session). Primary outcomes include Sensory Integration, measured using modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and Anticipatory postural control assessed through Limits of Stability (LOS) test. Timed up and Go (TUG) will capture functional mobility, which will serve as the secondary outcome in this study. Both mCTSIB and LOS will be administered using the Postural Stability System of Biodex, a reliable and valid computerized platform designed to objectively quantify postural control under varying sensory conditions. With evidence-based outcome tools and rigorous analysis, this project doesn't just aim to compare two programs, it's about challenging tradition, modernizing rehab, and making balance training smarter, safer, and more engaging for the elders we serve. This research could be a leap forward in community-based fall prevention and a step toward a more responsive, personalized future in Neurological Rehabilitation.

Whole-Body Photobiomodulation Use in Professional Soccer Players During a State Championship

This study aims to investigate the effects of whole-body photobiomodulation on professional soccer players during a state championship. The primary question is whether photobiomodulation improves recovery, reduces muscle fatigue, and enhances performance compared to standard training without photobiomodulation.

The Acute and Accumulative Effects of Snack Foods on Exercise Recovery

The purpose of the research is two-fold. One goal is to determine if post-exercise almond or cereal bar consumption can promote muscle gain as well as increasing muscular strength throughout an eight-week weight training program. The other goal is to assess the short-term effects of almonds or cereal bar on recovery that may explain the overall long-term adaptations.

A Randomized Controlled Trial Comparing Whole Body Vibration Therapy With Usual Care and Usual Care to Improve Muscle Health in Older Adults

This study is a randomized controlled trial where participants would be randomly assigned to one of 2 groups. One group would receive Whole body vibration therapy and usual care and the other group only usual care. Measurements of muscle mass, strength and function would be taken before the interventions, and at 2 other points after interventions. Differences in the outcomes between the two groups would be analysed.

The Effect od Beetroot Juice on Forearm Muscle Strength and Muscle EMG Activity After BloodFlow Restriction

The primary aim of the current study is determine the effect of beetroot juice consumption on maximal grip strength and EMG muscle activity

Normative Values for Peripheral Muscle Strength in Critical Patients and Healthy Individuals

Muscle strength is an important indicator of overall health and is a factor that has been associated with increased mortality in critical patients. Its measurement must be reliable and reproducible to ensure a quality outcome for clinical applicability. Recently, the use of digital handheld dynamometers in intensive care has gained support; however, analysis becomes challenging due to the absence of standardized reference equations for the Brazilian population. The aim of this study is to develop reference equations for the Brazilian population and define specific cutoff points for men, women, healthy individuals, and critical patients.

Relationship Between Vertical Jump, Balance, Muscle Strength, Flexibility, and Foot Posture in Artistic Gymnasts

