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Background: As a result of coronavirus disease 2019 (COVID-19) related lockdown restrictions, people with musculoskeletal (MSK) disorders could be at increased risk of physical and psychological disabilities. This review aimed to summarise the impact of COVID-19 related lockdown restrictions on people with MSK disorders., Methods: Six electronic databases were searched for studies in the English language published until June 10, 2024. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify, select, and critically appraise relevant research. Two reviewers independently abstracted data from the included studies. Data were summarised using narrative synthesis, and the Newcastle-Ottawa Scale was used for quality assessment., Results: The search strategy identified 637 articles, 129 of which were removed as duplicates. Fifteen studies that met the inclusion criteria were analysed. The sample size the studies reviewed ranged from 40 to 1800. Having MSK disorders during COVID-19 related lockdown restrictions led to increased risk of pain, stress, depression, anxiety, MSK related injuries, decreased quality of life and increased use of emergency department., Conclusions: This is the first study to report that COVID-19 related lockdown restrictions led to increased risk of pain, MSK injuries and healthcare resource utilisation as well as decreased quality of life among patients with MSK disorders. These results may help inform policy and management strategies in future for people with MSK disorders to mitigate the negative impact of pandemic., (© 2024 The Author(s). Musculoskeletal Care published by John Wiley & Sons Ltd.)

Background: Understanding the concept and dynamic process of the evolution of professional identity and roles of market access (MA) in the pharmaceutical industry (pharma) is critical to personal, interpersonal, and professional levels of development and impact., Objective: The aim was to carry out a scoping review of the conceptualisation of MA within pharma., Data Sources: BioMed Central, WorldCat.org, and Directory of Open Access Journals were searched from 2003 to 2023., Study Selection: All articles on concepts or definitions and other surrogate terms on MA in pharma were selected., Data Extraction: Keywords generated from an initial cursory literature search on MA in pharma were used in conjunction with AND/OR as search terms. Using the data charting method, key findings were mapped and summarised descriptively. inductive analysis was performed, allowing codes/themes that are relevant to the concept to emerge., Data Synthesis: Arskey and O'Malley's six-stage framework and the PRISMA extension for scoping reviews extension checklist were used as the review and reporting templates. The databases search yielded 222 results. Following title and abstract screening, a total of 146 papers were screened, and 127 of them were excluded. Full-text review was conducted for 19 papers that were deemed by two reviewers to meet the eligibility criteria. One of the authors arbitrated on disputed papers for inclusion. Only 14 of the included papers were found to meet the criteria for the final analysis. Five conceptual dimensions of MA in pharma were identified as "right products", "right patient", "right price", "right point" (time), and "right place" (setting)., Conclusions: Market access in pharma is a process that commences with the development and availability of the right products that are proven to be efficacious and disease/condition-specific (including medications, medical devices, and vaccines); specifically produced for the right patients or end users who will maximise best clinical outcomes and economic value; delivered at the right point in a timely, sustained, and efficient manner, given at the right price (commercially viable or reimbursed price that represents good value); and conducted within the economic, policy, societal, and technological contexts, with the overarching goal of achieving the best patient outcomes and ensuring product profitability., Competing Interests: Conflicts of InterestThe authors declare no conflicts of interest., (© 2024 by the authors.)

Background: Missed appointments is a significant challenge to efficient running of physiotherapy departments and it has cost implications. In this study, wait time, and pattern, predictors and impact of Missed appointments (MAs) on cost, efficiency and recovery time was assessed among Nigerian patients receiving physiotherapy., Method: In this retrospective study a total of 3,243 physiotherapy appointments were booked between 2009 and 2019 at an Outpatient Physiotherapy Clinic in Nigeria. Data were collected on Missed appointments, on costs of of treatment and on socio-demographic characteristics. The total revenue loss due to missed appointments was calculated as a product of the total of Missed appointments and cost per treatment; recovery time was also estimated., Results: Missed appointments were 1,701 out of 3,243 booked (52.5%) and the average wait time for the first appointment was 9.6 ± 23.2 days. The proportion of Missed appointments was higher among females (50.2%), patients who were not resident of the same location as the clinic (45.3%), patients with orthopaedic conditions (56.2%) and patients referred from an orthopaedic surgeon (32.8%). Females, those who live within the city, and those with neurological/medical conditions were 1.68, 1.24, and 1.52 times more likely to have Missed appointments compared to males (OR = 1.68, Confidence intervals = 1.44 - 1.96, p = < 0.001), those who live outside the city (OR = 1.24, CI = 1.05 - 1.46, p = 0.01), and to those who have orthopaedic conditions (OR = 1.52, CI = 1.20 - 1.93, p = < 0.001), respectively. Using per treatment schedule cost of N1000 (an equivalent of $ 2.31), a 52.5% Missed appointments rate resulted in lower efficiency of 76.6% with an efficiency ratio of 0.23. Further, a 52.5% Missed appointments rate could potentially impact patient recovery time by 3402 days if Missed appointments slow a patient recovery process by 2 days., Conclusions: Missed appointments for physiotherapy treatment pose a significant challenge in terms of costs, efficiency, and patient recovery time. Thus, an innovative reminder system may help reduce patients' non-attendance to physiotherapy and its consequences.

