Spinal manipulation or mobilization for lumbar disc herniation with radiculopathy : a protocol for a systematic review and meta-analysis

Introduction: The purpose of this study is to conduct a systematic review and meta-analysis into the effects of spinal manipulation or mobilization for Lumbar Disc Herniation with Radiculopathy (LDHR). Methods: An electronic database search of titles and abstracts of articles published in English will be conducted in the following databases: PEDro (Physiotherapy Evidence Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, Science Direct, Google Scholar, and The Cochrane Library. The specific search strategies will be dependent on the particular database being searched and hand searches of the reference lists of the included articles will also be performed. Studies will be included if they reported an acceptable comparison group, and also reported at least one of the main clinically relevant outcome measures for LDHR. Two independent reviewers will screen the identified records, and all disagreements will be resolved. The internal and external validities of the included studies will be assessed using the PEDro scale and the External Validity Assessment Tool (EVAT) respectively. The clinical relevance and risk of bias of the studies will be determined using the 5-Criteria developed by the Cochrane Back Review Group and the Cochrane Risk of Bias Assessment Tool respectively. Studies will be pooled into meta-analysis where appropriate using RevMan software and the outcomes will be reported using the PRISMA guidelines. Discussion: This review will summarize the current evidence about the effects of spinal manipulation or mobilization compared with other interventions in the management of individuals with Lumbar Disc Herniation with Radiculopathy (LDHR). A meta-analysis will also be conducted where appropriate in this review to compare the effects of spinal manipulation or mobilization with other interventions with a view to finding out which technique is better in the management of individuals with LDHR. Review Registration: This review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019131292). Keywords: Spinal manipulation; spinal mobilization; lumbar disc herniation; systematic review; meta-analysi

Knowledge and current practices of physiotherapists on the physical activity and exercise in the rehabilitation of children with epileptic seizures

Background: Physiotherapists play a key role in the rehabilitation of children with epileptic seizures. Regular physical exercise generates psychological and physiological benefits for people with epilepsy. Design: This study was a cross-sectional design. Purpose: The purpose of this study was to evaluate the knowledge and current practices of Physiotherapists on the physical activity and exercise in the rehabilitation of children with epileptic seizures in Nigeria. Methods: Physiotherapists with minimum Bachelor’s degrees were invited to participate in the study using an electronic questionnaire. The subjects (N=117) answered a questionnaire comprising 33 simple closed-ended questions with three domain personal information, knowledge, and current practices. Results; Out of the 117 physiotherapists, 77.7% (n=91) had postgraduate degrees, 16.2% (n=19) had bachelor’s degree in physiotherapy, and only 5.9% (n=7) had doctor’s degree in physiotherapy (DPT). The results also indicated that 79.5% (n=93) of physiotherapists had sufficient knowledge about epilepsy, and 86.3% (n=101) of physiotherapists were using current skills/physical activity to rehabilitate children with epileptic seizures. Conclusions; It was concluded that physiotherapists had sufficient knowledge about epilepsy and were using current skills/physical activity in the rehabilitation of children with epileptic seizures. Keywords; Physiotherapists knowledge; Exercises; Physical activity; Epileptic seizure; Childre

Relationship between the mode and location of delivery and neurodevelopmental sequalae in infants who suffered birth asphyxia in Kano Northern Nigeria

Background: Birth asphyxia defined as a failure to initiate or sustain spontaneous breathing at birth. According to the American College of Obstetricians and Gynaecologists and the American Academy of Paediatrics a neonate is labelled to be asphyxiated if the following conditions are fulfilled: Umbilical cord arterial pH <7; Apgar score of 0-3 for longer than 5 min; neurological manifestations (e.g., seizures, coma, or hypotonia); and multisystem organ dysfunction, e.g., cardiovascular, gastrointestinal, haematological, pulmonary or renal system. Adverse birth outcomes continues to be a global public health challenge, particularly in developing and underdeveloped countries. Over 1 million asphyxiated babies die annually around the globe and almost the same number developed severe consequences such as epilepsy, cerebral palsy, and developmental delay. Birth asphyxia accounts for about 23% of the neonatal deaths, and 10% of all deaths in children less than 5 years of age that occur each year worldwide, 98% of which occur in developing countries where more than half of the deliveries in developing countries occur at home. The world Health statistics reported remarkable progress in reducing child mortality, with the global under-five mortality rate dropping from 93 per 1000 live births in 1990 to 41 per 1000 live births in 2016 in the developed world. However, developing countries still have a higher rate, ranging from 4.6 per 1000 in Cape Town to 26 per 1000 in Nigeria, with case fatality rates around 40%. Objective: The aim of the present study was to determine the correlation between mode and location of delivery and neurodevelopmental sequelae in infants who suffered birth asphyxia in Kano, Northern Nigeria. Methods: A cross-sectional study of all neonates diagnosed with birth asphyxia admitted in the neonatal unit of the Murtala Mohammed Specialist Hospital and Hasiya Bayero paediatrics Hospital over a 12 months period (January 2017–December 2018) was undertaken. The occurrence rate of neurodevelopmental sequalae were determined using Modified Robins Smith questionnaire, while relationship between mode and location of delivery and the occurrence of neurodevelopmental sequalae were calculated with the correlation coefficient. Data entry and analysis were performed using SPSS version 21. Results: Results revealed a statistically significant negative correlation between mode of delivery and some of the neurodevelopmental sequelae (NDS) Moro reflex and ANTR at (r = -0.454, p = 0.004**, r = -0.536, p = 0.001**). However, statistically significant positive correlation was found between location of delivery and some of the neurodevelopmental sequelae (NDS) such as the fine motor, speech and communication, Moro reflex and head lag pull to sit legs at (r = 0.597,p = 0.001** , r = 0.540,p = 0.001**, r = 0.580,p = 0.001** , r = 0.536,p = 0.001**) respectively. Conclusion: The study concluded that there are relationship between mode and location of delivery and the occurrence of neurodevelopmental sequelae in infants who suffered birth asphyxia. But to establish these findings on a solid ground a larger multi-centres study is needed