Nigerian physiotherapists’ perceptions of their profession’s prestige and implications

AbstractThis study investigated Nigerian physiotherapists’ perceived prestige of their profession relative to 11 selected occupations and how their perception was influenced by selected sociodemographics. A total of 368 copies of a questionnaire adapted from a previous study were sent to registered physiotherapists working in Nigeria as of May 2007. Data were analysed using Chi-square, Kendall’s W, and multidimensional scaling analysis. Two hundred sixty copies of the questionnaire were completed and returned (70.7% response rate). Respondents included 161 men (62%) and 99 women (38%). Most of them (78.5%) were aged between 20 years and 39 years and were bachelor degree holders (67.2%). Physiotherapy was ranked second on level of education, third on usefulness to the society, fifth on level of responsibility, sixth on social standing, and seventh on income. Physiotherapy was rated fifth overall. The only sociodemographic variable that significantly influenced overall perceived occupational prestige of physiotherapy was type of workplace. Physiotherapists in Nigeria perceived their profession as having moderate occupational prestige, placing it in the fifth position below accountant, lawyer, doctor, and engineer. Physiotherapists in Nigeria need to work hard on improving the prestige standing of their profession

Development and effectiveness testing of a mobile health education package for stroke prevention among stroke survivors

Background: Addressing limited stroke literacy among stroke survivors based on social cognitive theory, using trending Mobile Health (m-health) devices can be a valuable interventional approach to reduce secondary stroke risk. Objectives of this study were to develop and test effectiveness of m-health based educational package for stroke prevention among stroke survivors. Method: This was a multimodal methodology involving content development and effectiveness testing using Delphi protocol and pre-test and post-test design respectively. Role shifting involved a physiotherapist administering stroke prevention education. Development comprised items selection, rating and retention; script writing, translation and recording into an audio and video educational packages. Effectiveness testing involved 30 consenting, consecutively assigned SSVs in each of audio (AIG) and video (VIG) intervention group. Stroke literacy was assessed at baseline, 2nd and 4th week post-intervention. Data was summarized using descriptive and inferential statistics at p<0.05 Alpha value. Results: Participants were majorly males (63.3%), over 60 years old (51.7%), hypertensive (83.3%) and had tertiary education (31.7%). Knowledge of stroke risk factors improved between AIG and VIG from baseline (11 23 ± 4 01 and 10.07 ± 3.24) to 2nd week (17 73 ± 0.78 and 15.30 ± 1.78) and 4th week (17.97 ± 0.18 and 16.77 ± 1.01) post-intervention respectively. There were significant differences between the two groups (p<0.01). Conclusion: Mobile health education based on social cognitive theory effectively improves stroke literacy among SSVs and should be tested among larger samples in the community

Cross-cultural adaptation and psychometric evaluation of the Yoruba version of Oswestry disability index.

INTRODUCTION:Low-Back Pain (LBP) is a common public health problem that is often worsened by maladaptive beliefs and disability. Thus, necessitating the need for availability of outcome measures to assess these sequelae among patients with chronic LBP. This study aimed to cross-culturally adapt and determine the psychometric properties of the Yoruba version of the ODI (ODI-Y). METHODS:The ODI-Y was cross-culturally adapted following the process involving forward translation, synthesis, backward translation, expert review, and pilot testing. Internal consistency and test-retest reliability of the ODI-Y were determined using the Cronbach's alpha and intra-class correlation. Other psychometric properties explored included the factor structure, convergent validity, standard error of measurement and the minimal detectable change. RESULTS:One hundred and thirty-six patients with chronic LBP took part in the validation of the ODI-Y; 86 of these individuals took part in the test-retest reliability (within 1-week interval) of the translated instrument. The mean age of the respondents was 50.5±10.6years. The ODI-Y showed a high internal consistency, with a Cronbach's alpha (α) of 0.81. Test-retest of the Yoruba version of the ODI within 1-week interval yielded an Intra-Class Correlation coefficient of 0.89. The ODI-Y yielded a three-factor structure which accounted for 61.56% of the variance. Correlation of ODI-Y with the visual analogue scale was moderate (r = 0.30; p = 0.001). The standard error of measurement and minimal detectable change of the ODI-Y were 2.0 and 5.5. CONCLUSIONS:The ODI was adapted into the Yoruba language and proved to have good psychometric properties that replicated the results of other obtainable versions. We recommend it for use among Yoruba speaking patients with LBP

Validity and reliability of a Nigerian-Yoruba version of the stroke-specific quality of life scale 2.0

