Abstract
Lower limb disorders are a major contributor to functional disability, reduced mobility, and muscle weakness in Pakistan, necessitating effective rehabilitation strategies grounded in context-specific evidence. This review aimed to systematically evaluate the effectiveness of physiotherapy, orthotic, and combined rehabilitation interventions in improving functional mobility and muscle strength among individuals with lower limb disorders in Pakistan. A comprehensive literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework across multiple electronic databases. Following screening, eligibility assessment, and methodological appraisal, 12 studies met the inclusion criteria and were retained for synthesis. For analytical clarity, the included studies were categorized into three groups: physiotherapy-based interventions, orthotic interventions, and combined or integrated rehabilitation approaches. Evidence from physiotherapy-focused studies demonstrated statistically significant improvements in pain, functional mobility, balance, and muscle strength, across outcome measures such as WOMAC, KOOS, Timed Up and Go, Gross Motor Function Measure, gait speed, and functional strength tests. Orthotic intervention studies reported improvements in gait alignment, joint loading, range of motion, and activities of daily living; however, outcomes were inconsistent, and several studies highlighted increased fatigue, comfort-related issues, or limited functional independence when orthoses were used without active rehabilitation. Studies examining combined rehabilitation approaches consistently reported superior outcomes, including greater gains in functional strength, mobility, and quality of life, compared with single-modality interventions. Collectively, the evidence indicates that physiotherapy constitutes the primary determinant of functional recovery, while orthotic devices are most effective when prescribed as adjuncts within comprehensive, multimodal rehabilitation programs tailored to the Pakistani healthcare context.