Relationship between caregiver related factors and their proxy report of quality of life of children with cerebral palsy in Kano City, Nigeria

Background: Caregivers have intimate knowledge of their children and can provide reliable information on their quality of life (QoL). Objective: This study assessed the factors that could influence caregiver report of QoL of children with Cerebral Palsy.Methods: The cross-sectional survey recruited 30 caregivers and children diagnosed with CP using purposive sampling technique. QoL was assessed with CP-QoL questionnaire, depression with Patient Health Questionnaire (PHQ-9) and functional level with Gross Motor Function Classification System (GMFCS). Socio-demographic data and perceived stress were assessed with a pro-forma. The data were summarised with descriptive statistics and analysed with Spearman Rank Order correlation at alpha level of 0.05. Results: The mean age of caregivers and that of children with CP were 34.40 ± 7.02 years and 7.23 ± 2.08 years respectively. The mean QoL score was 60.06±4.27. The ‘social well-being and acceptance’ (75.07 ± 9.52) and ‘Access to services’ (66.65±7.87) domains have the highest mean scores. Marital status has significant relationship with proxy report of children’s overall QoL (Rho=0.40; P<0.05) and caregiver depression (Rho=-0.414; P<0.05). Conclusion: Children with CP in Kano City have moderate QoL. Proxy report of overall QoL was significantly related to marital status with married caregivers’ more likely to report better QoL. Child’s functional status, caregivers’ age and their level of income have also influenced the proxy report of some QoL domains. Researchers should always endeavor to compare parents’ and children’s reports in order to obtain a more accurate measure of children’s QoL.

Review of Cerebral Palsy Cases in the University Of Nigeria Teaching Hospital Ituku-Ozalla, Enugu

Background: Cerebral palsy (CP) is a major cause of childhood disability. The objective of this study was to review the causes, types, complications, demographic and clinical characteristics of children with CP over a period of ten years as seen in the physiotherapy (PT) department of the University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu, Nigeria.Methods: A retrospective study that reviewed a total of 497 case folders of children with CP. Ethical clearance was obtained from the Health Research Ethics Committee of the University of Nigeria Teaching Hospital, Enugu. The case records were randomly selected, a data retrieval form developed through a two-stage process was used to obtain the required information. Data was analyzed using descriptive statistics and Chi-square tests. Level of significance was set at 0.05.Results: Four hundred and ninety-seven cases of children with CP were reviewed. Birth asphyxia (29.9%) and jaundice (28.7%) were the leading causes of CP while spastic CP (56.7%) was the most common type. Motor disorder (67.0%) was the predominant clinical presentation. There was a significant association between type of CP and each of cause (X2 =28.303, p = 0.001), and duration of PT treatment (X2 =31.784, p < 0.0001).Conclusion: It was concluded that Birth asphyxia and jaundice are the major cause of CP in this environment. There is a significant association between type of CP and the cause of CP as well as the duration of PT treatment received.Keywords: Review; Cerebral Palsy; Hospital

A descriptive study on work related musculoskeletal disorders (WMDs) among physiotherapy practitioners in Kigali city: prevalence, risk factors and preventive strategies

Background: Work related Musculoskeletal Disorders (WMSDs) represent a significant occupational problem among physiotherapy practitioners worldwide; however, data on this problem are sparse in Rwanda.Objective: To identify the prevalence, risk factors and preventive strategies for WMSDs among physiotherapists in Kigali-Rwanda.Methods: A cross-sectional descriptive quantitative design was used. A self-administered questionnaire was used among 49 physiotherapists. Data were analysed using the descriptive statistics. Ethical clearance was obtained from the IRB of University of Rwanda, College of Medicine and Health Sciences.Results: The prevalence of WMSDs among physiotherapists in Kigali was 77.8%. The lower back was the most affected body part (77.1%). Forty percent experienced WMSDs in their first one to five years of experience. Working in the same positions for long periods (40.0%) and treating excessive number of patients per day (31.1%) were the most perceived risk factors. The commonest identified preventive strategies were to avoid sitting or standing for long periods of time 77.8% and adjust plinth or bed height 77.8. Only 31.1% stopped patients’ treatment if it caused or aggravated their WMSDs.Conclusion: The prevalence of WMSDs among physiotherapists in Kigali was high. Risk factors have been identified and vaious preventive strategies have been suggested by physiotherapists themselves and should be applied.

