Use of standardised outcome measures among physiotherapists in French-speaking sub-Saharan Africa

Background: The use of standardised assessment tools is a fundamental aspect of good clinical practice. However, to our knowledge, no study has documented the use of standardised assessment tools in physiotherapy in French-speaking sub-Saharan Africa. Objectives: Documenting the use of standardised outcome measures in physiotherapy in French-speaking sub-Saharan Africa. Method: Our cross-sectional survey used an online self-questionnaire on facilitators and barriers to the use of standardised outcome measures, distributed to physiotherapists in French-speaking sub-Saharan Africa. Results: A total of 241 physiotherapists working in French-speaking sub-Saharan Africa responded to the survey. The most represented countries were Benin (36.9%), Cameroon (14.1%), and Burkina Faso (10.8%). Although 99% of participants reported using standardised outcome measures, only 27% of the respondents used them systematically (all the time). The most reported facilitators included the recognition that standardised outcome measures help to determine whether treatment is effective, help to guide care, and improve communication with patients. The most significant barriers were the lack of time, unavailability of the standardised outcome measures, and non-sensitivity of measures to patients’ cultural and ethnic concerns. There was a higher proportion of use in the middle age group (30–40) (p = 0.02) and a lower proportion of use in physiotherapists simultaneously working in public and private sectors (p = 0.05). Conclusion: Standardised outcome measures are still not widely used by physiotherapists in French-speaking sub-Saharan Africa. Clinical implications: The perceived barriers and facilitators could help to develop strategies to improve the systematic use of outcome measures in French-speaking sub-Saharan Africa

Is the Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) feasible and effective in the socio-cultural context of West Africa (Benin)?

Cerebral palsy (CP) is the leading cause of motor disability in children, a family’s predicament. It is widely studied in High-Income Countries where the prevalence of severe cases is declining thanks to the constant development of better prevention and care strategies. Unfortunately, it is still very poorly known in Low and Middle-Income Countries such as in Sub-Saharan Africa where children show poor developmental outcomes and where there is a higher proportion of severe cases and premature deaths. Therefore, this thesis aimed to contribute to the management of CP in Sub-Saharan Africa, typically in Benin in West Africa, with the development of specific assessment tools and intervention strategies.(MOTR - Sciences de la motricité) -- UCL, 202

Assessing locomotion ability in West African stroke patients: Validation of ABILOCO-benin scale

Objective To calibrate and validate the Benin version of ABILOCO, a Rasch-built scale developed to assess locomotion ability in stroke patients. Design Prospective study and questionnaire development. Setting Rehabilitation centers. Participants Stroke patients (N=230; mean age ± SD, 51.1±11.6y; 64.3% men). Intervention Not applicable. Main Outcome Measures Participants completed a preliminary list of 36 items including the 13 items of ABILOCO. Items were scored as "impossible," "difficult," or "easy." The mobility subdomain of FIM (FIM-mobility), the Functional Ambulation Classification (FAC), the 6-minute walk test (6MWT), and the 10-meter walk test (10MWT) were used to evaluate and elucidate the validity of the ABILOCO-Benin scale. Results Successive Rasch analyses led to the selection of 15 items that define a unidimensional, invariant, and linear measure of locomotion ability in stroke patients. This modified version of the ABILOCO scale, named ABILOCO-Benin, showed an excellent internal consistency, with a Person Separation Index of.93, and excellent test-retest reliability with high intraclass correlation coefficients of.95 (P<.001) for item difficulty and.93 (P<.001) for subject measures. It also presented good construct validity compared with FAC, FIM-mobility, 6MWT, and 10MWT (r≥.75, P<.001). Conclusions ABILOCO-Benin presents good psychometric properties. It allows valid, reliable, and objective measurements of locomotion ability in stroke patients. © 2014 by the American Congress of Rehabilitation Medicine

Mothers’ perception of cerebral palsy in a low-income country of West Africa: a cross-sectional study

