Journal of Health and Rehabilitation Research

Association Between Vitamin D Deficiency and Chronic Musculoskeletal Pain Among Adults: An Analytical Study

2026-05-31T06:53:48+00:00

Background: Vitamin D deficiency has emerged as a clinically significant contributor to chronic musculoskeletal pain, functional limitation, and impaired rehabilitation outcomes. Low serum 25-hydroxyvitamin D [25(OH)D] levels may influence pain sensitization, skeletal muscle function, and inflammatory pathways, yet evidence regarding its association with persistent musculoskeletal symptoms remains inconsistent across populations. Objective: To determine the association between vitamin D deficiency and chronic musculoskeletal pain among adults and to identify predictors of poor clinical outcome in patients presenting to rehabilitation and orthopedic services at Riphah International University, Lahore, Pakistan. Methods: A hospital-based analytical observational study was conducted among 178 adults with chronic musculoskeletal pain. Demographic, clinical, and laboratory data were collected using structured assessment protocols. Pain severity was evaluated using the Visual Analog Scale (VAS), while serum 25(OH)D levels were measured using standardized biochemical methods. Vitamin D deficiency was defined as serum 25(OH)D <20 ng/mL and severe deficiency as ≤10 ng/mL. Logistic regression analysis was used to identify predictors of poor clinical outcome. Results: Vitamin D deficiency was identified in 57.9% of participants, while severe deficiency was present in 17.4%. Mean baseline VAS pain score was 6.7 ± 1.9. Poor clinical outcome occurred in 35.4% of participants. Vitamin D deficiency independently predicted poor outcome (OR 2.41, 95% CI: 1.31–4.46, p = 0.004), while severe deficiency markedly increased risk (OR 3.18, 95% CI: 1.42–7.11, p = 0.002). Low sunlight exposure, sedentary lifestyle, obesity, chronic widespread pain, and higher baseline pain severity were also significant predictors. Improvement in serum vitamin D levels was associated with reduced odds of persistent symptoms (OR 0.69, 95% CI: 0.52–0.88, p = 0.005). Conclusion: Vitamin D deficiency was significantly associated with chronic musculoskeletal pain, functional limitation, and poor recovery outcomes. Incorporating vitamin D assessment and lifestyle-based interventions into rehabilitation and musculoskeletal care may improve clinical recovery and functional outcomes in affected adults.

Association Between Glycemic Control and Diabetic Peripheral Neuropathy Among Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Analytical Study

2026-05-31T07:40:55+00:00

Background: Diabetic peripheral neuropathy is one of the most common microvascular complications of diabetes mellitus and is associated with substantial morbidity, impaired quality of life, and increased risk of foot ulceration and lower-limb amputation. Chronic hyperglycemia, prolonged disease duration, and associated metabolic comorbidities contribute to progressive peripheral nerve damage and worsening neurological dysfunction. Objective: To determine the association between glycemic control and diabetic peripheral neuropathy and to identify clinical predictors of poor neuropathic outcomes among patients with diabetes mellitus. Methods: This cross-sectional analytical study was conducted at the University of Lahore Teaching Hospital and included 206 patients with diabetes mellitus. Demographic, biochemical, and clinical variables including HbA1c, duration of diabetes, body mass index, blood pressure, fasting glucose, chronic kidney disease, hypertension, smoking status, vibration perception, and monofilament test findings were assessed. Logistic regression analysis was performed to estimate odds ratios and 95% confidence intervals for predictors of poor clinical outcome. Results: The mean age of participants was 54.8 ± 12.6 years, and the mean HbA1c level was 8.4 ± 1.7%. Poor glycemic control (HbA1c ≥7.0%) was present in 70.9% of participants and was significantly associated with poor clinical outcomes (OR 2.84, 95% CI 1.52–5.31, p=0.001). Each 1% increase in HbA1c increased the odds of poor neuropathic outcome by 42% (OR 1.42, 95% CI 1.18–1.71, p<0.001). Diabetes duration ≥10 years (OR 2.36, 95% CI 1.32–4.21, p=0.004) and chronic kidney disease (OR 1.91, 95% CI 1.02–3.59, p=0.043) were also significantly associated with adverse neuropathic outcomes. Reduced vibration perception and abnormal monofilament test findings were significantly more common among patients with poor outcomes (p<0.001). Conclusion: Poor glycemic control, prolonged diabetes duration, and chronic kidney disease were significant predictors of diabetic peripheral neuropathy and adverse neuropathic outcomes. Early neuropathy screening and optimization of glycemic control may help reduce progression of neurological complications in diabetic patients.

Factors Associated With Exercise Capacity in Patients With Chronic Obstructive Pulmonary Disease