WhatsApp has become a medium of communication with the potential of promoting collaborative environment with peers, patients and general population. Till date, no analysis of professional WhatsApp groups' activities exists in physiotherapy. The official WhatsApp group chats of the Association of Clinical and Academic Physiotherapists of Nigeria (ACAPN) was analyzed. A total of 20760 chats were gleaned from July 2020 to June 2021. Videos, audios and emoticons were excluded in the analysis. Administrative permission to conduct was obtained from ACAPN leadership. Two consenting physiotherapists who had never deleted their ACAPN group chats shared and exported all chats to a Gmail. The social presence theory for group communication was used as the framework of analysis. Thematic content analysis was used to analyze qualitative data. Descriptive statistics of frequency and percentages were used to summarize data. Based on social presence theory classifications, interactive messages (64.5%) followed by cohesive messages (30%) were predominant. Members used the platform more for expression of emotions affectively (100%), referring explicitly to others' messages interactively (56.6%) and for greetings (phatic and salutation) cohesively (61.8%). Qualitative themes indicate that all three categories of social presence theory communications were present sufficiently with interactive category being the most common, as members used the WhatsApp platform to interact, construct and share knowledge. Group WhatsApp platform is a veritable means of communication and an indicator of level of social presence among Nigerian physiotherapists. Communication among Nigerian physiotherapists is mostly interactive, then cohesive and affective in terms of dynamics., Competing Interests: The author(s) received no specific funding for this work., (Copyright: © 2023 Mbada et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Osteoarthritis is a primary cause of pain and disability, and it places a considerable economic burden on individuals and the society. In the management of total knee or hip replacement (TKHR), the long-term effectiveness of physiotherapy interventions may slowly accumulate over a period., Objectives: To evaluate all the model-based cost-effectiveness (CE) of physiotherapy interventions for patients with (TKHR)., Data Sources: A literature search was carried out on AMED, MEDLINE, CINAHL, DARE, HTA, NHSEED and cost-effectiveness registry databases from inception to May 2021., Study Selection: Studies that assessed model-based CE of physiotherapy interventions following TKHR and were published in English language. The methodological quality of the included studies were assessed using the Philips Checklist criteria., Data Extraction/data Synthesis: Two reviewers, using a predefined data extraction form, independently extracted data. A descriptive synthesis was used to present the results., Result: Eight hundred eighty-six studies were identified, and the only 3 that met the inclusion criteria were included. Different model structures and assumptions were used in the included studies. The included studies were conducted in the United States of America (n=1), Singapore (n=1) and Italy (n=1). The societal (n=2) and healthcare (n=1) perspective were adopted in the studies. The included studies reported an incremental cost effectiveness ratio (ICER) of $57,200 and 27,471 Singapore dollar (SGD) per quality-adjusted life years in a time horizon of lifetime and three months, respectively. Physiotherapy (hydrotherapy) interventions were potentially cost-effective., Conclusion: Based on the best available evidence, the findings of this review suggest that physiotherapy interventions were CE and cost saving. However, it is important to note that among others the CE of the interventions was a function of the healthcare system, duration of interventions, patient compliance and price., Systematic Review Registration Number Crd: CRD42019151214., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The EuroQol-5 Dimension (EQ-5D) is a generic self-administered questionnaire used for the measurement and economic valuation of a wide range of health conditions, which necessitates its existence and adaptation in different languages. Currently, the tool does not exist in any Nigerian language. This study aimed to translate, cross-culturally adapt, and determine the reliability and validity of the Yoruba version of the EQ-5D-5L questionnaire., Methods: The International Quality of Life Assessment (IQOLA) project guidelines, involving forward translation, reconciliation and harmonization, backward translation, and reconciliation of problematic items were used in the Yoruba translated version of the EQ-5D-5L (EQ-5D-Yor). A total of 113 and 109 persons with musculoskeletal disorders participated in the validity and 7-day test-retest reliability testing of the EQ-5D-Yor. Convergent and discriminant validity of the EQ-5D-Yor were determined using the Yoruba version of the 12-Item Short-Form Health Survey (SF-12) (SF-12-Y) and Visual Analog Scale (VAS). Data were analyzed using descriptive and inferential statistics of Spearman correlation, Intra-Class Correlation, Cronbach alpha, and multi-trait scaling analysis. Alpha level was set as p < 0.05., Results: The construct validity of the EQ-5D-Yor yielded Spearman rho ranging from 0.438 to 1.000, with the EQ-VAS having the highest co-efficient ( r = 1.000; p = 0.001). The convergent validity of the EQ-5D-Yor index with scales and domains of the SF-12-Y yielded no significant correlations ( p < 0.05), except for the physical functioning scale ( r = -0.709, p = 0.001). On the other hand, the divergent validity of the EQ-5D-Yor index with VAS yielded a moderate negative correlation ( r = -0.482; p = 0.001). The Intra-class Correlation Coefficient (ICC) and Cronbach's alpha for the test-retest reliability of the EQ-5D-Yor were 1.000 and 0.968. The confirmatory factor analysis showed the factor loadings were poor when including VAS in the model., Conclusion: The EQ-5D-Yor has acceptable validity and reliability and can be used as a valid tool among Yoruba speaking population with musculoskeletal disorders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Fatoye, Akinfala, Gebrye, Fatoye, Ojelade, Oyewole and Mbada.)