Purpose Investigating mothers’ perceptions of Cerebral Palsy (CP) and the impact of caregiving on family life in Benin, a west-African low to middle-income country (LMIC). Methods In this cross-sectional study we interviewed at their homes 88 mothers of children with CP about their perception of the cause of CP and stigmatization issues. Additionally, they completed the Impact on Family Scale and the Family Support Scale questionnaires. Multinomial and ordinal regressions analyses were used (p < 0.05). Results Most mothers (78%) referred to non-biomedical causes of CP (God’s will or curse). Caregivers with a limited education level were more likely to report non-biomedical beliefs. Only 28% reported having received from physicians an explanation of the causes of CP. Around 38% endorsed neighbors considered their children as cursed, which is a source of stigmatization. Mothers perceived a high impact of caregiving on their family life that correlated with non-biomedical beliefs, low education level, and the severity of CP. Conclusion There is a need in Benin, and probably in West-African LMICs generally, to shift to a family-centered care system and to inform the public about the root causes of CP to improve social integration of children with CP and decrease the negative impact on their families. • Implication for rehabilitation • Mothers with a limited education level are more likely to report non-biomedical causes of CP in this LMIC; • mothers’ level of education and non-biomedical beliefs of causes of CP are associated to a high impact of caregiving on family life in this LMIC; • mothers of children with CP in this LMIC do not perceive health-workers helpful

A Cross-sectional Study of the Clinical Profile of Children With Cerebral Palsy in Benin, a West African Low-Income Country

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries

Measuring global activity performance in children with cerebral palsy in West Africa: validation of an adapted version of the ACTIVLIM-CP questionnaire.

PURPOSE: To calibrate a West-African version of the ACTIVLIM-CP questionnaire (ACTIVLIM-CP-WA) for children with cerebral palsy (CP). MATERIALS AND METHODS: We recruited 287 children with CP of various age range: 2-6 years (n = 117, preschoolers), 6-12 years (n = 96, children) and 12-19 years (n = 74, adolescents). Caregivers of children of each age range completed the experimental version of the ACTIVLIM-CP-WA including 76 (preschoolers), 78 (children) and 76 (adolescents) global daily life activities. Responses were analyzed using the Rasch RUMM2030 software. RESULTS: The final West-African version of ACTIVLIM-CP including 31 items (both common and age-specific items) defined a unidimensional, linear scale with well-discriminated response categories. It presented a high internal consistency (R = 0.94). Moreover, all items were locally independent and the item difficulty hierarchy was invariant regarding caregivers' education, children's age and gender, MACS and GMFCS levels. The ACTIVLIM-CP-WA measures were significantly correlated (p < 0.05) with Gross Motor Function Classification System (ρ = -0.77), Manual Ability Classification System (ρ = -0.75), Box and Block test (dominant hand r = 0.51; non-dominant hand r = 0.49), One-minute walking test (r = 0.28), and Timed up and Go test (r = -0.40). CONCLUSIONS: The ACTIVLIM-CP-WA questionnaire provides a valid and reliable tool that has the potential to follow children's evolution and quantify changes consecutive to neurorehabilitation in Sub-Saharan Africa.IMPLICATIONS FOR REHABILITATIONThe West-African version of the ACTIVLIM-CP questionnaire (ACTIVLIM-CP-WA) measures global activities requiring a combination of lower and upper extremities in children with cerebral palsy.As a Rasch-built scale, measures are unidimensional and linear to document changes in children with cerebral palsy from 2 to 19 years in Sub-Saharan Africa.Rehabilitation professionals are encouraged to use the ACTIVLIM-CP-WA questionnaire as a psychometrically robust assessment tool measuring the global performance in daily life activities in children with cerebral palsy in Sub-Saharan Africa

Feasibility and effectiveness of HABIT-ILE in children aged 1 to 4 years with cerebral palsy: A pilot study.

No abstract availabl