Artistic gymnastics is a highly demanding and technically complex sport that requires strength, flexibility, agility, balance, and coordination (Nassib et al., 2020). Gymnasts perform a series of dynamic movements, such as flips, turns, and somersaults, which require explosive muscular power and precise control (Potop et al., 2014). In this sport, jumping ability, balance, muscle strength, and flexibility are fundamental physical parameters that directly influence both movement quality and injury risk. Among these, jumping ability plays a particularly critical role by facilitating take-offs and aerial maneuvers, enabling gymnasts to generate the necessary height and momentum to perform complex routines effectively. Moreover, gymnasts with greater jump capacity are able to absorb landings more efficiently, thereby reducing injury risk and maintaining consistent performance throughout their routines (Feng et al., 2024; Geiblinger et al., 2025). Another essential parameter is balance-particularly dynamic balance, which can be defined as the body's ability to perceive and respond to postural changes that occur during motor activities. This involves maintaining the center of mass within the base of support, requiring a high level of neuromuscular activation. Dynamic balance is vital not only in sports but also in daily life activities such as walking, stair climbing, running, and sit-to-stand transitions. Its role in preventing injuries and enhancing athletic performance has been well established (Paillard, 2019; Dana et al., 2021). The Y-Balance Test (YBT), which measures dynamic balance in three directions-anterior (ANT), posterolateral (PL), and posteromedial (PM)-is commonly used in clinical and athletic settings. In clinical practice, a difference of less than 4 cm between limbs in each direction is considered normative. Lehr et al. (2013) reported in a study conducted among collegiate athletes that average YBT performance could serve as a predictor of future lower extremity injuries. From a biomechanical perspective, the foot represents the distal segment of the lower extremity kinetic chain. Any morphological changes or alterations in the weight-bearing alignment of the foot can influence balance control. Considering the critical role of the foot in stabilizing and modulating the kinetic chain, accurately assessing foot posture is essential. Postural characteristics such as high or low arches may impact balance capacity, jump performance, and the ability to attenuate forces during landing (Seyedahmadi et al., 2024). In light of this evidence, the primary aim of the present study is to examine the relationships between vertical jump performance, balance, muscle strength, flexibility, and foot posture in artistic gymnasts. Investigating these parameters comprehensively is expected to provide valuable insights from both scientific and clinical perspectives. Specifically, the study seeks to: Determine the relationship between vertical jump performance and lower extremity muscle strength, flexibility, and balance. Analyze the potential associations between foot posture and vertical jump, balance, and muscle strength. By addressing these objectives, the study aims to contribute to both guiding the design of training programs and reducing the risk of injury among gymnasts, thereby offering meaningful clinical implications. This is an observational, cross-sectional study. Participants will continue their regular gymnastics training routines without any intervention assigned by the investigators. Data collection will consist solely of measurements (vertical jump, balance, muscle strength, flexibility, and foot posture). No exercise program, treatment, or intervention will be applied as part of the study.

Abdominal Muscle Strengthening for Menstrual Symptoms in Primary Dysmenorrhea

This randomized controlled trial aims to investigate the effects of abdominal muscle strengthening exercises using a stabilizer pressure biofeedback device on menstrual symptoms and abdominal muscle strength in young women with primary dysmenorrhea. Primary dysmenorrhea, characterized by painful menstrual cramps without underlying pelvic pathology, is common among women of reproductive age and can negatively affect quality of life. In this study, 58 female participants aged 18-25 with regular menstrual cycles and a Visual Analog Scale (VAS) pain score of ≥4 will be randomly assigned to either an intervention group or a control group. The intervention group will perform abdominal strengthening and stretching exercises guided by a stabilizer pressure biofeedback device, three times per week for 6 weeks (excluding menstruation weeks). The main outcomes include menstrual symptom severity (assessed by the Menstrual Symptom Scale), pain intensity (VAS), and abdominal muscle strength (measured using the stabilizer pressure biofeedback device). The results will help determine whether targeted abdominal muscle training can reduce menstrual symptoms and improve muscle strength in women with primary dysmenorrhea.

Influence of Strength Training on Myopia Care in Kindergarten Children

With the advancement of technology and changes in lifestyle, the physical activity levels of modern children have gradually decreased. This affects their physical health, psychological development, and social skills, and may increase the risk of nearsightedness. Therefore, it is essential to implement muscle training and outdoor activities in schools, travel agencies, and kindergartens. This project aims to promote the comprehensive development of children through systematic muscle training and enhanced outdoor activities, integrating college students from early childhood education programs, travel agencies, and kindergartens to establish habits that prevent nearsightedness. In the kindergarten setting, 60 children in the senior class will serve as the control group, while another 60 will be in the intervention group. The intervention group will participate in 10 weeks of muscle training and outdoor activities, including core exercises 3 times a week for 60 minutes each session from 4pm to 6pm. Additionally, there will be subsidized a total of 2 outdoor activities on weekends. This approach will not only improve the children's coordination and flexibility but also enhance their physical fitness. Regarding travel agencies, tailored outdoor activities specifically designed for young children can be created, such as ecological explorations and wilderness survival training, allowing children to enjoy the fun of movement and learning in a safe environment. Travel agencies should collaborate with educational institutions to provide professional guidance and safety assurances, giving parents peace of mind. For kindergartens, a comprehensive outdoor activity plan should be established, regularly organizing sports days and group competitions to encourage children to participate in team sports like soccer and relay races. This not only helps improve the children's muscle strength but also fosters their spirit of cooperation and social skills. Through these methods, we aim to effectively increase children's activity levels, promote their overall development, and reduce the risk of nearsightedness.