36 research outputs found
Training, care delivery, and research in physiotherapy in sub-Saharan French-speaking Africa
No abstract available
Physical Activity Level, Barriers, and Facilitators for Exercise Engagement for Chronic Community-Dwelling Stroke Survivors in Low-Income Settings: A Cross-Sectional Study in Benin
After a stroke incident, physical inactivity is common. People with stroke may perceive several barriers to performing physical activity (PA). This study aimed to document the PA level and understand the barriers and facilitators to engaging in PA for community-dwelling stroke survivors in Benin, a lower middle-income country. A cross-sectional study was conducted in three hospitals in Benin. Levels of PA were recorded by means of the Benin version of the International Physical Activity Questionnaire long form (IPAQ-LF-Benin), which is validated for stroke survivors in Benin. The perceived exercise facilitators and barriers were assessed by the Stroke Exercise Preference Inventory-13 (SEPI-13). A descriptive analysis and associations were performed with a Confidence Interval of 95% and <0.05 level of significance. A total of 87 participants (52 men, mean age of 53 ± 10 years, mean time after a stroke of 11 (IQR: 15) months and an average of 264.5 ± 178.9 m as distance on the 6 min walking test (6MWT) were included. Overall, stroke survivors in Benin reached a total PA of 985.5 (IQR: 2520) metabolic equivalent (METs)-minutes per week and were least active at work, domestic, and leisure domains with 0 MET-minutes per week. The overview of PA level showed that 52.9% of participants performed low PA intensity. However, 41.4% performed moderate PA or walking per day for at least five days per week. Important perceived barriers were lack of information (45.3%), hard-to-start exercise (39.5%), and travelling to places to exercise (29.9%). The preference for exercise was with family or friends, outdoors, for relaxation or enjoyment (90.2%), and receiving feedback (78.3%). Several socio-demographic, clinical, and community factors were significantly associated with moderate or intense PA (p < 0.05) in stroke survivors in this study. Our findings show that the PA level among chronic stroke survivors in Benin is overall too low relative to their walking capacity. Cultural factors in terms of the overprotection of the patients by their entourage and/or the low health literacy of populations to understand the effect of PA on their health may play a role. There is a need for new approaches that consider the individual barriers and facilitators to exercise
Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke
Background: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting.
Objective: Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors.
Methods: PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs).
Results: Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration â„ 120 min/week; intensity â„ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings.
Conclusions: Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL.
Clinical implications: A high dosage of aerobic exercise, duration â„ 120 min/week; intensity â„ 60% heart rate reserve is beneficial for improving walking capacity
Bilateral versus unilateral upper limb training in (sub)acute stroke: A systematic and meta-analysis
Background: Integrating high dosage bilateral movements to improve upper limb (UL) recovery after stroke is a rehabilitation strategy that could potentially improve bimanual activities.
Objectives: This study aims to compare the effects of bilateral with unilateral UL training on upper limb impairments and functional independence in (sub)acute stroke.
Method: Five electronic databases (PubMed, Scopus, PEDro, ScienceDirect, Web of Science) were systematically searched from inception to June 2023. Randomised controlled trials comparing the effect of bilateral training to unilateral training in stroke survivors ( 6 months poststroke) were included. The treatment effect was computed by the standard mean differences (SMDs).
Results: The review included 14 studies involving 706 participants. Bilateral training yielded a significant improvement on UL impairments measured by FMA-UE compared to unilateral training (SMD = 0.48; 95% CI: 0.08 to 0.88; P = 0.02). In addition, subgroup analysis based on the severity of UL impairments reported significant results in favour of bilateral UL training in improving UL impairments compared to unilateral training in âno motor capacityâ patients (SMD = 0.66; 95% CI: 0.16 to 1.15; P = 0.009). Furthermore, a significant difference was observed in favour of bilateral UL training compared to unilateral UL training on daily activities measured by Functional Independence Measure (SMD = 0.45; 0.13 to 0.78; P = 0.006).
