Is Mode of Delivery a Determinant of Postpartum Health-Related Quality of Life in Nigerian Women?

Background: Women experience many changes that might affect their well‑being during the postpartum period. In some climes, there is an established association between mode of delivery (MOD) and postpartum health‑related quality of life (HRQoL), but there is a dearth of related literature in southeastern Nigeria. Such information will guide health‑care providers on health promotion strategies for improved maternal and infant well‑being. Aim: The aim of this study was to assess the influence of MOD on HRQoL of Nigerian postpartum women. Material and Methods: This was a cross‑sectional descriptive survey of 200 postpartum women in Enugu, Nigeria. Information on maternal characteristics was collected with a structured questionnaire, while the investigation of their postpartum HRQoL was with the Short Form 36 health survey questionnaire. Results: In general, the majority of the respondents had moderate HRQoL values in most domains, including physical function, bodily pain, general health (GH), energy and fatigue, social function, and perceived mental health. Values for role limitations as a result of physical and emotional problems were predominantly low. HRQoL scores did not significantly vary between the cesarean section (CS)and spontaneous vaginal delivery (SVD) groups. MOD was a correlate of respondents’ GH with women in the CS group showing lower values, as compared to those with SVD. Conclusion: In general, postpartum women in this study recorded low‑to‑moderate HRQoL scores. MOD was a determinant of their GH scores. Follow‑up interprofessional health care is recommended in the postpartum period to improve HRQoL. Keywords: Health‑related quality of life, mode of delivery, Nigeria, postpartum, women’s healt

Does Load Position on the Trunk Affect Cardiopulmonary Responses of the Bearer during Simulated Front and Back Infant Carrying Methods?

Background: The position of the infant on the trunk during back and front infant carrying methods (ICMs) may be a potential factor of maternal physiological changes. Related information is necessary for the establishment of guiding principles for infant carrying tasks. Thus, this study was carried out to evaluate cardiopulmonary responses to infant‑load positions on the trunk during simulated back and front ICMs. Materials and Methods: Twenty‑three nulliparous females completed four trials while walking with a 6 kg simulated infant, being carried in four trunk positions (upper back, lower back, upper front, and lower front). Cardiopulmonary indices (systolic blood pressure, diastolic blood pressure, respiratory rate, and heart rate) and rating of perceived exertion were assessed pre‑ and post‑trials. Results: All the cardiopulmonary indices did not change significantly (P > 0.05) as the infant load moved from upper to lower trunk positions during the back and front ICMs. However, marginal differences were observed. Participants perceived the lower back and upper front ICMs as less exerting than the upper back and lower front ICMs. Conclusions: Infant‑load position on the trunk is not an important factor in the cardiopulmonary responses to back and front infant carrying tasks, although the lower back and upper front ICMs were perceived to be more comfortable. Keywords: Back, cardiopulmonary indices, front, infant carrying, infant‑load positions, perceived exertio

Musculoskeletal imaging authority, levels of training, attitude, competence, and utilisation among clinical physiotherapists in Nigeria: a cross-sectional survey

BACKGROUND: Direct-access physiotherapy practice has led to a global review of the use of differential-diagnostic modalities such as musculoskeletal imaging (MI) in physiotherapy. OBJECTIVE: To explore the MI authority, levels of training, attitude, utilisation, and competence among clinical physiotherapists in Nigeria. METHODS: This national cross-sectional study analysed a voluntary response sample of 400 Nigerian physiotherapists that completed the online version of the Physiotherapist’s Musculoskeletal Imaging Profiling Questionnaire (PMIPQ), using descriptive statistics, Spearman’s correlation, Mann-Whitney U, Kruskal-Wallis, and Friedman’s ANOVA tests. RESULTS: Of the 400 participants, 93.2% believed that physiotherapists should use MI in clinical practice. However, only 79.8% reported having MI authority in their practice settings. The participants’ median (interquartile range) levels of training =10 (24) and competence =16 (24) were moderate. Nonetheless, levels of training (χ2 [15] = 1285.899, p = 0.001), and competence (χ2 [15] = 1310.769, p < 0.001) differed across MI procedures. The level of training and competence in x-ray referral and utilisation was significantly higher than magnetic resonance imaging, computed tomography scan, ultrasonography, scintigraphy, and dual-energy x-ray absorptiometry, in that order (p < 0.05). There was a significant positive correlation between the levels of training and competence (rho =0.61, p < 0.001). The participants had a positive attitude =32 (32) and occasionally used MI in clinical practice =21 (28). CONCLUSION: Majority of the respondents believed they had MI authority although there was no explicit affirmation of MI authority in the Nigerian Physiotherapy Practice Act. Participants had a positive attitude towards MI. However, levels of MI training, competence, and utilisation were moderate. Our findings have legislative and curriculum implications

Assessment of Range of Motion in Selected Upper Limb Joints of Patients with Type 2 Diabetes Mellitus: A Case Control

