A Telephone-based Physiotherapy Intervention for Patients with Osteoarthritis of the Knee

This study assessed the effects of a 6-week telephone based intervention on the pain intensity and physical function of patients with knee osteoarthritis (OA), and compared the results to physiotherapy conducted in the clinic. Fifty randomly selected patients with knee OA were assigned to one of two treatment groups: a clinic group (CG) and a tele-physiotherapy group (TG). The CG received thrice-weekly physiotherapist administered osteoarthritis-specific exercises in the clinic for six weeks. The TG received structured telephone calls thrice-weekly at home, to monitor self-administered osteoarthritis-specific exercises. Participants’ pain intensity and physical function were assessed at baseline, two, four, and six weeks, in the clinic environment. Within group comparison showed significant improvements across baseline, and at weeks two, four, and six for both TG and CG’s pain intensity and physical function. Between-group comparison of CG and TG’s pain intensity and physical function at baseline and weeks two, four, and six showed no significant differences. This study demonstrated that a six-week course of structured telephone calls thrice-weekly to patients at their home, to monitor self-administered osteoarthritis-specific exercises for patients with knee OA (i.e., tele-physiotherapy) achieved comparable results to physiotherapy conducted in the clinic. 

Validity and internal consistency of a Hausa version of the Ibadan knee/hip osteoarthritis outcome measure

<p>Abstract</p> <p>Background</p> <p>The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM) was developed for measuring end results of care in patients with knee or hip OA in Nigeria. The purpose of this study was to validate a Hausa translation of IKHOAM in order to promote its use among the Hausa populations of Nigeria and other West African countries.</p> <p>Methods</p> <p>Sixty-seven patients with knee OA, literate in Hausa and English, recruited consecutively from all government hospitals in Kano were assessed on both English and Hausa versions of IKHOAM. The order of assessment with the versions was randomized and separated by 24 hours. Participants also rated their pain intensity on the Visual Analogue Scale. Data was analyzed using the Spearman Rank Order correlation and Cronbach's alpha.</p> <p>Results</p> <p>The participants (17 males, 50 females) were aged 55.7 ± 13.4 years. Participants' scores on the Hausa version correlated significantly with the original version (r = 0.67, p = 0.000) and with pain intensity scores on the Visual Analogue Scale (r = -0.24, p = 0.005). The Cronbach's alpha for correlation on the different parts of the Hausa version ranged between 0.28 and 0.95.</p> <p>Conclusion</p> <p>The Hausa version of IKHOAM meets the criteria for validity and internal consistency and may be used in the Hausa speaking parts of Nigeria and other West African countries.</p

Development and structural validity of a Nigerian culture- and environment-friendly low back pain outcome measure: Ibadan Low Back Pain Disability Questionnaire

Background: Low Back Pain (LBP) is the leading cause of disability globally. Standardized outcome measures for measuring LBP disability exist but none was developed with consideration for the Nigerian culture and environment.Objective: This study was aimed to develop a Nigerian culture- and environment-friendly LBP scale, the Ibadan Low Back Pain Disability Questionnaire (ILBPDQ).Methods: Items on ILBPDQ were devised from literature review, interview of patients (231 consecutively-sampled patients with chronic non-specific LBP) and 12 professionals experienced in LBP management and were contentvalidated.The first draft of the questionnaire underwent pretesting twice among individuals with chronic non-specific LBP (n=35 and 114 respectively), factor analysis and experts’ reviews to produce the final version.Results: The final scale comprised 18 items with a two-factor structure (common Activity of Daily Living [ADL] and culture-specific ADL). It has eigen value ≥ 1 and explained 60% of variance. Items on ILBPDQ covered important constructs relevant to an average Nigerianpatient with LBP.Conclusion: A scale for assessing disability in LBP is made available for use in Nigeria and similar populations.Keywords: Low back pain, Outcome measure, Ibadan, Development, Structural validityFunding: None declare

The Clinical and Cost-Effectiveness of Telerehabilitation for People With Nonspecific Chronic Low Back Pain: Randomized Controlled Trial

