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Background: Constraint induced movement therapy (CIMT) is effective at improving upper limb outcomes after stroke.Aim: The aim of this study was to carry out a systematic review and meta-analysis of the effects of lower limb CIMT studies of any design in people with stroke.Materials/ Method: PubMED, PEDro, OTSeeker, CENTRAL, and Web of Science were searched from their earliest dates to February 2021. Lower limbs CIMT studies that measured outcomes at baseline and post-intervention were selected. Sample size, mean, and standard deviation on the outcomes of interest and the protocols of both the experimental and control groups were extracted. McMaster Critical Review Form was used to assess the methodological quality of the studies.Result: Sixteen studies with different designs were included in this review. The result showed that lower limb CIMT improves functional, physiological and person's reported outcomes including motor function, balance, mobility, gait speed, oxygen uptake, exertion before and after commencement of activities, knee extensor spasticity, weight bearing, lower limb kinematics and quality of life in people with stroke post intervention. However, there were only significant differences in quality of life in favor of CIMT post-intervention [mean difference (MD) = 16.20, 95% CI = 3.30–29.10, p = 0.01]; and at follow-up [mean difference (MD) = 14.10, 95% CI = 2.07–26.13, p = 0.02] between CIMT and the control group. Even for the quality of life, there was significant heterogeneity in the studies post intervention (I2 = 84%, p = 0.01).Conclusion: Lower limb CIMT improves motor function, balance, functional mobility, gait speed, oxygen uptake, weigh bearing, lower limb kinematics, and quality of life. However, it is only superior to the control at improving quality of life after stroke based on the current literature.

Background: Healthcare professionals in different countries are governed by laws and statutes for their scopes of practice to ensure that services are rendered by suitably licenced and qualified professionals in order to protect the public. A few of these laws are found to paradoxically hinder the autonomy of physiotherapy. Objective: My article documents the autonomy-hindering scope for physiotherapy practice in selected African countries. Method: The methodologies used in my article were both a review and comparative approach for the interpretation of statutes. Results: Three African countries presented a clear legal definition of physiotherapy in their regulatory frameworks and regulated other rehabilitation professions as well. In my article, these regulations are referred to as ‘combo regulations’. The rationale for ‘combo regulations’ is not clear and found to hinder professional autonomy. Only one statute from Rwanda provided a scope for physiotherapy that was not autonomy-hindering. Conclusion: There is, therefore, a need for urgent review of most laws regulating physiotherapy in the selected African countries to assist with the duty of protecting the public. All autonomy-hindering scopes for physiotherapy practice in African countries should be repealed and amended accordingly. Clinical implications: A clear scope shall assist with protecting the public and clinical practice and clearly states ‘what physiotherapy is and what it is not’.

Background. Constraint-induced movement therapy (CIMT) is used for the rehabilitation of motor function after stroke. Objectives. The aim of this study was to compare the effects of lower limb CIMT that uses number of repetition of tasks with the one that uses number of hours of practice. Method. The study was a randomized clinical trial approved by the Ethics Committee of Kano State Ministry of Health. Fifty-eight people with stroke participated in the study. Groups 1 and 2 performed daily 600 repetitions and 3 hours of task practice, respectively, 5 times weekly for 4 weeks. Motor impairment (primary outcome), balance, functional mobility, knee extensor spasticity, walking speed and endurance, and exertion before and after commencement of activities were assessed at baseline and postintervention. The data was analyzed using Friedmann and Mann-Whitney U tests. Result. The results showed that there was only significant difference ( p < 0.05 ) in knee extensor spasticity (group 1 ( median = 0 0 , mean rank = 27.50 ); group 2 ( median = 0 0 , mean rank = 31.64 )), exertion before commencement of activities (group 1 ( median = 0 0.5 , mean rank = 21.90 ); group 2 ( median = 1 0.5 , mean rank = 37.64 )), and exertion after commencement of activities (group 1 ( median = 1 1 , mean rank = 20.07 ); group 2 ( median = 1 0 , mean rank = 39.61 ) postintervention in favour of the experimental group (group 1)). Conclusion. The group 1 protocol is more effective at improving outcomes after stroke.

