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

Normative scores for select neuropsychological battery tests for the detection of HIV‑associated neurocognitive disorder amongst Nigerians

BACKGROUND : The study aimed to derive socio‑demographic–corrected norms for selecting neuropsychological (NP) battery tests for people living with HIV (PLWHIV) in Nigeria. This cross‑sectional study was conducted amongst patients who attended the general outpatient clinic and junior staff of the University of Nigeria Teaching Hospital (UNTH), Ituku‑Ozalla. AIMS AND OBJECTIVES : To determine the normative scores for select neuropsychological battery test for the detection of neurocognitive disorder amongst Nigerians PLWHIV. A sample of 92 individuals received voluntary HIV testing. METHODS : Eligibility criteria were being HIV negative, aged 18–64 years and formal education. We undertook a brief neuromedical examination to identify putative exclusion criteria. We sampled four NP tests covering seven cognitive domains and the motor speed component of the International HIV Dementia Scale (IHDS‑MS). We presented the normative scores using statistics of mean, median, standard deviation (SD), kurtosis and skewness. RESULTS : All the participants were Nigerians aged 18–64 years. Most (74.1%) of the participants were females. The mean and median ages of the participants were 42.6 ± 11.42 years and 44 years, respectively. The effect of gender on NP performance was limited to the digit span test (DST)‑forwards, while education affected all expect IHDS‑MS and DST‑backwards. The cut‑off scores for defining mild and severe impairment varied (moving from 1SD to 2SD) for all cognitive domains except for IHDS‑MS and DST. CONCLUSIONS : With these preliminary normative scores, it will be easier to identify and classify the severity of neurocognitive impairment amongst PLWHIV in Nigeria, thus facilitating the goal of keeping HIV‑associated dementia to a minimum. The lack of variability in the IHDS‑MS and DST is unfavourable.http://www.npmj.orgam2023Physiotherap

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

Clinical factors associated with bone mineral density among individuals with osteoarthritis of the hip and/or knee: a systematic review

Background and objective: The association of clinical factors of osteoarthritis (OA) with bone mineral density (BMD) is not well understood. We aimed to synthesize evidence regarding the associated clinical factors for low BMD in people with knee and/or hip osteoarthritis. Methods: A systematic literature search limited to human studies was conducted from inception to September 12, 2022. CINAHL, Cochrane, Medline, PsycINFO, PubMed, Web of Science, and African Journal online databases were searched for all clinical factors associated with low BMD (either as osteopenia or osteoporosis). Gray literature or abstracts or protocols, studies with a mixed population of OA without a subgroup analysis for hip and or KOA and non-English were excluded. Following the title and abstract, full-text, screenings, and data extraction, data from eligible studies were synthesized based on the main objective of the study. The Joanna Brigg’s Institute (JBI) Critical Assessment tool was used for quality appraisal. Narrative synthesis and best evidence synthesis were used in the study. Result: Five studies (2 case–control, 3 cross-sectional) were included after screening 3355 titles and abstracts. Clinical factors reported in the five studies included: body mass index (BMI); pain, function, and stiffness; symptom duration; presence of varus/valgus deformity; quality of life; and knee function. Whilst there was limited evidence to support the association between BMD measured at any site of the body and BMI, as well as conflicting evidence for the association of BMD with age and gender, there was insufficient evidence to support the association of BMD with other identified clinical factors of hip and or/ knee OA (p < 0.05). In addition, there is conflicting evidence for the association between BMD measured at the lumbar spine and BMI. Conclusion: There is insufficient evidence on the association between BMD and its associated clinical factors. With the attendant likelihood of bias in existing studies, there is a need for well-designed studies on bone health in OA

Developmental Pattern of Tibio-Femoral Angle in a Cohort of Nigerian Children: A Preliminary Report

A cohort measurement of tibio-femoral angle (TFA) is more meaningful and reliable than a cross-sectional survey in investigating TFA pattern of development. This study reports the pattern of knee angle development in a cohort of 152 normal Nigerian children during the first 12 months of life. The infants’ tibio-femoral angle, inter-condylar, and inter-malleoli distances were measured at monthly intervals using clinical methods. Age-reference values were generated. Results showed that the developmental pattern of tibio-femoral angle is extreme varus at birth with values ranging from 5°to 25°. The mean varus at birth (13.2±3.7°) decreased to reach the lowest value (5.6±0.7°) at nine months and then rose slightly to (6.9±1.2°) at 12 months. None of the infants exhibited a measurable valgus angle. In conclusion, the chronological development of TFA in these cohort Nigerian infants was varus, maximal at birth and decreasing during first 12 months of life. The age-reference values herewith generated may serve as a useful guide in evaluating lower limb alignment in Nigerian children, age 0 to 12 months