Abstract Background Psychometric evidence is necessary to establish scientific integrity and clinical usefulness of translations and cultural adaptations of the Stroke-Specific Quality of Life (SS-QoL) scale. However, the limited evidence on psychometrics of Yoruba version of SS-QoL 2.0 (SS-QoL(Y)) is a significant shortcoming. This study assessed the test-retest reliability, internal consistency, convergent, divergent, discriminant and known-group validity of the SS-QoL(Y). Methods Yoruba version of the WHOQoL-BREF was used to test the convergent and divergent validity of the SS-QoL(Y) among 100 consenting stroke survivors. The WHOQoL-BREF and SS-QoL(Y) was administered randomly in order to eliminate bias. The test-retest reliability of the SS-QoL(Y) was carried out among 68 of the respondents within an interval of 7 days. All respondents were purposively recruited from selected secondary and tertiary health facilities in South-west Nigeria. Data were analysed using descriptive statistics of mean and standard deviation, and inferential statistics of Spearman correlation, Cronbach’s alpha, Intra-class Correlation Coefficient (ICC), Independent t-test and One-way ANOVA. Alpha level was set at p < 0.05. Result The physical health, psychological health, social relationship and environment domains on WHOQoL-BREF with correlation coefficient that ranged from 0.214 to 0.360 showed significant correlation with similar domains on SS-QoL(Y). Dissimilar domains between the two scales had r values from 0.035 to 0.366. Discriminant validity of SS-QoL(Y) showed that items’ r value ranged from 0.711 to 0.920 with their hypothesized domains. The scale demonstrated moderate to strong test-retest reliability with Intra-class correlation coefficient (ICC) for the domains and overall scores (r = 0.47 to 0.81) and moderate to high internal consistency (Cronbach’s alpha =0.61 to 0.82) for domains scores. These correlations were also significant for the domains and overall scores (p < 0.05). There were no significant differences across different age groups or gender for the domains or overall scores of SS-QoL(Y). Conclusions Discriminant and known-group validity, test-retest reliability and internal consistency of the Yoruba version of the Stroke Specific Quality of Life 2.0 are adequate while the convergent and divergent validity are low but acceptable. The SS-QoL(Y) is recommended for assessing health-related quality of life among Yoruba stroke survivors

Effectiveness of three modes of kinetic-chain exercises on quadriceps muscle strength and thigh girth among individuals with knee osteoarthritis

Abstract Background The study was designed to evaluate and compare the effectiveness of 12-week open, closed and combined kinetic-chain exercises (OKCE, CKCE and CCE) on quadriceps muscle strength and thigh girth of patients with knee osteoarthritis (OA). Method The randomized clinical trial involved ninety-six consecutive patients with knee OA who were randomly assigned to one of OKCE, CKCE or CCE groups. Participants’ static quadriceps muscle strength (SQS), dynamic quadriceps muscle strength (DQS) and thigh girth (TG) were assessed using cable tensiometer, one repetition method and inelastic tape measure respectively at baseline and at the end of weeks 4, 8 and 12 of study. Results The three groups were comparable regarding their demographic and dependent variables at baseline; there was significant time effect (p  0.05) for all three measures. Changes in SQS, DQS and TG between baseline and week 12 were also not significantly different (p > 0.05) among the three groups. Conclusion All three exercise regimens are effective and demonstrate similar effects on quadriceps muscle strength and muscular trophism. Trial registration NHREC/05/01/2008a . Registered 20th March, 2014 Retrospectively

Prevalence and Pattern of Symptomatic Knee Osteoarthritis in Nigeria: A Community-Based Study

Purpose: Osteoarthritis (OA) is a leading cause of disability, affecting 60-70% of people aged ≥60 years. Community-based prevalence estimates of OA in Nigeria are not readily available for referencing. This study investigated the prevalence and pattern of knee OA in Igbo-Ora, a rural community in Southwestern Nigeria. Methods: A total of 1044 adults (487 males, 557 females) aged ≥ 40 years in Igbo-Ora were recruited into this door-to-door survey through multi-stage cluster sampling. Knee OA was diagnosed using the American College of Rheumatology (ACR) clinical criteria. Knee OA severity was assessed using the Lequesne Algofunctional Index and interference with role performance was rated by participants who met the ACR criteria. Plain radiographs of a multiphase sample of 15 participants with Knee OA were taken. Data was analysed using percentages and Chi square. Results: Two hundred and five (119 females, 86 males) out of the 1044 participants fulfilled the ACR criteria, giving a point prevalence of symptomatic knee OA of 19.6%. The prevalence of knee OA was 21.4% among the females and 17.5% among the males, giving a female bias in the ratio of 1.2:1. Prevalence increased and was significantly associated (P\u3c 0.001) with age. Most participants (98.5%) had moderate-extremely severe disease and knee OA interfered with role performance in 90.2% of participants. All radiographs showed signs consistent with OA. Conclusion: One out of every five adults aged ≥40 years in this Nigerian rural community has symptomatic knee OA, with a female preponderance in the ratio of 1.2:1

Informal caregiving burden and perceived social support in an acute stroke care facility