Introduction:the prevalence of non-communicable and chronic diseases has been on the increase globally and has been a major factor responsible for high morbidity and mortality. Multimorbidity of the chronic diseases in low/medium income countries should be a major concern for public health practitioners because of the communicable diseases they also battle with. This study was carried out to determine the prevalence of multi-morbidity of chronic diseases of lifestyle (CDL) among adult South Africans. Methods:we employed General House Survey (GHS) data released by Statistics South Africa (Stats SA) in December 2015 with a response rate was 90.5%. Data on diabetes mellitus, high cholesterol, stroke, heart attack/myocardial infarction, hypertension were analysed using descriptive and inferential statistics. Results:the outcome of this secondary data analysis showed that about 16.3% of South Africans respondents aged 18 years and above had a single/or multiple CDL. The majority of the respondents with CDL were females (10.9%), older adults (9.4%), married (8.5%), of the black racial extract (11.9%), and reside in urban areas (3.4%). Also, high blood pressure (13.7%) was the most reported prevalent chronic disease while heart attack (1.1%) was the least reported chronic disease. The outcome of regression analysis after adjustment showed that gender (OR=0.56, CI=0.53-0.60, p

Background Pregnancy results in many changes, including reduced hand grip strength (HGS). However, good HGS is required for physical functions such as carrying and breastfeeding the baby after birth. The aim of this study was to determine the factors that may predict HGS during pregnancy. Methods The study was a cross-sectional study approved by the Research Ethics Committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital in Kano, north-west, Nigeria. Pregnant women at the designated hospitals were included in the study if they had no serious comorbidities or any known neurological condition that affects the hands and the neck. Demographic characteristics and independent (predictor) variables (age, weight, height, BMI, maternity leave status, number of full-term deliveries, number of preterm deliveries, number of live births, number of abortuses, gravidity, trimester, systolic blood pressure, diastolic blood pressure, inter arm systolic BP difference [IASBP], inter arm diastolic BP difference [IADBP], and heart rate) of each of the participants were recorded by experienced therapists. The data were analysed using descriptive statistics, t-test, Pearson correlation coefficient and standard multiple regression. Result One hundred and sixty-one pregnant women with mean age, 25.04 ± 4.83 years participated in the study. In the dominant hand, 120 participants (74.5%) had weak grip strength. In the non-dominant hand, 135 participants (83.9%) had weak grip strength. For the dominant hand, the total variance explained by the whole model was significant, 28.5%, F(11, 161) = 1.187, R2 = 0.081, p = 0.300 . In the final model, none of the variables significantly predicted HGS. However, systolic blood pressure contributed to the model more than any other variable (Beta = -0.155). For the non-dominant hand, the total variance explained by the whole model was not significant, 33.1%, F(11, 161) = 1.675, R2 = 0.111, p = 0.089 . In the final model, only systolic blood pressure (Beta = -0.254, p = 0.023) significantly predicted hand grip strength. Conclusion Cardiovascular events or changes during pregnancy (such as change in systolic blood pressure) may be related to HGS in pregnant women. It is therefore, important for clinicians to pay attention to this, in planning rehabilitation strategies for pregnant women.

Background. Association football, otherwise known as soccer, is the most popular sport in the world. The increase in the popularity of the game and the expectations from players make injury risk in football high. Objective. To describe the types, severity, prevalence and mechanism of injuries among professional footballers in the Nigeria Premier League (NPL). Methods. The Union of European Football Association (UEFA) Injury Study Questionnaire was used for data collection. A total of 240 footballers from 11 clubs, who participated in the 2011/2012 NPL premiership season, was selected through proportionate stratified random sampling technique, and the participants were studied using a prospective cohort study design for 6 months. Descriptive statistics of means, percentages and frequency distributions were used to answer the research questions. Results. The mean (standard deviation) age, height and weight of the injured footballers was 22.9 (3.4) years, 1.69 (0.05) m and 71.3 (3.9) kg, respectively. There was a high injury prevalence (78%) associated with actual league games, whereas the incidence rate per 1 000-hour exposure was 300.2 exposure-hours from 19 games within 6 months. Sprain (32%) was the predominant type of injury recorded. The tackle event (34%) was the predominant mechanism of injury recorded, and 63% of the injuries led to 1 - 3 days of player absence from football activities. Most of the injuries were recurrent injuries (63%). Conclusion. This study showed a high occurrence of injuries in the NPL, in particular associated with league (competitive) games. The findings of this study will serve to guide the development and implementation of injury prevention strategies in the NPL.

This study assessed the risk of back and neck pain and its ergonomic implications on workers in a University setting in South Africa. The designs for this study were both cross-sectional descriptive survey and observational study. A total of 53 academic and administrative employees participated in this study. The mean age ± SD of participants was 46.45±8.31. The minimum age was 32 and maximum was 64 years old. About 71% of the female participants were at a high risk of sustaining back injuries. There was however no significant association between gender of participant and risk of sustaining back injury (p= 0.87). Administrators recorded the highest level of high risk of sustaining back injury, while lectures reported the highest level of medium risk of sustaining back pain at work. About 53% of respondent fall within the medium level of risk, another 26% were within the high level of risk. Administrators presented within the highest risk level of 41.2% in sustaining back injury. There was also no significant relationship between jobs and risk of sustaining back injuries (p=0.382). More females presented with medium to high risk of sustaining back injuries. Overall, the risk of sustaining back and neck pain amongst university employees was found to be medium to high. Gender was found to have no significant influence on the risk of sustaining back and neck injuries. Low back pain was also found to be common across the jobs, with adminstrators presenting higher risk by disciplines.