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

Cross-cultural adaptatiion and validation of the stroke specific quality of life 2.0 scale into Hausa language

Abstract Background The Stroke Specific Quality of Life 2.0 (SS-QoL 2.0) is a widely used scale that has been cross-culturally adapted to many languages including Yoruba, one of the three major Nigerian languages. Non-availability of SS-QoL 2.0 in Hausa, the indigenous language of Northern Nigeria has restricted its use in Hausa stroke-survivors (SSV). This study was aimed at cross-culturally adapting SS-QoL 2.0 to Hausa and assessing validity and reliability of the Hausa version. The English version of SS-QoL 2.0 was cross-culturally adapted to Hausa following the American Association of Orthopaedic Surgeons’ guideline. A final Hausa version (FHV) was produced through forward and back-translations, expert committee review, pretesting and cognitive debriefing interview. The FHV was investigated for test-retest reliability, internal consistency, convergent, construct and known-group validity on 86 consenting Hausa SSV. Hausa version of WHOQoL-BREF was used to assess convergent validity (n = 57) while English versions of SS-QoL was used to assess construct validity (n = 51) of FHV. The FHV was re-administered on 53 of the participants at 7-day interval to assess test-retest reliability. Each scale was administered in random order to eliminate bias. Data were analysed using Spearman correlation, Cronbach’s alpha, Intra-class Correlation Coefficient (ICC), Independent t-test and One-way ANOVA at p < 0.05. Results The SS-QoL 2.0 was successfully cross-culturally adapted to Hausa. Participants’ mean overall score on SS-QoL 2.0 (145.30 ± 39.78) did not differ significantly from that of FHV (150.41 ± 40.45) p = 0.28. The mean domains score did not differ significantly except in self-care and work domains. There were weak to good correlations for 6 out of 8 similar domains on Hausa versions of SS-QoL and WHOQoL-BREF (r = 0.21–0.61; p = 0.001–0.006); and good to excellent correlations between Hausa and English versions of SS-QoL (r = 0.70–0.92; p = 0.001). The FHV showed high to excellent test-retest reliability (ICC = 0.86–0.99) and acceptable to excellent internal consistency (Cronbach’s α = 0.71–0.90). No significant gender differences were demonstrated for any domains of FHV and for most domains across age groups. Conclusion The FHV is valid and reliable. The scale is recommended for assessing health-related quality of life among Hausa stroke survivors

Pattern of Osteoarthritis Seen In Physiotherapy Facilities in Ibadan and Lagos, Nigeria

Osteoarthritis (OA) is the leading cause of disability in the elderly. Studies on its prevalence and pattern in Nigeria are few. The aim of this retrospective study was to describe the pattern of OA seen in 10 physiotherapy facilities in Ibadan and Lagos. The University of Ibadan/University College Hospital Ethical Review Committee approved the study. Information on age, gender, joint affectation, impairments, disabilities and co-morbidities were recorded from the hospital files of patients with OA in each hospital. The proportion of all new patients accounted for by OA during the 3 year study period was computed. Data was analyzed using descriptive statistics.The patients with OA, aged 56.8+ 12.6 years accounted for 8.9% of all (11574) new patients seen in the clinics during the study period. The female to male ratio was 3.5:1. The knee was the most frequently affected joint. Common impairments were pain (100%), reduced range of motion (75%), crepitus (64%) and joint swelling (30%). Common functional limitations were difficulty in walking long distances (42%), squatting (22.5%), standing up from sitting (18%) and climbing stairs (9%). Low back pain (10.4%) and obesity (8.6%) were the two most commonly documented comorbid conditions. It was concluded that OA is a common condition seen in the Physiotherapy facilities in Lagos and Ibadan, accounting for about 9% of new patients; it is more common in females than males (3.5:1) and the knee joint is the most frequently affected