Abstract Background Providing informal caregiving in the acute in-patient and post-hospital discharge phases places enormous burden on the caregivers who often require some form of social support. However, it appears there are few published studies about informal caregiving in the acute in-patient phase of individuals with stroke particularly in poor-resource countries. This study was designed to evaluate the prevalence of caregiving burden and its association with patient and caregiver-related variables and also level of perceived social support in a sample of informal caregivers of stroke survivors at an acute stroke-care facility in Nigeria. Methods Ethical approval was sought and obtained. Fifty-six (21 males, 35 females) consecutively recruited informal caregivers of stroke survivors at the medical ward of a tertiary health facility in South-Southern Nigeria participated in this cross-sectional survey. Participants’ level of care-giving strain/burden and perceived social support were assessed using the Caregiver Strain Index and the Multidimensional Scale of Perceived Social Support respectively. Caregivers’ and stroke survivors’ socio-demographics were also obtained. Data was analysed using frequency count and percentages, independent t-test, analysis of variance (ANOVA) and partial correlation at α =0.05. Results The prevalence of care-giving burden among caregivers is 96.7% with a high level of strain while 17.9% perceived social support as low. No significant association was found between caregiver burden and any of the caregiver- or survivor-related socio-demographics aside primary level education. Only the family domain of the Multidimensional Scale of Perceived Social Support was significantly correlated with burden (r = − 0.295). Conclusion Informal care-giving burden was highly prevalent in this acute stroke caregiver sample and about one in every five of these caregivers rated social support low. This is a single center study. Healthcare managers and professionals in acute care facilities should device strategies to minimize caregiver burden and these may include family education and involvement

Catastrophising, pain, and disability in patients with nonspecific low back pain

Background: Attention has been drawn to examining the contributions of “catastrophising” to the prediction of pain and disability in individuals with low back pain (LBP). Objectives: This study investigated the proportion of patients with LBP who engaged in catastrophic thinking about pain and its association with pain intensity and disability. We also investigated the components of pain catastrophising that is predictive of disability. Methods: A total of 275 participants with nonspecific LBP completed the Pain Catastrophizing Scale, the quadruple visual analog scale, and the Revised Oswestry Disability Questionnaire (RODQ). The associations among pain intensity, disability, and catastrophising were investigated using t test. The components of catastrophising that best predicts disability were investigated using multiple linear regressions, and the level of significance was set at 0.05. Results: The majority (85.5%) of the participants had LBP for more than 6 weeks, with 45.5% of the participants having moderate disability and 52.7% being high catastrophisers. High catastrophisers to pain had a significantly higher rating of pain intensity (p < 0.001) and higher score on the RODQ than low catastrophisers to pain. The main components of catastrophising that predicts disability were magnification (p < 0.001) and rumination (p = 0.006). Conclusion: Clinicians should screen patients with nonspecific LBP for a heightened level of catastrophic thinking and endeavour to manage such when present

Cross-cultural adaptation and validation of the IGBO language version of the stroke-specific quality of life scale 2.0

Introduction: availability of the Stroke-Specific Quality of Life scale 2.0 (SS-QoL(E)) in Yoruba and Hausa, two of the three major indigenous languages in Nigeria have the potential to promote its uptake among these population, however, its non-availability in the Igbo languages makes its use restrictive among the south-eastern Nigerians. This study was aimed at cross-culturally adapting and assessing validity and reliability of the Igbo version of the SS-QoL. Methods: the SS-QoL(E) was cross-culturally adapted to Igbo following the American Association of Orthopaedic Surgeons’ guideline. This involved forward and back-translations, expert committee review, pretesting and cognitive debriefing interview to produce the final Igbo version, SS-QoL(I). The validity and reliability test involved 50 consenting Igbo stroke survivors. The construct validity was assessed by administering SS-QoL(E) and SS-QoL(I) on all 50 respondents, while SS-QoL(I) was re-administered at 7-day interval to assess test-retest reliability. Each scale was administered in random order. Data were analysed using Spearman’s correlation, Wilcoxon’s signed-rank test, Cronbach’s alpha, Intra-class Correlation Coefficient (ICC), independent t-test and one-way ANOVA at p<0.05. Results: respondents’ domains scores on SS-QoL(E) and SS-QoL(I) did not differ significantly except in mobility and work (r=0.58 to 0.87; p=0.001). Cronbach’s alpha was 0.69 to 0.87 for domains scores. The ICC ranged from 0.48 to 0.84, while no significant differences was found across different age groups or gender for the domains or overall scores of SS-QoL(I). Conclusion: the Igbo version of the SS-QoL has limited alterations from the original version and has moderate to excellent validity and reliability values

Opracowanie i testowanie wykonalności aplikacji do samoopieki opartej na animowanych kreskówkach w przypadku dolegliwości bólowych w dolnym odcinku kręgosłupa – badanie pilotażowe