The study sought to identify the long term plans of graduating physiotherapy students from a Nigerian university. Eighty-four graduating students participated in this study. Sample of convenience w...

The aim of this study was to assess the impact of physiotherapy on HRQoL of patient with arthritis. The design for this study was a prospective survey design. The EuroQol tool was used to collect d...

Background and purpose: Depression has been found to be associated with pain and poor physical function in patients with knee osteoarthritis though it is not sufficiently documented in Nigeria. This study was aimed at investigating the relationship among pain, depression and physical function in patients with knee osteoarthritis in Ibadan. Methods: Eighty individuals diagnosed with knee osteoarthritis were screened for depression using the mood/ depression assessment questionnaire. Depression, physical function and pain were assessed by Becks Depression Inventory, Ibadan Knee Hip Osteoarthritis Outcome Measure and Modified Visual Analogue Scale respectively. Data were analyzed using Pearson’s correlation test and linear regression (alpha level set at 0.05). Results: Screening for depression was positive in 28.8% of patients aged 62.69 ± 5.96 years. There were significant correlations between physical function and each of pain intensity (r=-0.659) and depression (r = - 0.660) and between pain intensity and depression (r= 0.611). Negative linear relationship exist between physical function and each of pain (R2=0.434), depression (R2=0.436). A positive linear relationship exists between pain intensity and depression (R2=0.374).Conclusion: About a quarter of patients with knee osteoarthritis had depression. Individuals with knee osteoarthritis who had higher levels of pain were more depressed and had lower level of physical function.

Background: The increase in the prevalence of chronic disease among people of different colours, religion, age group and economic status has been documented. Having adequate knowledge of chronic disease is a major impetus towards behavioural changes that lead to prevention and management of chronic diseases.Methods: This was a cross-sectional online survey that examined the knowledge of a University community on the risk factors and signs and symptoms of chronic diseases of lifestyle. Chronic disease of lifestyle assessment questionnaire was administered, online, on the Community. A list-based sampling frame survey was conducted via the emails.Results: A total of 124 (50.2%) respondents were females and 132 (53.7%) of our respondents were within 21–30 years of age. About 13.1% of our respondents were single while 41.6% completed tertiary education. Also, 26.9% were employed and vast majority of them were from black (92.2%) racial affiliation. The majority of them knew that smoking (92.2%), obesity (87.3%), alcohol consumption (84.1%) and stress (88.2%) are the causes of chronic diseases of lifestyle. More than half (52.66%) of the participants had adequate knowledge of the chronic diseases of lifestyle while 21.63% had poor knowledge of chronic diseases of lifestyle.Conclusion: The majority of the participants had good knowledge about the risk factors of chronic diseases of lifestyle but their overall knowledge was poor.Keywords: stroke, hypertension, diabetes, knowledge, chronic diseases of lifestyle

Background: The increase in the prevalence of overweight and obesity in low- and medium-income countries has a negative impact on overall health. Correct perception of one’s body weight is a step in seeking healthy help toward weight reduction in overweight and obese individuals. Objective: This study was carried out to assess the body weight misperception and dissatisfaction among overweight and obese adults in an urban African setting. Methods: This study was part of a larger cross-sectional study that was designed to plan an intervention for overweight and obese adults in an urban African setting. For this study, we randomly selected only overweight and obese adults (≥18 years old) who consented to participate in the study from 15 enumeration areas in Alimosho Local Government Area of Lagos State, Nigeria. We followed the World Health Organization guidelines for conducting community surveys in recruiting overweight and obese participants. We assessed body weight perception and dissatisfaction through their responses to the following: “How do you describe your weight?” and “I feel bad about myself because of my weight.” Data for this study were collected between November 2012 and March 2013. Results: We recruited 567 participants, of whom more than half (n=304, 53.6%) misperceived their weight as either underweight or normal weight, and 61.2% (n=186) of whom were women. The strength of agreement between the actual body mass index and weight perception was very poor (κ=.032, SE .015, P=.04). The strongest predictor of weight perception was sex (female) with an odds ratio of 1.63 (95% CI 1.13-2.35). About 41.1% (n=233) of the participants were dissatisfied with their weight, of whom 30.0% (n=70) were men. Age (young adult) was a predictor of weight dissatisfaction with an odds ratio of 2.37 (95% CI 1.62-3.46). Conclusions: More than half of the participants misperceived their body weight as either underweight or normal weight, and the majority of them were women. More men were not happy with their body weight, and participants in the young adult age group were more dissatisfied with their body weight. [JMIR Public Health Surveill 2017;3(3):e56]