Limitation in joint mobility was recognized as the most common and earliest long-term complication of patients with type 2 diabetes mellitus. The study assessed the range of motion in selected joints of patients with type 2 diabetes mellitus and compared it with aged matched apparently healthy individuals Fifty subjects volunteered to participate in the study this comprised of 25 patients with type 2 diabetic mellitus and 25 age matched apparently healthy individuals. The range of motion of the joints of shoulder, wrist thumb, index and the middle fingers of diabetics and normal subjects were measured with a full circle universal goniometer using standard protocol. Data were analysed using descriptive and inferential statistics. Alpha level was set at 0.05 The result showed that there was significant difference between the range of motion of the measured joints; shoulder (t=-23, p=0.000), metacarpophalangeal joints of the index finger in flexion (t=7.056, p=0.000) and in extension (t=-13.548, p=0.000) in diabetics and non-diabetic subjects (p<0.005). In conclusion, limited joint mobility occurs in subjects with type 2 diabetics as one of the complications of the diseas

Assessment of Range of Motion in Selected Upper Limb Joints of Patients with Type 2 Diabetes Mellitus: A Case Control

Limitation in joint mobility was recognized as the most common and earliest long-term complication of patients with type 2 diabetes mellitus. The study assessed the range of motion in selected joints of patients with type 2 diabetes mellitus and compared it with aged matched apparently healthy individuals Fifty subjects volunteered to participate in the study this comprised of 25 patients with type 2 diabetic mellitus and 25 age matched apparently healthy individuals. The range of motion of the joints of shoulder, wrist thumb, index and the middle fingers of diabetics and normal subjects were measured with a full circle universal goniometer using standard protocol. Data were analysed using descriptive and inferential statistics. Alpha level was set at 0.05 The result showed that there was significant difference between the range of motion of the measured joints; shoulder (t=-23, p=0.000), metacarpophalangeal joints of the index finger in flexion (t=7.056, p=0.000) and in extension (t=-13.548, p=0.000) in diabetics and non-diabetic subjects (p<0.005). In conclusion, limited joint mobility occurs in subjects with type 2 diabetics as one of the complications of the disease

Porównanie Metody Przesiewowej STarTBack oraz Baterii Testów Opartych na Sprawności Fizycznej Simmonds’a w przewidywaniu ryzyka niepełnosprawności wśród pacjentów z przewlekłym bólem dolnego odcinka kręgosłupa.

