Relative Therapeutic Efficacy of the Treadmill and Step Bench in Gait Rehabilitation of Hemiparetic Stroke Patients

The aim of this research is to compare the efficacy of treadmill and step bench exercises in hemiparetic gait rehabilitation. Previous studies have supported the use of treadmill and step bench exercises in gait rehabilitation. Nineteen patients were recruited for an 8-week, 2-group quasi-experimental study which was conducted at the Aminu Kano Teaching Hospital. The patients were randomly distributed into 2 groups: A (step bench exercise) and B (treadmill). Groups A and B had 9 and 10 participants respectively. The mean age of the participants in group A was 47.78 + 8.17 years, while that of participants in group B was 46.9 + 7.11 years. Data collected on cadence, stride length, stride width, step length, stride velocity and foot angle before treatment at the 4th and 8th weeks of treatment were analysed using inferential statistics. There was a significant difference (p < 0.05) in the pre-treatment and post-treatment scores in both groups. Comparison of the post-treatment mean scores of the 2 groups was made and the t-values for cadence, stride length, step length, stride width, stride velocity and foot angle were 1.18, -0.91,-0.86, 0.78,1.19 and 0.01, respectively, after analysis was carried out using the unpaired t test. The results showed no significant difference in the mean scores of the measured gait parameters for the groups (p>0.05). It was concluded that hemiparetic stroke patients will benefit from both rehabilitation protocols, and that neither rehabilitation protocol is superior to the other

Assessment of functional and musculoskeletal problems, and barriers to obtaining physiotherapy services among the elderly in a rural community in Kano State, Nigeria

Functional and musculoskeletal problems are a major cause of disability among the elderly in the rural areas. Unfortunately, rehabilitation services are presently inadequate for this population in many parts of the world. This study evaluated the pattern of musculoskeletal disorders, functional status and barriers to obtaining physiotherapy services among the elderly in a rural community in Kano, Nigeria.This cross sectional survey was carried out using a Hausa translated version of the modified Older American Resource and Services (OARS) multidimensional functional assessment questionnaire and other instruments to assess the pattern of functional and musculoskeletal problems and barriers to obtaining physiotherapy services. The questionnaires were administered to 384 elderly consenting individuals (aged 60 years and above) who were recruited using cluster sampling. The data obtained was analysed using SPSS version 16.0.The results from this study revealed that the majority of the participants were females (59.9%). The prevalence of musculoskeletal problems was significant (47%), mostly affecting the lower extremity joints and the spine. Generally, the participants were mostly independent in carrying out activities of daily living (ADL), such as feeding (92.5%), grooming (85.7%), money management (84.9%) and management of medication (83.9%). The results also showed that a few of the participants were dependent in bathing (10.2%), walking (9.9%) and dressing (9.9%). Furthermore, the majority (61.9%) of the participants who reported musculoskeletal problems had good ADL performance capacity rating. Almost all the participants (98%) reported that they have never heard of physiotherapy. Lastly, those with musculoskeletal problems reported that they mainly utilized traditional medicine or home remedies and their health-seeking behaviour was mainly determined by affordability (41.8%).It was concluded that there is a high prevalence of musculoskeletal problems among the participants of this study. Nevertheless, their level of function remained optimal. The study also identified lack of awareness, unavailability, affordability and accessibility as the major barriers to obtaining physiotherapy services among the participants.Keywords: elderly, musculoskeletal disorders, knowledge, disability, rural community, physiotherap

Determinants of quality of life among community‑dwelling persons with spinal cord injury: A path analysis

Context: Recent advancement in technology and medical care has resulted in an increase not only in disability arising from spinal cord injury (SCI) but also its attendant challenges such as poor quality of life (QoL).Aim: To test a theoretical model of predictors of QoL among persons with SCI.Settings and Design: Study was conducted in the South Eastern Nigeria. A longitudinal study design was employed.Materials and Methods: A total of 64 persons with SCI discharged from in‑hospital admission participated in this study. QoL, state self‑esteem (SSE), social support satisfaction (SSS), and functional potentials (FPs) were assessed using short form health survey‑12, SSE scale, social support questionnaire 6, and spinal cord independent measure III, respectively. Their motor function (MF) and sensory function (SF) were assessed using the motor and sensory subscales of American Spinal Cord Association impairment scale.Statistical Analysis Used: Data obtained were analyzed using path analysis. The level of significance was set at α = 0.05.Results: Most of the participants were male (92.3%) with incomplete type of SCI (65.4%). The selected variables (SSE, SSS, FP, MF, and SF) significantly predicted a large percentage (R2 = 0.861) of QoL. All the predictor variables except age had a direct significant effect on QoL (P < 0.05). The trimmed model revealed that SSS (β =3.04, P = 0.002) had the highest direct effect on QoL.Conclusions: This study revealed that the combined assessment of SSE, SSS, FP, MF, and SF can be used to predict QoL significantly. Moreover, psychosocial factors are as important as clinical (biological) factors in predicting the outcomes of SCI, especially their QoL. Thus, the study buttresses the need to emphasize on the biopsychosocial model in the rehabilitation of persons with SCI.Key words: Determinants, path analysis, quality of life, spinal cord injur

Predictors of caregiver depression and family functioning after perinatal stroke

BACKGROUND: Perinatal stroke is a leading cause of cerebral palsy and lifelong neurological morbidity. Studies on perinatal stroke outcomes are increasing, although examinations of its broader impact on parents and families have been limited. A recent study found that parents of children with moderate and severe outcomes have increased risk for psychosocial concerns, including depressive symptoms and poor family functioning. Other parents adapt remarkably well, but how this occurs is unknown. The primary aim of this study was to examine predictors of parent and family outcomes, namely caregiver depression and family functioning. The secondary aim was to explore potential mediators and moderators of the relationship between condition severity and parent and family outcomes. METHODS: Parents were recruited from a large, population-based perinatal stroke research cohort, and they completed measures assessing their demographics, social supports, stress levels, marital quality, feelings of guilt and blame, psychological well-being, and family functioning. Bivariate analyses compared these variables. Predictor variables, mediators, and moderators were chosen according to the strength of their relationship with the outcome variables (i.e., caregiver depression and family functioning) and theory. Hierarchical regression, mediator, and moderator analyses were conducted accordingly. RESULTS: A total of 103 parents participated in this study (76 mothers, 27 fathers; mean age of 39.2 years; mean child age of 7.46 years). Condition severity, anxiety, social support, and blame independently predicted caregiver depression while condition severity, stress levels, and marital quality independently predicted family functioning. Blame regarding the cause of their child’s condition also mediated the relationship between condition severity and caregiver depression. CONCLUSIONS: Adverse parental outcomes can be predicted in perinatal stroke populations. Moreover, anxiety and stress management techniques, marital support, and psychoeducation regarding the unpreventable nature of perinatal stroke may be utilized in the future to enhance family outcomes