Objective: To investigate the association between the three anatomical factors of Q-angle (QA), pelvic width (PW) and Intercondylar notch width (INW) and knee injuries among the U-23 female soccer players of South Africa Methods: The study is a case-control prospective study design. Twenty four U-23 women soccer players of the South African team were purposively chosen to participate in this study. Participants were divided into two groups: group1 (Case) was those with knee injuries, while those without injuries were in group-2 (Control). PW and INW were measured after Xrays of the hip were taken while the QA was measured manually with the goniomenter. Association between anatomical factors and knee injuries were tested with ANOVA. Results: Q-angle ranged from 140 to 180 for both injured and non injured groups. PW was between 24 -29 cm for both injured and non injured groups. INW was between 1.3mm and 2.8mm for the right and between 1.4mm and 2.5mm for the left notch for the injured group, while INW for the right and left of the non injured group were between 1.7mm to 2.1mm and 1.8mm to 2.1mm, respectively No significant association between knee injuries and each of the anatomical factors was found QA (p= 0.74), PW (p=0.34), INW (right and left respectively) (p=0.142 & p=0.089). Conclusion: The three anatomical factors of QA, PW and INW could not be used to predict knee injuries amongst the U-23 female players in South Africa. Keywords: Pelvic width; Q-Angle; Intercondylar Notch Width; Female Soccer; Knee Injuries

This study described the learning experiences of physiotherapy students during the 2009 comrades marathon. A quali-tative approach using focus group discussions was employed for this study.The population for this study was all the 43 B.Sc. physiotherapy final year students of the university of limpopo, who provided physio-therapy services at the 2009 comrades Marathon. forty (93%) students participated in this study. All the participants were black with majo-rity 23 (58%) of them from the limpopo province. Twenty one (52%) of the participants were females with ages ranging between 21 and 30 years. The field trip provided both sport specific and general learning experiences. participants had the opportunity to handle sports injuries and athletes, work and learn as a team and were quite independent. This trip also provided participants the opportunity experiencing workplace communication and interaction, the reality of the real workplace experience of heavy workload, experience of prejudice, time management and an unsafe environment.Despite organizational challenges of the trip, the event provided an opportunity for the participants to practice sport physiotherapy. Participants appreciated the opportunity to experience the dynamics of team and collaborative learning. To ensure effective use of this event for experiential learning, it is recommended that proper guidance and support be provided by the faculty.

Background: Burnout syndrome in health care workers is a state of physical, emotional and mental exhaustion caused by long-term involvement in high-stress situations. Burnout is regarded as the result of chronic stress that has not been successfully addressed. The purpose of this study was to determine the prevalence, patterns and comparison of the different stages of burnout syndrome amongst various health care professionals. Materials and Methods: Total of 280 health care professionals comprising 55 doctors, 165 nurses, three physiotherapists, five radiographers and 52 medical laboratory scientists participated in the survey. Participants were chosen using a proportionate stratified random sampling technique. The instrument used for data collection was the Maslach Burnout Inventory (MBI) .The data were analysed using descriptive statistics such as means and standard deviations, and inferential statistics (ANOVA). Significance was set at 95%. Results: The results reveals that burnout (EE-emotional exhaustion, DP-depersonalisation, PA-personal accomplishment) occurred in the following order, medical lab scientist (EE 33.85, DP:14.83, PA:21.77), nurses (EE:30.81, DP:12.80,PA:27.81), doctors (EE:25.47, DP:9.87, PA:31.64), radiographers (EE:16.8, DP:7.6, PA:36.2), physiotherapist (EE:8.67, DP:4.33, PA:37.68). There was significant difference in all the stages of burnout ( P Conclusion: Health care organisations need to acknowledge that those who work in the health care profession may need help to cope with the stress and burnout that are often associated with such practice. Efforts to alleviate burnout among health care professionals will have positive effect on health care service delivery.

The purpose of this study is to investigate the knowledge, attitudes and practices related to HIV and AIDS among teenagers in rural schools in Vhembe district. This study focused on teenagers’ sources of knowledge about HIV/AIDS; their knowledge of how to avoid contracting HIV/AIDS; their knowledge of the methods of transmission of the disease; their knowledge of condoms and usage levels; and people with whom they are comfortable to talk about HIV/AIDS. This was a quantitative descriptive research design where a random sample of 128 participants between the ages of 14 and 19 years was selected. The participants were in grades 8 to 12. The study recommended that holistic HIV/AIDS preventive programmes which were culture and gender sensitive be developed. Custodians of culture should be involved in dealing with HIV/AIDS. Parents should also play their role in discussing HIV/AIDS with their children in a non-threatening environment.