Objectives This study identified disability sub-groups of patients with chronic low back pain (LBP) using the Subgroup for Targeted Treatment (or STarT) Back Screening Tool (SBST) and Simmonds Physical Performance Tests Battery (SPPTB). In addition, the study investigated the divergent validity of SBST, and compared the predictive validity of SBST and SPPTB among the patients with the aim to enhance quick and accurate prediction of disability risks among patients with chronic LBP. Methods This exploratory cross-sectional study involved 70 (52.0% female and 47.1% male) consenting patients with chronic non-specific LBP attending out-patient physiotherapy and Orthopedic Clinics at the Obafemi Awolowo University Teaching Hospitals, Ile-Ife and Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Disability risk subgrouping and prediction were carried out using the SBST and SPPTB (comprising six functional tasks of repeated trunk flexion, sit-to-stand, 360-degree rollover, Sorenson fatigue test, unloaded reach test, and 50 foot walk test). Pain intensity was assessed using the Quadruple Visual Analogue Scale. Data on age, sex, height, weight and BMI were also collected. Descriptive and inferential statistics were used to analyze data at p<0.05 Alpha level. Results The mean age, weight, height and body mass index of the participants were 51.4 ±8.78 years, 1.61 ±0.76 m and 26.6 ±3.18 kg/m2 respectively. The mean pain intensity and duration were 5.37 ±1.37 and 21.2 ±6.68 respectively. The divergent validity of SBST with percentage overall pain intensity was r = 0.732; p = 0.001. Under SBST sub-grouping the majority of participants were rated as having medium disability risk (76%), whilst SPPTB sub-grouped the majority as having high disability risk (71.4%). There was a significant difference in disability risk subgrouping between SBST and SPPTB (χ²=12.334; p=0.015). SBST had no floor and ceiling effects, as less than 15% of the participants reached the lowest (2.9%) or highest (1.4%) possible score. Conversely, SPPBT showed both floor and ceiling effects, as it was unable to detect ‘1’ and ‘9’, the lowest and highest obtainable scores. The ‘Area Under Curve’ for sensitivity (0.83) and specificity (0.23) of the SBST to predict ‘high-disability risk’ was 0.51. The estimated prevalence for ‘high-disability risk’ prediction of SBST was 0.76. The estimate for true positive, false positive, true negative and false negative for prediction of ‘high-disability risk’ for SBST were 0.77, 0.23, 0.31, and 0.69 respectively. Conclusion The Start Back Screening Tool is able to identify the proportion of patients with low back pain with moderate disability risks, while the Simmonds Physical Performance Tests Battery is better able to identify high disability risks. Thus, SBST as a self-report measure may not adequately substitute physical performance assessment based disability risks prediction. However, SBST has good divergent predictive validity with pain intensity. In contrast to SPBBT, SBST exhibited no floor or ceiling effects in our tests, and demonstrated high sensitivity but low specificity in predicting ‘high-disability risk’.Cele: W badaniu tym zidentyfikowano podgrupy niepełnosprawności pacjentów z przewlekłym bólem dolnego odcinka kręgosłupa (ang. Chronic Low Back Pain, LBP) używając Podgrupy do Ukierunkowanego Leczenia – ang. Subgroup for Targeted Treatment (or STarT), Metody Przesiewowej Badania Pleców (Back Screening Tool, SBST) oraz Baterii Testów Simmonds’a oceniających Sprawność Fizyczną (Simmonds Physical Performance Test Battery, SPPTB). Ponadto, aby przyspieszyć i dokładniej przewidzieć ryzyko niepełnosprawności wśród pacjentów z przewlekłym LBP, w badaniu zbadano trafność różnicową SBST i porównano trafność predykcyjną SBST i SPPTB u pacjentów. Metody: To przekrojowe badanie poznawcze obejmowało 70 (52,0% kobiet i 47,1% mężczyzn) pacjentów z przewlekłym niespecyficznym LBP, którzy wyrazili zgodę i uczestniczyli w fizjoterapii ambulatoryjnej, przy udziale Kliniki Ortopedycznej w Szpitalu Uniwersyteckim w Obafemi Awolowo, Ile-Ife oraz Szpitala Uniwersytetu Technologii w Ladoke Akintola, Osogbo, w Nigerii. Podgrupowanie ryzyka niepełnosprawności i prognozowanie przeprowadzono przy użyciu SBST i SPPTB (składającego się z sześciu zadań funkcjonalnych: wielokrotnego zginania tułowia, wstawania z pozycji siedzącej, 360-stopniowego przewrotu, testu zmęczenia Sorenson’a, testu zasięgu bez obciążenia i testu chodu na odległość 50 stóp). Intensywność bólu oceniano za pomocą Poczwórnej Wizualnej Skali Analogowej (ang. Quadruple Visual Analogue Scale – QVAS). Zebrano również dane dotyczące wieku, płci, wysokości ciała, masy ciała i BMI. Do analizy danych użyto statystyki opisowe i inferencyjne na poziomie istotności statystycznej Alpha p< 0,05. Wyniki: Średni wiek, masa ciała, wzrost i wskaźnik masy ciała uczestników wynosiły odpowiednio 51,4 ±8.78 lat, 1,61 ±0,76 m i 26,6 ±3,18 kg/m2. Średnia intensywność bólu i jego czas trwania wyniosły odpowiednio 5,37 ±1,37 i 21,2 ±6,68. Trafność różnicowa SBST z procentem ogólnej intensywności bólu wyniosła r = 0,732; p = 0,001. W klasyfikacji zgodnie z SBST, większość uczestników oceniono jako średnie ryzyko niepełnosprawności (76%), podczas gdy SPPTB sklasyfikowało większość jako wysokie ryzyko niepełnosprawności (71,4%). Stwierdzono istotną różnicę w ocenie ryzyka niepełnosprawności między grupami poddanymi SBST i SPPTB (χ ² = 12,334; p = 0,015). SBST nie miał efektów podłogowych ani sufitowych, ponieważ mniej niż 15% uczestników osiągnęło najniższy (2,9%) lub najwyższy (1,4%) możliwy wynik. Natomiast SPPBT pokazał zarówno efekty podłogowe, jak i sufitowe, ponieważ nie był w stanie wykryć „1” i „9”, najniższego i najwyższego osiągalnego wyniku. „Obszar Pod Krzywą” dla czułości (0,83) i swoistości (0,23) SBST do przewidywania „wysokiego ryzyka niepełnosprawności” wynosił 0,51. Oszacowana częstość występowania dla przewidywanego „wysokiego ryzyka niepełnosprawności” przy zastosowaniu SBST wyniosła 0,76. Szacowana wartość dla wyników prawdziwie dodatnich, fałszywie dodatnich, prawdziwie ujemnych i fałszywie ujemnych dla przewidywania „wysokiego ryzyka niepełnosprawności” w przypadku SBST wyniosła odpowiednio 0,77, 0,23, 0,31, i 0,69. Wnioski: Metoda Przesiewowa StarT Back jest w stanie lepiej zidentyfikować odsetek pacjentów z bólem dolnego odcinka kręgosłupa znajdujących się w grupie średniego zagrożenia niepełnosprawnością, podczas gdy Bateria Testów Sprawności Fizycznej Simmonds’a jest w stanie lepiej zidentyfikować wysokie zagrożenie niepełnosprawnością. Tym samym SBST jako narzędzie do samooceny, nie może w wystarczającym stopniu zastępować przewidywania zagrożenia niepełnosprawnością w oparciu o ocenę sprawności fizycznej. Jednakże SBST ma dobrą trafność różnicową przewidywań w kwestii intensywności bólu. W przeciwieństwie do SPBBT, SBST nie wykazywał w naszych testach żadnych efektów podłogowych ani sufitowych i wykazał się wysoką czułością, ale niską swoistością w przewidywaniu „wysokiego ryzyka niepełnosprawności”