Pain and Prescribed Exercise Parameters are Associated with Homebased Exercise Adherence Among Community-dwelling Stroke Survivors: A Multicenter Cross-sectional Study

Objective: Adherence to a home-based exercise program (HEP) is important in the achievement of rehabilitation goals among stroke survivors. Earlier studies have measured adherence to HEPs among this population using non-specific outcome measures, which may not be suitable. In addition, the influence of prescribed exercise parameters on adherence remains unclear. This study assessed adherence to HEPs among stroke survivors using stroke-specific measures of adherence to HEP and determined its correlates. Materials and Methods: This multicenter cross-sectional study involved 125 consenting Nigerian community-dwelling stroke survivors. Data on HEP adherence, prescribed exercise parameters, patients' attitudes, perceived/encountered barriers to exercise, stroke-related characteristics, and socio-demographics were assessed. Descriptive and inferential statistics were employed. A P value of <0.050 indicated statistical significance. Results: The mean age of the participants was 60.26 +- 12.11 years. Findings showed that only approximately 35% of the participants were adherent to their HEP. Among the non-adherent group, 22% had no adherence and 43% had low adherence. The results indicated that stroke severity, pain during exercise, a number of prescribed exercises of ≥3, a number of weekly exercise sessions of ≥7, a duration of the exercise of ≥43 min, and exercise intensity of ≥5 on a 0–10 Borg's rate of perceived exertion scale were found to be related with non-adherence to the HEP (P < 0.050). Conclusion: Adherence to HEPs among Nigerian community-dwelling stroke survivors is poor. HEP adherence is associated with stroke severity, pain, and the prescribed exercise parameters. This study highlights the need to consider exercise parameters in HEP prescription to enhance patient adherence

Development and feasibility testing of a remote support application for adherence to home exercise programs: a randomized pilot study

Objectives: Poor adherence to home exercise programs (HEPs) is a significant barrier to continuity of care and eventual outcomes, thus requiring innovative mitigating approaches. This study aimed to develop and test the feasibility of a remote support application (RSA) designed to encourage adherence to HEPs. Methods: Using standard computer programing, an RSA with administrator and user interfaces was developed for mobile phone or tablet. Consenting patients receiving physiotherapy for musculoskeletal conditions (n=19) were randomly assigned into the experimental group (n=10) or the control group (n=9). The experimental group received their customized HEP reminders via the RSA, whereas the control group used conventional paper handouts for HEPs. Adherence to HEPs was assessed over 4 weeks. The feasibility of the RSA was assessed using the Mobile Application Rating Scale and System Usability Scale (SUS) questionnaires. Data were summarized using descriptive and inferential statistics. Results: The adherence rate of patients in experimental group was significantly higher than that of patients in the control group after 2 weeks [median diff.=−6.0, 95% confidence interval (CI): −8.0 to −5.0; U=5.00; Z=−3.304; P=0.001; r=0.75] and 4 weeks (median diff.=−7.0, 95% CI: −8.0 to −5.0; U=0; Z=−3.695; P<0.001; r=0.84) of intervention. The RSA had a mean SUS score of 82.53±9.04 (out of 100) and a mean app quality rating score of 75.95±4.98 (out of 95). Conclusions: The use of an RSA to improve adherence to HEPs is feasible for patients with musculoskeletal conditions

Reference values for 3-meter backward walk test among apparently healthy adults

Objective: The 3-meter backward walk (3MBW) test is an outcome performance measure to assess backward walking mobility, balance, and risk of fall. However, the lack of baseline values is a potential limitation for its use as a rehabilitation target value or predictor of outcomes. This study aimed at ascertaining a gender- and age-reference value of 3MBW and determining its correlation with sociodemographic and anthropometric variables. Methods: A total of 1,601 Nigerian healthy adults participated in this cross-sectional study. 3MBW was measured following standardized procedure on a marked 3-m floor. Anthropometric and sociodemographic parameters were taken. Data were summarized using the descriptive statistics of mean, standard deviation, and percentile (less than the 25th, between the 25th and 75th, and above the 75th percentiles were regarded as low, average, and high 3MBW, respectively). Results: From this study, less than 2.23 s and 2.60 s were regarded as low risk of fall for males and females, respectively; 2.23–3.00 s and 2.60–3.50 s were regarded as average risk of fall for males and females, respectively, while greater than 3.00–3.9 s and 3.50–3.90 s were regarded as high risk of fall for males and females, respectively. 3MBWT was significantly associated with age (r = 0.51, p = 0.001), sex (r = 0.315, p = 0.001), weight (r = 0.14, p = 0.001), BMI (r = 0.28, p = 0.001), but not height (r = −0.03; p = 0.250). Conclusion: This study provided a reference set of values according to age and gender for 3MBW in healthy individuals. Males have shorter 3MBW than females, and the time taken to accomplish 3MBW increases with age

Awareness, attitude and expectations of physiotherapy students on telerehabilitation