Effectiveness of static and intermittent cervical tractions in the management of patients with chronic non-specific neck pain: A pilot randomised trial

Background: Physiotherapists commonly employ cervical traction for patients with neck pain. There is a dearth of literature on the effects of static and intermittent cervical traction on pain, range of motion and disability among patients with chronic non-specific neck pain. Therefore, this study aims to compare the effect of static and intermittent cervical traction on pain, disability and range of motion among patients with chronic, non-specific neck pain.Methods: Twenty-four participants were randomised into two groups – Static and Intermittent cervical traction respectively. They were recruited from the Aminu Kano Teaching Hospital and the National Orthopaedic Hospital in Dala-Kano, Kano. Both groups received exercises and infrared treatment, in addition to Static and Intermittent cervical traction. Outcomes were assessed at the baseline and at the end of six weeks of intervention. Pain was assessed through the use of a Visual Analogue Scale, neck disability through a Neck Disability Index questionnaire and cervical range of motion with a goniometer. Data was analysed using descriptive and inferential statistics, and alpha was set at <0.05.Results: The mean ages of the participants were 46.00±7.81 and 36.00±15.02 for the groups Static and Intermittent respectively. Both groups were comparable at baseline (p>0.05). Both Static and Intermittent cervical traction was effective in reducing the disability (p<0.05) and pain (p<0.05). There was no significant difference between the groups at six weeks in terms of pain, disability and range of motion (P>0.05).Conclusion and recommendation: Both Static and Intermittent cervical traction effectively manages chronic, non-specific neck pain and neither is superior to the other.

Factors promoting Proficiency in Cardiorespiratory Physiotherapy Practice in Nigeria.

Background: Cardiorespiratory physiotherapy specialty practice is one of the specialty areas in physiotherapy experiencing gradual development in Nigeria with more practitioners undergoing specialisation training programmes in it.Objective: This paper therefore attempts to describe the factors that influence proficiency of physiotherapy specialists in cardiorespiratory care practice in Nigeria as there is currently no such document in Nigeria and possibly Africa.Methods: The study adopted a descriptive qualitative design using a self-structured and validated questionnaire. The participants were physiotherapists from various health institutions in Nigeria who gathered for continuous professional development (CPD) training programmes in cardiorespiratory practice. 82 properly filled of the 87 questionnaire forms administered were retrieved from participants who included 49 males and 33 females of varying age and practice years of experience (YoE). Descriptive and inferential statistics were used to explore the data obtained using SPSS. Alpha level was set at 0.05.Results: The results of the study showed that age(r=0.862, p<0.05) and gender (r=0.146, p<0.005) of cardiorespiratory physiotherapy practitioners do not significantly influence their proficiency in practice while YoE (r=0.000, p<0.05), institutions of practice (r=0.001, p<0.05) and attendance of CPD programmes have significant association with practitioners’ proficiency in terms of familiarity with cardiorespiratory devices (r=0.032, p<0.05) and assessment of patients with cardiorespiratory problems(r=0.000, p<0.05).Conclusion: It is concluded that proficiency in cardiorespiratory physiotherapy is majorly influenced by factors such as institution of practice and participation in CPD training programmes in the specialty area. YoE in cardiorespiratory care also has promotive influence on familiarity of practitioners with intensive care devices.