Conclusion: Bilateral UL training was superior to unilateral training in improving impairments measured by FMA-UE and functional independence in daily activities measured by Functional Independence Measure in (sub)acute stroke.
Clinical implications: Bilateral upper limb training promotes recovery of impairments and daily activities in (sub)acute phase of stroke
Tableau dâencephalite revelant un anevrisme de lâartere communicante posterieure a parakou (Benin)
LâanĂ©vrisme intra crĂąnien est une dilatation localisĂ©e et persistante dâune artĂšre cĂ©rĂ©brale. Nous rapportons le cas dâune patiente de 30 ans prĂ©sentant des cĂ©phalĂ©es Ă rĂ©pĂ©tition depuis 3 mois et admise en Soins Intensifs pour un syndrome infectieux et des troubles neurologiques. Les rĂ©sultats de la tomodensitomĂ©trie et de lâexamen du liquide cĂ©rĂ©bro-spinal ont permis dâĂ©voquer le diagnostic de mĂ©ningo-encĂ©phalite; lâĂ©volution sous traitement adaptĂ© a Ă©tĂ© marquĂ©e par la disparition des troubles de la vigilance et lâamĂ©lioration de la force musculaire. Sa sortie de lâhĂŽpital a alors Ă©tĂ© faite. Un mois aprĂšs, il a Ă©tĂ© notĂ© la persistance du ptosis droit, du syndrome pyramidal hĂ©micorporel gauche et lâapparition dâun trouble du comportement et dâune agitation : un angioscanner cĂ©rĂ©bral rĂ©alisĂ© rĂ©vĂ©la alors un anĂ©vrisme partiellement thrombosĂ© de la communicante postĂ©rieure droite. Le traitement neurochirurgical indiquĂ© nâa pu ĂȘtre fait pour des raisons financiĂšres ; elle est donc suivie en consultation neurologique.
English title: A case of aneurysm of the posterior communicating artery mimicking an encephalitis in Parakou (Benin)
The intracranial aneurism is a permanent enlargement of a cerebral aretery. We are reporting the case of a female patient who had a headache since 3 months and was admitted to Intensive Care Unit because of neurological deficiencies and fever. The CT scan and the cerebrospinal liquidâs exams realized leaded to a meningoencephalitis diagnosis. Under the adapted treatment, the consciousness disorder disappeared and the muscular strength become better. Therefore, she went to home. After one month, she presented a persistence of the right ptosis, of a pyramidal syndrome. Moreover, she developped a behavioural trouble and become agitate: then an angioscanner were done and had shown an aneurism of the posterior communicating artery. The neurosurgical care recommended did not apply due to the patientâs economic problems. She is currently following by the neurologist
Enquete sur la prevalence de la migraine chez lâadulte a titirou au Nord du Benin en 2017
Introduction: La migraine est une maladie neurologique frĂ©quente en population, source de handicap et classĂ©e 13Ăšme des affections les plus handicapantes par lâOMS. Lâobjectif de cette Ă©tude Ă©tait dâĂ©tudier la prĂ©valence de la migraine Ă Titirou en 2017. MĂ©thodes: Il sâest agi dâune Ă©tude transversale de type porte-Ă -porte menĂ©e sur 2065 sujets ĂągĂ©s de 18 Ă 65 ans. LâenquĂȘte a Ă©tĂ© effectuĂ©e sur une pĂ©riode de 4 mois allant du 10 avril au 05 aoĂ»t 2017. Les critĂšres diagnostiques de lâInternational Headache Society (IHS) de 2013 ont servi de base pour le diagnostic de la migraine. Les informations sociodĂ©mographiques, le poids et taille et les donnĂ©es relatives Ă la frĂ©quence et lâintensitĂ© des cĂ©phalĂ©es furent collectĂ©s. Les donnĂ©es ont Ă©tĂ© saisies, traitĂ©es et analysĂ©es grĂące au logiciel Epi Info version 2.2.0.165. RĂ©sultats: Il y avait une prĂ©dominance masculine avec un sex-ratio de 1,41. Les sujets Ă©taient ĂągĂ©s de 18 Ă 65 ans avec une moyenne dâĂąge de 