2026-05-31T07:00:27+00:00

Background: Chronic obstructive pulmonary disease (COPD) is associated with persistent airflow limitation, systemic manifestations, and progressive reduction in exercise capacity, resulting in impaired functional performance and poor clinical outcomes. Exercise intolerance in COPD is multifactorial and influenced by pulmonary dysfunction, skeletal muscle impairment, pulmonary hemodynamic abnormalities, and psychosocial factors. Objective: To determine the clinical, physiological, and psychosocial factors associated with exercise capacity and poor clinical outcomes among patients with chronic obstructive pulmonary disease. Methods: A comparative observational study was conducted among 94 COPD patients, including 47 participants in the intervention group and 47 in the control group. Baseline assessment included demographic characteristics, smoking status, body mass index, forced expiratory volume in one second (FEV1), GOLD stage, six-minute walk distance (6MWD), Borg dyspnea score, and relevant comorbidities. Clinical outcomes assessed during follow-up included change in 6MWD, dyspnea score, quality-of-life improvement, exercise intolerance, COPD exacerbation, hospitalization, and poor clinical outcome. Inferential analysis was performed using odds ratios with 95% confidence intervals. Results: The mean age was 66.4 ± 8.7 years, and 86.2% of participants were male. Mean baseline 6MWD was 431.8 ± 121.6 meters, which improved to 461.7 ± 118.4 meters during follow-up. Baseline 6MWD ≤350 meters significantly predicted poor clinical outcome (OR 2.84, 95% CI 1.15–7.02, p=0.024). Reduced forced vital capacity (OR 2.37, 95% CI 1.01–5.57, p=0.047), quadriceps weakness (OR 3.18, 95% CI 1.29–7.86, p=0.012), pulmonary hypertension or abnormal pulmonary hemodynamics (OR 3.64, 95% CI 1.22–10.89, p=0.021), and low exercise self-efficacy (OR 2.52, 95% CI 1.01–6.31, p=0.048) were also significantly associated with adverse outcomes. Intervention participation demonstrated a protective effect (OR 0.46, 95% CI 0.19–0.98, p=0.041). Conclusion: Exercise capacity impairment in COPD is influenced by multidimensional physiological, muscular, hemodynamic, and psychosocial factors beyond spirometric airflow limitation alone. Comprehensive assessment and targeted rehabilitation strategies may improve functional outcomes and reduce adverse clinical events in COPD patients

Lifestyle Adherence and Clinical Outcomes Among Hypertensive Patients at UMT University Teaching Hospital: A Cross-Sectional Study

2026-05-31T07:54:11+00:00

Background: Lifestyle modification is essential for hypertension control, yet adherence remains poor in routine clinical practice. Objective: To assess lifestyle adherence and clinical outcomes among hypertensive patients at Riphah Rehablitation Center. Methods: This cross-sectional study included 317 patients. Demographic, clinical, lifestyle adherence, disease-related knowledge, and cardiometabolic outcome variables were analyzed. Poor clinical outcome predictors were assessed using multivariable logistic regression. Results: The mean age was 64.8 ± 13.9 years, and 66.6% were female. Overall lifestyle adherence was observed in only 23.7% of participants, while 76.3% had poor clinical outcomes. LDL cholesterol was not at goal in 59.9%, BMI was not at goal in 79.8%, and inadequate physical activity was reported by 65.6%. Independent predictors of poor clinical outcome included age ≥65 years, diabetes mellitus, metabolic syndrome, poor disease-related knowledge, and family history of cardiometabolic disease. Secondary or higher education and income above the median were protective factors. Conclusion: Poor lifestyle adherence and adverse clinical outcomes were highly prevalent among hypertensive patients. Structured lifestyle counseling, patient education, and targeted cardiometabolic risk management are needed to improve hypertension outcomes

Effectiveness Of Cardiac Rehabilitation On Clinical Outcomes And Functional Recovery After Myocardial Infarction: A Quasi-Experimental Study

2026-05-31T07:36:58+00:00

Background: Myocardial infarction remains a major cause of morbidity, recurrent hospitalization, impaired functional recovery, and reduced quality of life despite advances in acute cardiovascular management. Cardiac rehabilitation has emerged as an important secondary prevention strategy aimed at improving exercise tolerance, cardiovascular recovery, and long-term clinical outcomes after myocardial infarction. Objective: To evaluate the effectiveness of cardiac rehabilitation on functional recovery and clinical outcomes among patients after myocardial infarction compared with usual care. Methods: A quasi-experimental study was conducted among 94 patients recovering after myocardial infarction, including 47 patients enrolled in cardiac rehabilitation and 47 receiving usual care. Baseline demographic, clinical, and functional characteristics were recorded, including left ventricular ejection fraction, exercise capacity, and cardiovascular comorbidities. Clinical outcomes assessed included poor clinical outcome composite, major adverse cardiovascular events, rehospitalization, recurrent angina, arrhythmia, mortality, follow-up exercise capacity, and EQ-VAS health status score. Inferential analysis was performed using odds ratios with 95% confidence intervals and p-values. Results: The mean age of participants was 58.9 ± 10.8 years, and 74.5% were male. Cardiac rehabilitation participation was associated with significantly lower odds of poor clinical outcomes (OR: 0.38; 95% CI: 0.14–0.96; p=0.041) and reduced rehospitalization rates (10.6% vs 27.7%; p=0.032). Rehabilitation participants demonstrated significantly higher follow-up exercise capacity (8.0 ± 1.9 vs 6.2 ± 1.8 METs; p<0.001), improved left ventricular ejection fraction (49.5 ± 11.6% vs 44.1 ± 12.2%; p=0.029), and higher EQ-VAS health status scores (79.8 ± 15.4 vs 68.6 ± 17.2; p=0.004). Improvement in exercise capacity of at least 2 METs independently demonstrated a protective association against adverse outcomes (OR: 0.31; 95% CI: 0.10–0.89; p=0.030). Conclusion: Cardiac rehabilitation after myocardial infarction was associated with improved functional recovery, enhanced quality of life, and lower odds of adverse cardiovascular outcomes compared with usual care. These findings support broader implementation of structured rehabilitation programs as an integral component of secondary prevention after myocardial infarction