Background and Objective: Explosion in information technology knowledge and utilization among young people, referred to as digital natives, seems less explored in the health sector and training. This study was aimed to assess awareness, attitude and expectations of physiotherapy students on telerehabilitation. Methods: This cross-sectional survey employed systematic probability sampling technique to recruit 200 physiotherapy students. A self-developed questionnaire which was tested for its face and content validity was used to obtain data. Data was analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. Results: The mean age of the respondents was 21.2 ± 2.04 years. There was higher prevalence of moderate awareness (43%) and positive attitude towards telerehabilitation (39%). Majority of the respondents (62%) had high expectation towards future telerehabilitation products and services. There was significant association between level of awareness of telerehabilitation and age (X2 = 7.119; p = 0.001). Discussion: The responding students in this study are by age in the class of digital natives, who should be conversant with technology. This could account for the higher moderate level of awareness of telerehabilitation. However, the higher rates of negative attitude towards telerehabilitation could be attributed to prevailing barriers to its utilization in Nigeria. Nonetheless, a large percentage of the students had high expectations for the future of telerehabilitation. Conclusion: Nigerian physiotherapy students have moderate awareness and high expectation for future telerehabilitation applications. However, a larger number of them hold negative attitude towards it use

Relationship between 3-meter backward walk test and grip strength test in community-dwelling older adults

Introduction The 3-Meter Backward Walk Test (3-MBWT) is an important assessment tool used in evaluating neuromuscular control, proprioception, risk of falls and balance. On the other hand, the Hand Grip Strength (HGS) test primarily is used to measure muscular strength or maximum tension generated by one’s forearm muscles. This study aimed to assess the relationship between 3-MBWT and HGS among community-dwelling older adults. Material and methods Sixty-two community-dwelling older adults participated in this study. 3- MBWT was measured using a standardized procedure. HGS was measured in line with the guidelines of the American Society of Hand Therapists. Anthropometric variables were assessed following standard procedures. Pearson’s correlation coefficient was used to verify the correlation between 3-MBWT and HGS and the influence of socio-demographic factors on both 3-MBWT and HGS. Results The mean age was 68 ± 2 years. The mean values for 3-MBWT and HGS were 3.45 ± 0.80s and 29.58 ± 15.53kg. There was a significant correlation between 3-MBWT and HGS (r = -0.39; p = 0.002). However, there was no significant correlation between 3-MBWT and sociodemographics (p > 0.05). Similarly, there was no significant correlation between HGS and sociodemographics (p>0.05), except height (r=0.51, p<0.001). Conclusions The 3-MBWT and HGS were significantly correlated with one another. Anthropometric characteristics did not influence the 3-MBWT. On the other hand, only height and gender showed a significant influence on HGS. Therefore, both 3-MBWT and HGS may serve as useful functional outcome measures for fall predictability and frailty in older adults

Influence of neighborhood environment and social support on physical activity among patients with diabetes mellitus

This study was aimed to determine the relationship of physical activity (PA) with the neighborhood environment and social support for PA among patients with diabetes mellitus (DM). A total of 193 consenting individuals with DM attending endocrinology clinic in a Nigerian tertiary hospital participated in this cross-sectional study. The international physical activity questionnaire short form, physical activity neighborhood environment scale (PANES), and physical activity and social support scale (PASSS) were used to assess the PA level (low, moderate, and high), neighborhood environment and social support for PA, respectively. The results of bivariate analyses showed that all elements of built environment and social support were significantly associated with PA. Regression model analyses indicate that PANES score was associated with moderate (adjusted odds ratio [aOR]: 10.76; 95% confidence interval [CI]: 3.82-30.32) to high (aOR: 45.73; 95% CI: 12.14-172.27) PA. In addition, easy access to quality walking facilities (aOR: 46.53; 95% CI: 3.89-557.32; aOR: 46.13; 95% CI: 2.65-802.40) and easy access to recreation infrastructure (aOR: 46.89; 95% CI: 3.95-487.83; aOR: 17.99; 95% CI: 1.28-252.98) were associated with moderate to high PA, respectively, while safety from crime (aOR: 0.21; 95% CI: 0.07-0.64) and easy access to services and shops (aOR: 21.90; 95% CI: 1.83-262.59) were associated with moderate and high PA. Informational social support was associated with moderate PA (aOR: 1.44; 95% CI: 1.04-2.00). In conclusion, the neighborhood environmental and social support factors were associated with the PA activity level among Nigerian patients with DM

Feasibility and validity of a mobile application goniometer for assessing knee joint range of motion