31,87±8,37ans. La prĂ©valence des cĂ©phalĂ©es Ă©tait de 63,49%. La prĂ©valence de la migraine Ă Titirou Ă©tait de 3,82% [IC95% : (3,06%-4,72%)] (79 sur les 2065). Les facteurs associĂ©s Ă la migraine Ă©taient lâĂąge (p=0,0026), le sexe (p=0,0001), le niveau dâinstruction (p=0,0039), la profession (p<10-4 ) et lâindice de masse corporelle (p<10-4 ). LâintensitĂ© des cĂ©phalĂ©es Ă©tait modĂ©rĂ©e dans 44,30%, forte dans 51,90%, extrĂȘmement forte chez 3,80% des sujets. La plupart des migraineux (78,48%), avait moins de 5 crises par mois. La migraine avec aura reprĂ©sentait 49,4%. Les auras les plus observĂ©es Ă©taient les phosphĂšnes (34,18%), les scotomes (13,92%) et lâaura sensitive (13,92%). Les facteurs dĂ©clenchant les accĂšs Ă©taient le manque de sommeil (84,81%), la contrariĂ©tĂ© (68,35%) et le souci (62,03%). Conclusion : La migraine est assez frĂ©quente et sa prĂ©valence est comparable Ă celle rapportĂ©e dans la plupart des Ă©tudes en communautĂ© en Afrique.Mots clĂ©s: Migraine -PrĂ©valence-Adulte-Benin Introduction: The migraine is a common neurological disorder with a serious handicap and classified as the 13th disabling disease worldwide. The most consistently data on epidemiology of migraine are available in general population in Africa but not in northern Benin. We aimed to study the prevalence of migraine at Titirou in Parakou in 2017. Methods: This was a cross-sectional with door-to-door survey which included 2065 subjects aged 18 to 65 years. The survey was conducted over a period of 4 months from 10 April to 05 August 2017. The IHS diagnostic criteria of 2013 were used to define migraine. Socio-demographics information was collected. The data were analyzed using Epi Info 2.2.0.165.fr software. Results: There was a male predominance with 58.45% of men with sex ratio of 1.41. The mean age was 31.87 ± 8.37 years. The prevalence of headache was 63.49%. The prevalence of migraine in Titirou was 3.82% [95%CI: 3.06%-4.72%]. The associated factors were the age (p=0.00), the sex (p=0.00), level of education (p=0.00), occupation (p<10-4 ) and the body mass index (p<10-4 ). The migraine with aura represented 49.4%. The most type were visual aura (34.18%), sensitive aura (13.92%) and scotoma (13.92%).The intensity of headache was moderate in 44.30%, strong in 51.90%, extremely strong in 3.80% of subjects. The main triggering factors were lack of sleep (84.81%), annoyance (68.35%) and worry (62.03%). Conclusion: Migraine was more frequent in Parakou and this data are comparable to those reported elsewhere in sub-Saharan Africa.Key words: Headache, Migraine- Prevalence, epidemiology, Adult; Benin
Factors associated with balance impairments amongst stroke survivors in northern Benin: A cross-sectional study
BACKGROUND: Balance impairment is the predominant risk factor for falls in stroke survivors. A fear of falling after stroke can contribute to sedentary lifestyles, increased disability and risk of recurrence, leading to poor quality of life. OBJECTIVE: To determine the frequency and factors associated with balance impairments amongst stroke survivors at the University Hospital of Parakou. METHOD: This cross-sectional study included adult stroke survivors. Stroke survivors after discharge were enrolled at the University Hospital of Parakou between 01 January 2020 and 30 September 2020. Balance impairments were measured by using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) and the Get Up and Go (GUG) tests. RESULTS: A total of 54 stroke survivors were included, with a mean age of 58.37 ± 12.42 years and a male predominance of 68.52%. The mean BBS score was 36.87 ± 14.34 with a minimum and a maximum of 10 and 56, respectively. Thirteen (24.07%) had balance impairments (BBS score †20), 34 (62.96%) had a TUG score ℠14 s (abnormal), 9 (16.67%) presented a moderate risk of falling and 6 (11.11%) presented high risk of fall with the GUG test. Post-stroke duration (odds ratio [OR] = 0.04; 95% CI: 0.04-0.30; p < 0.01), severity of disability (OR = 8.33; 95% CI: 1.03-67.14; p = 0.03) and the number of physiotherapy sessions (OR = 0.18; 95% CI: 0.03-0.93; p = 0.02) were significantly associated with balance impairments. CONCLUSION: Our results showed that almost one quarter of stroke survivors after discharge at the University Hospital of Parakou had balance impairments. Post-stroke duration, severity of disability and the number of physiotherapy sessions were significantly associated with balance impairments. CLINICAL IMPLICATIONS: [AQ1] Balance should be regularly assessed in people post-stroke. Further studies should document the content of rehabilitation and any rehabilitative efforts to improve balance in people post-stroke in Benin
Stroke burden in Benin 2008 to 2018: systematic review of the Literature
International audienc
Restrictions de participation à la vie sociale aprÚs un accident vasculaire cérébral chez les sujets ùgés au Bénin
International audiencePeu de donnĂ©es sont disponibles sur la participation Ă la vie sociale chez les personnes ĂągĂ©es victimes dâaccident vasculaire cĂ©rĂ©bral (AVC). Ce travail a Ă©tĂ© rĂ©alisĂ© dans la ville de Parakou au BĂ©nin en 2017. Il sâest agi dâune Ă©tude cas-tĂ©moins ayant inclus 33 sujets ĂągĂ©s ayant fait un AVC et 66 tĂ©moins appariĂ©s sur lâĂąge, le sexe et le milieu de rĂ©sidence. Les informations sur la participation, le handicap global et de la capacitĂ© cognitive des sujets ont Ă©tĂ© recueillies Ă partir de diffĂ©rentes Ă©chelles : la Participation Measurement Scale, le Rankin et le questionnaire Community Screening Instrument for Dementia. LâĂąge moyen des participants Ă©tait 61±8 ans. La participation moyenne chez les sujets post-AVC Ă©tait de 2,34±1,58 logit et chez les sujets tĂ©moins de 3,21±1,21 logit (t=â2,4 ; p=0,02). Cette diffĂ©rence se situe principalement au niveau des situations en rapport avec la vie communautaire, sociale et civique. LâintĂ©gritĂ© cognitive Ă©tait le facteur dĂ©terminant de la participation aussi bien chez les cas que chez les tĂ©moins. Dans notre Ă©tude, lâAVC contribue Ă une restriction de participation Ă la vie sociale chez les personnes ĂągĂ©es
Perceived exertion and energy expenditure during physical activities in healthy young people and older adults
Aim: To test the validity of Borgâs 6â20 rating of perceived exertion scale in assessing the exertion intensity over a multi-activity session in young and older adults.Materials and methods: This cross-sectional study included 56 healthy participants. All participants underwent a single session of activities including working on a computer, treadmill walking, biking, and treadmill running.Results: Results showed a non-significant correlation between the overall perceived exertion and energy expenditure in young people (Rho=â0.05, p=0.75) and in older adults (Rho=â0.05, p=0.78) for the whole session. However, results showed that older adults perceived significantly higher exertion compared to young people while working on a computer, walking and running, whereas they presented lower energy expenditure while resting and working on a computer.Conclusions: Combining the perceived exertion method with other commonly used methods to estimate exercise intensity would be recommended for older adults