Background: Telerehabilitation can facilitate multidisciplinary management for people with nonspecific chronic low back pain (NCLBP). It provides health care access to individuals who are physically and economically disadvantaged. Objective: This study aimed to evaluate the clinical and cost-effectiveness of telerehabilitation compared with a clinic-based intervention for people with NCLBP in Nigeria. Methods: A cost-utility analysis alongside a randomized controlled trial from a health care perspective was conducted. Patients with NCLBP were assigned to either telerehabilitation-based McKenzie therapy (TBMT) or clinic-based McKenzie therapy (CBMT). Interventions were carried out 3 times weekly for a period of 8 weeks. Patients’ level of disability was measured using the Oswestry Disability Index (ODI) at baseline, week 4, and week 8. To estimate the health-related quality of life of the patients, the ODI was mapped to the short-form six dimensions instrument to generate quality-adjusted life years (QALYs). Health care resource use and costs were assessed based on the McKenzie extension protocol in Nigeria in 2019. Descriptive and inferential data analyses were also performed to assess the clinical effectiveness of the interventions. Bootstrapping was conducted to generate the point estimate of the incremental cost-effectiveness ratio (ICER). Results: A total of 47 patients (TBMT, n=21 and CBMT, n=26), with a mean age of 47 (SD 11.6) years for telerehabilitation and 50 (SD 10.7) years for the clinic-based intervention, participated in this study. The mean cost estimates of TBMT and CBMT interventions per person were 22,200 naira (US $61.7) and 38,200 naira (US$106), respectively. QALY gained was 0.085 for TBMT and 0.084 for CBMT. The TBMT arm was associated with an additional 0.001 QALY (95% CI 0.001 to 0.002) per participant compared with the CBMT arm. Thus, the ICER showed that the TBMT arm was less costly and more effective than the CBMT arm. Conclusions: The findings of the study suggested that telerehabilitation for people with NCLBP was cost saving. Given the small number of participants in this study, further examination of effects and costs of the interventions is needed within a larger sample size. In addition, future studies are required to assess the cost-effectiveness of this intervention in the long term from the patient and societal perspective

Exploring the relationship between falls, fall‐related psychological concerns, and personality traits in adults : a scoping review protocol

Background and Aims: Personality traits, such as neuroticism and extraversion, are emerging as important predictors of falls. Despite their significance, existing fall prevention programs often overlook these traits, creating a notable research gap. This study aims to conduct a comprehensive scoping review to explore the existing literature on the relationships among personality traits, falls, and fall-related psychological concerns (FrPCs). Methods: This scoping review will adhere to the framework established by Arksey and O'Malley, incorporating extensions recommended by the Joanna Briggs Institute and using the PRISMA-ScR checklist. A thorough search strategy will be employed, aligning with the population, concept, and context (PCC) selection criteria. Electronic databases, including MEDLINE, APA PsycINFO, Web of Science, CINAHL, and SPORTDiscus, will be searched from their inception to the present. Additionally, a manual search of the reference lists of identified and relevant full-text articles will be conducted. Two independent reviewers will screen titles and abstracts, perform full-text reviews, and extract data from pertinent articles. Discussion: Personality traits are increasingly recognized as influential predictors of falls and related psychological concerns. This review aims to make a substantial contribution to the existing literature by being the first to comprehensively explore and provide a descriptive synthesis of the relationship between personality traits and falls, as well as FrPCs in adults. It is hoped that the outcomes of this review will enhance our comprehension of the role of personality traits in falls, potentially informing future research and strategies for this critical area of study. Scoping Review Registration: This scoping review protocol was registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/KR74X)

Comparative Efficacy of Clinic-Based and Telerehabilitation Application of McKenzie Therapy in Chronic Low-Back Pain

Studies on validation of telerehabilitation as an effective platform to help manage as well as reduce burden of care for Low-Back Pain (LBP) are sparse. This study compared the effects of Telerehabilitation-Based McKenzie Therapy (TBMT) and Clinic-Based McKenzie Therapy (CBMT) among patients with LBP. Forty-seven consenting patients with chronic LBP who demonstrated ‘directional preference’ for McKenzie Extension Protocol (MEP) completed this quasi experimental study. The participants were assigned into either the CBMT or TBMT group using block permuted randomization. Participants in the CBMT and TBMT groups received MEP involving a specific sequence of lumbosacral repeated movements in extension aimed to centralize, decrease, or abolish symptoms, thrice weekly for eight weeks. TBMT is a comparable version of CBMT performed in the home with the assistance of a mobile phone app. Outcomes were assessed at the 4th and 8th weeks of the study in terms of Pain Intensity (PI), Back Extensors Muscles’ Endurance (BEME), Activity Limitation (AL), Participation Restriction (PR), and General Health Status (GHS). Data were analyzed using descriptive and inferential statistics. Alpha level was set at p&lt; 0.05.Within-group comparison across baseline, 4th and 8th weeks indicate that both CBMT and TBMT had significant effects on PI (p=0.001), BEME (p=0.001), AL (p=0.001), PR (p=0.001) and GHS (p=0.001) respectively. However, there were no significant differences (p&gt;0.05) in the treatment effects between TBMT and CBMT, except for ‘vitality’ (p=0.011) scale in the GHS where TBMT led to significantly higher mean score. Mobile-app platform of the McKenzie extension protocol has comparable clinical outcomes with the traditional clinic-based McKenzie Therapy, and thus is an effective supplementary platform for care of patients with low-back pain