Objective: To determine the feasibility and validity of Goniometer Records (GR), a mobile app goniometer for knee joint range of motion (ROM). Material & Methods: A total of 72 undergraduate physiotherapy students participated in this study. Knee flexion and extension was taken simultaneously with the Universal goniometer (UG) and GR, and the Mobile Application Rating Scale (MARS) and System Usability Scale (SUS) were used to assess the feasibility of GR. Results: The mean age of participants was 22.2 ± 1.6 years. There was a weak but significant correlation between UG and GR (r = 0.251; p = 0.030) for knee flexion but not for extension (r = 0.105; p = 0.37). The feasibility ratings of GR on MARS for all the sections were 17.6±2.7 (out of 25), 15.4±2.0 (out of 20), 11.4±1.3 (out of 15), 25.4±2.6 (out of 35), 14.8±2.2 (out of 20) and 21.2±2.1 (out of 30) for engagement, functionality, aesthetics and information respectively. Based on SUS statements about app usage, 63.9% of the respondents rated the App low. Conclusion: GR showed weak validity in knee flexion assessment but none with extension compared to UG. GR for knee ROM assessment had moderate feasibility but low usability rating

Knowledge and use of academic social networking tools among Nigerian physiotherapy educators

Abstract Background and aim The advent of academic social networking tools (ASNTs) has brought a paradigm shift to academic culture and practice dynamics; however, there is an apparent dearth of information on its adoption among health professions academics in developing countries. This study aimed to assess knowledge, use, and perceptions of ASNTs among physiotherapy educators in Nigeria. Methods This cross-sectional study involved 20 consented physiotherapy educators from five universities in South-west Nigeria offering physiotherapy degrees. A self-administered questionnaire with adequate face and content validity was employed to assess knowledge, perception, barriers, and use of ASNTs. Descriptive statistics of frequency and percentages were applied. Results A majority of the respondents had knowledge and utilized ASNTs such as Research Gate (80%), Google Scholar (80%), Google Plus (70%), LinkedIn (50%), and Academia.edu (50%). Mynetresearch (5%) and Lameresearch (5%) were not popular, while Llaslo.com, Quarzy, and Myscience.ch were not known. ASNTs were used to raise personal profiles in the research community (100%), publicize research (95%), share authorized content (85%), attract funds (65%), attract future employers (65%), and actively discuss research and discover job opportunities (45%). Electricity failure (70%), lack of infrastructural facilities (70%), unavailability of internet facilities (60%), lack of technical knowhow (45%), time constraints (45%), and personal factors (45%) were the significant barriers in utilizing ASNTs. Conclusion Nigerian physiotherapy educators were knowledgeable and adopted most ASNTs. Power failure, lack of technical know-how, infrastructural and internet facilities, and personal factors limit the utilization of ASNTs among Nigerian physiotherapy educators

Influence of body and hand anthropometric characteristics on handgrip strength in young Nigerian women

Abstract Background and aim Women are well known for having lower handgrip strength (HGS) compared to men. However, factors contributing to lower HGS in women remain unclear. This study investigated the influence of body and hand anthropometric characteristics (HAC) on HGS among young Nigerian undergraduate women. Methods Apparently healthy 500 young female adults from a Nigerian University were recruited conveniently. Age and physical characteristics were recorded. Right and left (R&L) HGS were measured using an electronic dynamometer. HAC including R&L arm girth (ArG), forearm girth (FaG), wrist girth (WrG), finger span (FSp), finger breath (FBr), finger length (FLg) and palm length (PLg) were measured. Data were analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. Results The mean age of the participants was 22.46 ± 3.72 years. Age and body mass index (BMI) contributed about 20.0 and 12.0% to the prediction of HGS, respectively. Similarly, R&L HAC: ArG, FaG, WrG, FSp, FBr, FLg and PLg contributed about 22.8 and 14.8% to the prediction of HGS, respectively. Significant correlations occurred between HGS and each of BMI, R&L HAC (p < .05). Furthermore, significant correlations were also found between age and each of R&L HAC (p < .001). Conclusions Age, BMI and HAC have significant influence on the HGS of young Nigerian undergraduate women. Hence, physical factors such as weight, height, BMI, and hand anthropometric measurements are recommended as part of routine assessment for effective rehabilitation plans in the care of women with hand disability or poor hand function

Caregivers’ Perception of Enablers and Barriers to Home Exercise Programme (Hep) Adherence Among Nigerian Stroke Survivors: a Qualitative Study

Background and objective: Stroke survivors often rely on caregivers to perform their Home Exercise Programme (HEP); however, little is known about enablers and barriers to HEP adherence from caregivers’ perspective. This study aims to explore the caregivers’ perspectives on the enablers and barriers to HEP adherence among stroke survivors. Methods: Fourteen caregivers of stroke survivors receiving physiotherapy at a Nigerian university teaching hospital were interviewed for the purpose of a qualitative study. An in-depth interview was used to explore respondents’ perspectives on enablers and barriers to HEP adherence. The gathered data was transcribed verbatim and analyzed. Results: The caregivers were mostly women (8/14) and close family members of the stroke survivors. In their opinion the main HEP adherence enablers were motivation and expectation, positive outcome and experience, availability of social support, timing, and religious beliefs. Overall health and wellness, caregiver’s schedule, negative emotions, and fear of falling were the dominant perceived barriers to HEP adherence. Conclusion: Home exercise programme adherence by stroke survivors is determined by a number of factors, including caregiver-related ones. It is necessary to pay close attention to all undercurrents of HEP adherence related to stroke survivors and their caregivers