Prevalence of Pes Planus and Its Associated Factors Among Primary School Pupils Aged 8-12 Years in Southeast Nigeria

ABSTRACTBackground: Footprints of hominoids already demonstrated the existence of a plantar arch 3.7 million years ago, and, during human evolution, feet and not hands experienced extraordinary changes. The arch index is useful in determining the prevalence of pes planus and possibly predicting pathologic foot conditions, and it may serve as warning signs of structural and functional defects of the foot in a given population.Objective: The purpose of this study was to evaluate the plantar arch index using the staheli`s evaluation method and determined the point prevalence of pes planus and its association with sex difference, BMI, type of footwear and using footwear early in life.Method: This ex-post facto study involved 352 (150 males and 202 females) apparently health primary school pupils aged 8-12 years in southeast Nigeria who volunteered to participate in the study. The participants` biodata were obtained and their footprints collected with the ink method. Footprints were traced and selected foot dimensions measured on the footprints. Plantar arch index of each foot was calculated using the staheli`s formula; PI=A/B, where PI= plantar arch index, A= central region of the footprint and B= heel region of the footprint. Data collected were summarized and analysed with descriptive statistics of mean, standard deviation, percentage, chi-square and independent t-test, alpha level was set at 0.05Results: Mean age of participants was 10.28±1.26 while the mean body mass index was 17.60±2.81.The findings of this study revealed a low prevalence of pes planus (7.1%) in the population under study with males having slightly higher prevalence (4.3%) than females (2.8%). This study also found no significant association between sex difference and pes planus (p= 0.114), no significant association between type of footwear and pes planus (p= 0.314), but it found a significant association between BMI and pes planus (p= 0.039).The study also reveal that type of first footwear, type of frequent footwear, type of school footwear, type of home footwear and early footwear were not significantly associated with occurrence pes planus p=0.205, p=0.170, p=0.819, p=0.062 and p= 0.714 .Conclusion: The findings of this research shows that the prevalence of pes planus in the age group studied is not high and not of any health concern. Keywords: Staheli index, BMI, pes planus, footwears, pupils

Evaluation of the Perception and Participation in Continuing Professional Development Among Physiotherapists in South-Western, Nigeria

BACKGROUND: Continuing Professional Development (CPD) programmes are important components of professional training to maintain competence. In spite of the documented relevance of CPD on professional development, it remains unclear as to the level of participation or perception of physiotherapists in CPD activities.OBJECTIVE: This study aimed to provide insight into perception, participation and barriers towards CPD among physiotherapists in south-western Nigeria.METHODS The study was an analytical cross-sectional survey involving 143 physiotherapists. All subjects were evaluated using a 27 item questionnaire that sought information on bio data, clinical practice issues, perception, participation, and barriers regarding CPD. Data was analysed using SPSS version 20 and summarised using descriptive statistics of mean, standard deviation, bar charts, pie charts and tables. Spearman’s Rank Order was used to find the relationship between variables.RESULTS: The reported experience of the respondents showed that forty-five (31.50%) of the participants had worked for less than five years while 41(28.70%) had worked for more than 10 years. A significant number of physiotherapists showed good attitude towards CPD. 88.70% recognized CPD as an integral aspect of being a modern health care, 81.90% reported that CPD is another perspective of clinical effectiveness, 77.60% also accept that CPD incorporates clinical proficiency into clinical practice. 94% of the respondents have engaged in CPD since graduation with majority doing less than 5 CPD courses yearly. There was a significant relationship between number of CPD courses taken yearly and the professional cadre of the respondents (p=0.002). Majority, (37.6%) of the respondents identified financial constraint and lack of CPD in area of interest (21.6%) as well as lack of motivation (16%) as constraints to participation in CPD programmes.CONCLUSION: Physiotherapists demonstrated positive attitudes towards CPD. Financial Constraints, lack of CPD in area of interest as well as lack of motivation were identified as main barriers at practice facilities, thus stressing the need to motivate healthcare personnel in their quest to improve skills. There should be need for reforms to develop targeted and cost-effective CPD programmes to improve professional competence and emphasis on some informal forms of CPD that would be easier to engage in depending on the learning objectives of the professionals.