Objectives: The use of animated cartoons for pain management is an emerging area, however, in no study has it been explored as a digital platform for the rehabilitation of low-back pain (LBP). This study was aimed to develop and evaluate the feasibility of an animated cartoon-based self-care (ACBSC) app for LBP, and to examine the correlation between the app rating parameters and patients’ pain. Methods: This 2-phase study comprised development and feasibility testing components. Development of the ACBSC app was based on Mckenzie’s Mechanical Diagnosis and Therapy (MDT) extension protocol plus back hygiene following standard iteration and prototyping process. Twenty-eight consecutive patients with chronic non-specific LBP with 'direction Preference’ for extension based on the MDT screening algorithm participated in the feasibility phase. The participants utilised the cartoon-based app thrice weekly for 2 weeks. Outcomes were assessed in terms of usability, satisfaction and user experience applying the system usability and mobile application rating scales. The Quadruple Visual Analogue Scale (QVAS) was used to assess the participants’ pain intensity. Results: On a unified scale up to 20, functionality (15.4 ± 2.41) and aesthetics 14 ± 2.00 had highest and least objective quality rating on the app parameters. Total objective and subjective quality rating of the app was 16.9 ± 1.97 and 15.6 ± 2.42, respectively. The total impact and usability scores were 24.1 ± 3.39 (out of 30) and 27.8 ± 3.09 (out of 50). Participants reported that the cartoon app for back care mostly affected mindfulness/meditation/relaxation (42.9%), increasing happiness/well-being (46.4%), leading to behavioural changes (60.7%), while targeting physical health (100%). There was no significant correlation between participants’ pain characteristics and app rating parameters (p>0.05). Conclusion: The animated cartoon-based self-care LBP app has moderate to high usability, functionality, aesthetics and quality rating, and may serve as an effective mobile-app for self-management of long-term LBP.Cele: Wykorzystanie animowanych kreskówek to rozwijający się obszar w leczeniu bólu, jednak żadne badanie nie analizowało go jako cyfrowej platformy do rehabilitacji bólu w dolnym odcinku kręgosłupa (ang. low-back pain – LBP). Badanie to miało na celu opracowanie i ocenę wykonalności aplikacji do samoopieki opartej na animowanych kreskówkach (ang. Animated Cartoon-Based Self-Care – ACBSC) dla LBP oraz zbadanie korelacji pomiędzy poszczególnymi parametrami aplikacji a bólem odczuwanym przez pacjentów. Metody: To dwufazowe badanie obejmowało komponenty opracowania i testowania. Rozwój aplikacji ACBSC oparto na protokole Rozciągania Metodą Mechanicznej Diagnozy i Terapii Mckenzie’a (ang. Mechanical Diagnosis and Therapy – MDT), oraz higienie pleców po standardowym procesie iteracji i prototypowania. Do fazy wykonalności włączono 28 kolejnych pacjentów z przewlekłym, niespecyficznym LBP z „preferencją kierunku” do rozciągania w oparciu o algorytm przesiewowy MDT. Uczestnicy korzystali z aplikacji opartej na kreskówkach 3 razy w tygodniu przez dwa tygodnie. Wyniki zostały ocenione pod kątem użyteczności, satysfakcji i doświadczenia użytkownika za pomocą skali użyteczności systemu oraz skali ocen aplikacji mobilnych. Do oceny natężenia bólu uczestników zastosowano poczwórną wizualną skalę analogową (ang. Quadruple Visual Analogue Scale - QVAS). Wyniki: Na ujednoliconej skali do 20, funkcjonalność (15,4 ± 2,41) i estetyka (14 ± 2,00) miały najwyższą i najmniej obiektywną ocenę jakości parametrów aplikacji. Całkowita obiektywna i subiektywna ocena jakości aplikacji wyniosła odpowiednio 16,9 ± 1,97 i 15,6 ± 2,42. Całkowity wynik oceny wpływu i użyteczności wyniósł 24,1 ± 3,39 (na 30) i 27,8 ± 3,09 (na 50). Uczestnicy zgłaszali, że aplikacja do pielęgnacji pleców wpływa głównie na uważność/medytację/relaks (42,9%), zwiększa uczucie szczęścia/dobrego samopoczucia (46,4%), prowadzi do zmian zachowania (60,7%) i jest ukierunkowana na zdrowie fizyczne (100%). Nie było istotnej korelacji między charakterystyką bólu uczestników a parametrami oceny aplikacji (p>0,05). Wnioski: Animowana, oparta na kreskówce aplikacja do samoopieki LBP ma umiarkowaną lub wysoką użyteczność, funkcjonalność, estetykę i ocenę jakości oraz może służyć jako skuteczna aplikacja mobilna do samodzielnego radzenia sobie z długoterminowym LBP