Development and Feasibility Testing of Video Home Based Telerehabilitation for Stroke Survivors in Resource Limited Settings

Tele-physiotherapy has been shown to be valuable to improve clinical outcomes after stroke. Yet, home-based interventions for stroke survivors (SSVs) who speak indigenous African languages are sparse. This study developed a video-based home exercise programme (VHEP) for SSV speakers of Yoruba.  A qualitative descriptive pilot study was conducted in two phases: development and feasibility testing. VHEP development followed the American Stroke Association’s recommendations to include demonstrations of task-specific mobility-task and postural training; trunk exercises, and overground walking. The exercise instructions were presented in the Yoruba language. Each exercise was demonstrated for five minutes on video for a total of 30 minutes. The feasibility testing involved ten consenting chronic SSVs.  Each imitated the VHEP twice per week for two weeks and thereafter completed a feasibility questionnaire. Criteria for feasibility were: cost of using VHEP, recruitment rate, retention of participants, adherence to the exercises, and intervention delivery. The ten SSVs were recruited within one week, had prior home access to a video player at no-cost, adhered to the exercises as recorded, completed the 30 minute-duration for two weeks, and confirmed intervention delivery of VHEP. Most participants liked the novel use of Yoruba as the language of instruction on VHEP. The VHEP was feasible and acceptable among the studied sample of SSVs. Video based home telerehabilitation for SSVs therefore has the potential to meet the growing need for tele-physiotherapy in resource limited settings. 

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Influence of gender on prevalence of overweight and obesity in Nigerian schoolchildren and adolescents

Overweight and obesity are serious health concerns for children. However, only a few studies have investigated the influence of gender on prevalence of overweight and obesity in children and adolescents in Nigeria. The objective of this study was to investigate gender influence on prevalence of overweight and obesity among Nigerian school children and adolescents. Information on age and gender of the participants was collected from the school register. Data on height, weight and BMI was collected using standard techniques. A total of 9,014 children and adolescents (male=4392; female=4622), aged 2-18 years, from 28 randomly selected schools were analyzed. Overweight and obesity were determined using the International Obesity Task Force cut-off points by age and gender. Males had higher BMI than females at age group 2-6 years, whereas females had higher BMI than males at age groups 11-14 years and 15-18 years. Females had significantly higher prevalence of overweight (P<0.05) than males at age group 11-14 and 15-18 years. However, there was no gender difference in the prevalence of obesity from childhood through adolescence. In conclusion, BMI is larger in males in early childhood but larger in females in during adolescence. More female adolescents are at risk of obesity than males

Physical Activity Level and Adiposity: Are they Associated with Primary Dysmenorrhea in School Adolescents?

Information on self-reported physical activity (PA) level in association with primary dysmenorrhea (PD) is not readily available on African populations, and there is a dearth of information on the association of adiposity with PD. This study explored the association of PA and adiposity indices with PD and associated menstrual pain. This cross-sectional study involved 1383 female adolescents from 12 randomly selected secondary schools (9 private and 3 public schools). They were categorized into &lt;1 hour/day or ≥ 1 hour/day of PA based on their reported average duration of PA per day. The adiposity [body mass index (BMI) and waist circumference (WC)] was assessed using standardized procedures. Majority of participants (85.4%) in this study sample reported experiencing PD. More participants without PD engaged in PA for more than one hour daily than those with PD (X2=11.49; p=0.001). The participants with PD experienced menstrual pain mostly (55.1%) during menstruation and the mostly reported pain intensity was moderate (38.7%). Majority of those (80.5%) who had menstrual pain did not report using medication for the pain. 77.0% of those who used medication reported having pain relief. Waist circumference, BMI and PA level showed no independent association (p&gt;0.05) with either PD or its pain intensity experienced among the adolescents. PA level and adiposity are not associated with PD in school adolescents. Keywords: Adiposity, Primary Dysmenorrhea, Physical Activity, Adolescence (Afr J Reprod Health 2013; 17[4]: 167-174

Physical Activity Level and Adiposity: Are they Associated with Primary Dysmenorrhea in School Adolescents?

Information on self-reported physical activity (PA) level in association with primary dysmenorrhea (PD) is not readily available on African populations, and there is a dearth of information on the association of adiposity with PD. This study explored the association of PA and adiposity indices with PD and associated menstrual pain. This cross-sectional study involved 1383 female adolescents from 12 randomly selected secondary schools (9 private and 3 public schools). They were categorized into <1 hour/day or ≥ 1 hour/day of PA based on their reported average duration of PA per day. The adiposity [body mass index (BMI) and waist circumference (WC)] was assessed using standardized procedures. Majority of participants (85.4%) in this study sample reported experiencing PD. More participants without PD engaged in PA for more than one hour daily than those with PD (X2=11.49; p=0.001). The participants with PD experienced menstrual pain mostly (55.1%) during menstruation and the mostly reported pain intensity was moderate (38.7%). Majority of those (80.5%) who had menstrual pain did not report using medication for the pain. 77.0% of those who used medication reported having pain relief. Waist circumference, BMI and PA level showed no independent association (p>0.05) with either PD or its pain intensity experienced among the adolescents. PA level and adiposity are not associated with PD in school adolescents.Les informations sur le niveau d&apos;activité physique auto-déclarée (AP) en association avec la dysménorrhée primaire (DP) par rapport aux populations africaines ne sont pas facilement disponibles et il y a un manque d&apos;informations sur l&apos;association de l&apos;adiposité avec la DP. Cette étude a exploré l&apos;association de l’AP et des indices d&apos;adiposité avec la DP et les douleurs menstruelles associées. Cette étude transversale a impliqué 1 383 adolescentes de 12 écoles secondaires choisies au hasard (9 écoles publiques, et 3 écoles privées). EIles ont été classées en < 1 heure / jour ou ≥ 1 heure / jour de AP en fonction de leur durée moyenne déclarée de AP par jour. L&apos;adiposité [indice de masse corporelle (IMC) et le tour de taille (TT) ] ont été évalués à l’aide des procédures standardisées. La majorité des participants (85,4%) de l&apos;échantillon de l&apos;étude ont déclaré avoir subi la DP. Plus de participants sans DP étaient engagés dans la AD pendant plus d&apos;une heure par jour que ceux DP (X2 = 11,49, p = 0,001). Les participants DP ont connu surtout les douleurs menstruelles (55,1%) pendant la menstruation et l&apos;intensité de la douleur souvent rapporté a été modérée ( 38,7%) . La majorité d&apos;entre elle (0,5%) qui ont eu la douleur menstruelle n&apos;ont pas signalé l&apos;utilisation de médicaments contre la douleur. 77,0% de ceux qui ont utilisé des médicaments ont déclaré avoir été soulagées. Le tour de taille, l&apos;IMC et le niveau d’AP n’ont pas montré une association (p > 0,05) avec soit la DP soit son intensité de douleur ressentie chez les adolescents. Le niveau d&apos;AP et de l’adiposité ne sont pas associés à la DP chez les adolescents qui fréquentent école

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding: UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union