Opportunities for Physiotherapists in Primary Health Care in Nigeria

Summary: This paper examines the concept, strength and weakness of Primary health care system (PHC) program in Nigeria, the opportunity and potential roles for physiotherapists in PHC delivery system as well as the perceived benefits of integrating physiotherapy profession into PHC delivery system in Nigeria.Currently, physiotherapy services are available at the big cities in the urban areas of the country, thus denying the myriads of people that might need the service that could not get to the big cities either due to their health conditions or due to financial incapacitation. Emphasis for the greater involvement of physiotherapists in PHC further arose from the fact PHC system in Nigeria is not yet adequately sensitized to promoting preventative measures needed to combats chronic non communicable diseases, the health care needs of the elderly and those of the people living with disability (PLWD).In conclusion, the paper recommendsa need for an urgent reform of the mode and delivery of PHC in Nigeria with emphasis on integrating physiotherapists and other relevant health care professionals and with enhancement of intersectoral/ interdisciplinary collaborations. This integration will undoubtedly increase health care providers’satisfaction and improve patients’ outcome in both acute and chronic care settingsKeywords: Primary Heath Care, Physiotherapy

Effect of Aerobic Exercise on the Functional Capacity and Health Status of Individuals Living With HIV/AIDS in Kano, Nigeria

Background: The Human Immune-deficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) and its associated complicationshas continued to be a major challenge to the health systems despite the use of alternative therapies. People living with HIV/AIDS (PLWHA) are known to suffer from functional impairments and health status among several other comorbidities requiring intervention. This present study was undertaken to investigate the effect of aerobic exercise on functional capacity and QOL in PLWHA.Methods: Thirty PLWHA(20 males; 10 females [35.3±7.98 years] from two tertiary hospitals in KanoState, Nigeria participated in this study. The participants were randomly assigned to either experimental or control groups. All participants were on their respective conventional anti-retroviral therapies (ART) medications. Those in experimental group received aerobic exercise training for 6 weeks in addition to the ARTs. The study focused on two outcomes; functional capacity and health status, whichwere measured prior to and after 6 weeks for each participant. Functional capacity was assessed using 6 minute walk distance (6MWD), while health status was determined using the short form (SF) 36 questionnaire separately for physical and mental component scores (PCS/MCS). Descriptive statistics and inferential statistics were used analyze the results. Probability values was significant at 0.05 alpha level.Results: The participants had a mean height, weight and body mass index (BMI) of1.64±0.07metres(m), 71.1±7 kilograms(kg) and 24.6±2.95kg/m2, respectively.The baseline parameters of physical characteristics (except for weight) and study outcomes between the experimental and control groups were comparable (p>0.05).The results also shows that aerobic exercises significantly increased the values for the 6MWD and the scores of PCS and MCS (p<0.05).Conclusion: It was concluded that aerobic exercise is beneficial forthe functional and health outcomes among PLWHA.Key words: HIV/AIDS, Quality of Life, Functional Capacity

Perceived stress and its relationship with the body composition of undergraduate students of a medical college in Nigeria.

Background: Stress among medical undergraduates has been reported to be on the increase with subsequent tendency towards obesity. However, the association between perceived stress and body composition has yet to be determined.Objective: This cross-sectional study was undertaken to determine the relationship between perceived stress and body composition among undergraduates of the College of Medicine, University of Lagos, Nigeria.Methods: Three hundred and twenty-nine apparently healthy undergraduates (165 males and 164 females) with ages between 17 to 35 years participated in the study. Physical characteristics such as weight, height, body mass index (BMI), and body composition indices were measured using standard procedures. Questionnaires were administered to assess the levels of perceived stress of the participants. The data were analyzed using mean, standard deviation and Spearman’s Correlation Coefficient analysis.Results: The mean stress level was low (27.33 ± 10.60). There were significant relationships between the body composition indices and perceived stress with visceral fat having the strongest relationship (p = 0.004) while BMI had the least correlation (p = 0.037). There were also significant relationships between age, gender and body composition indices. The percentage muscle mass, visceral fat, and body fat had significant relationships with the gender of the participants.Conclusion: Visceral fat, BMI, and percentage muscle mass increased with an increase in perceived stress level, and females had a lower level of perceived stress than males.