Influence of well-being and quality of work-life on quality of care among healthcare professionals in southwest, Nigeria

The Nigerian healthcare industry is bedevilled with infrastructural dilapidations and a dysfunctional healthcare system. This study investigated the influence of healthcare professionals' well-being and quality of work-life (QoWL) on the quality of care (QoC) of patients in Nigeria. A multicentre cross-sectional study was conducted at four tertiary healthcare institutions in southwest, Nigeria. Participants' demographic information, well-being, quality of life (QoL), QoWL, and QoC were obtained using four standardised questionnaires. Data were summarised using descriptive statistics. Inferential statistics included Chi-square, Pearson's correlation, independent samples t-test, confirmatory factor analyses and structural equation model. Medical practitioners (n = 609) and nurses (n = 570) constituted 74.6% of all the healthcare professionals with physiotherapists, pharmacists, and medical laboratory scientists constituting 25.4%. The mean (SD) participants' well-being = 71.65% (14.65), QoL = 61.8% (21.31), QoWL = 65.73% (10.52) and QoC = 70.14% (12.77). Participants' QoL had a significant negative correlation with QoC while well-being and quality of work-life had a significant positive correlation with QoC. We concluded that healthcare professionals' well-being and QoWL are important factors that influence the QoC rendered to patients. Healthcare policymakers in Nigeria should ensure improved work-related factors and the well-being of healthcare professionals to ensure good QoC for patients

Knowledge and perception of physiotherapy students and lecturers about the involvement of simulated patients in clinical examinations at physiotherapy training institutions in South-West, Nigeria

Background: Medical educators in Nigeria are beginning to incorporate the use of simulated patients (SPs) in clinical examinations. This study was designed to investigate and compare the knowledge and perception of physiotherapy students and lecturers about the involvement of SPs in clinical examinations at physiotherapy training institutions in South-West, Nigeria. Methods: This study used a mixed-method approach, combining cross-sectional analysis and focus group discussions. A validated questionnaire assessed the knowledge and perception of physiotherapy students and lecturers regarding SP involvement in clinical exams. Quantitative data were analyzed with descriptive statistics, chi-square, and Mann–Whitney U tests (p < 0.05). Qualitative data were analyzed using thematic analysis. Results: Two hundred and seven clinical students (83 males, 124 females, average age 22.02 ± 1.65 years) and 37 physiotherapy lecturers (25 males, 12 females, average age 48.27 ± 7.49 years) participated in this study. Among the students, 151 were aware of SP involvement in clinical exams: 35.1% had poor knowledge, 53.0% had fair knowledge, and 11.9% had good knowledge. The majority of lecturers (70.3%) demonstrated good knowledge. Most students (147, 71.0%) and lecturers (32, 86.5%) had positive perceptions of SP involvement in exams. Qualitative analysis indicated insufficient training for SPs in clinical examinations at physiotherapy training institutions in South-West Nigeria. Reported drawbacks included a preference for using models, familiarity with SPs, and limitations in the conditions that SPs can simulate. Conclusion: Physiotherapy students at physiotherapy training institutions in South-West Nigeria had fair knowledge about the involvement of SPs in clinical examinations while lecturers had good knowledge about the involvement of SPs in clinical examinations. However, both students and lecturers had a positive perception about the involvement of SPs in clinical examinations though the concept of SPs should be differentiated from the use of models

Translation and Alternate Forms Reliability of the Visual Analogue Scale in the Three Major Nigerian Languages

Purpose: Our aims were to translate the anchors on the Visual Analogue Scale (VAS) into the three major Nigerian Languages and determine the adequacy of the alternate forms reliability of the VAS in these translations. Methods: The anchors on the VAS were translated into Yoruba, Igbo, and Hausa languages by linguistic experts and taken through back translation, clinical committee review, and pre–testing. Sixty–seven Hausa, 54 Igbo, and 165 Yoruba Knee/Hip OA patients were assessed on the original and translated versions of VAS. Scores on each translated anchor of the VAS were correlated with scores on the original VAS (anchors in English language) to assess the alternate forms reliability of the VAS in these translations. Results: The subjects 31 males, 134 females [Yoruba]; 17 males, 50 females [Hausa]; and 20 males, 34 females [Igbo] were aged 56.1 + 10.1, 54.3 + 6.4 and 52.8 + 13.9 years respectively. Significant positive correlations existed between each of the translated anchors and the original English Version [r = 0.63; P\u3c 0.05 [Yoruba]; r = 0.98, P \u3c 0.05 [Hausa]; r = 0.93; P\u3c 0.05 [Igbo]. Conclusion: The VAS, when its anchors are translated into Yoruba, Hausa, and Igbo languages, is reliable and therefore recommended for use in the Nigerian clinical settings