Background: Health literacy is an important multidimensional concept of public health concern and a determinant of health outcomes and access to healthcare which requires robust measurement. The objective of this study was to culturally adapt and establish the psychometric properties of the Yoruba version of the Health Literacy Questionnaire., Methods: A cross-sectional survey of Nigeria Yoruba speaking adults was conducted with the Health Literacy Questionnaire following its translation and adaptation. Data were subject to psychometric evaluation (confirmatory factor analysis, composite reliability, Cronbach's alpha, intra class correlation) and association with sociodemographic variables., Results: A total of 258 adults with mean age 26.7 years participated in the study. The easiest scale to score highly was 'Actively managing my health' and hardest was 'Ability to find good health information' and 'Navigating the healthcare system'. Six one-factor models fitted well without correlated residuals but the other three had a good fit after model modification. Composite reliability and Cronbach's α of ≥ 0.7 were observed for all scales, suggesting good internal consistency of the scales. Test-retest reliability of the Yoruba translation of the Health Literacy Questionnaire was moderate to good in all scales, intra class correlation ranging from 0.66 to 0.76., Conclusion: The Health Literacy Questionnaire was successfully translated and culturally adapted and demonstrated good content and construct validity and high composite reliability. The Yoruba translation of the Health Literacy Questionnaire has the potential of being a useful clinical tool for the assessment of health literacy, especially among Yoruba speaking community of Nigeria. Thereby helping to improve the health outcomes through access to healthcare.

Conclusion: This is the first study to assess the psychometric properties of the Y-SF-12. It appears to be valid and may be an appropriate tool for assessing health-related quality of life among Yoruba population. The tool may help to improve the health outcomes of individuals, and redress health inequalities in low and middle-income countries., Background: Short Form 12 (SF-12) health survey has found its utility in clinical and research settings because of its short length that spares time. Though several translations into other languages do exist there is none available in Yoruba language. Hence, this study's objective was to culturally adapt and determine the reliability and validity of the Yoruba translated version of the SF-12., Methods: Forward and backward translations of SF-12 into Yoruba version of SF-12 (Y-SF-12) were done using the International Quality of Life Assessment Project Guidelines. Healthy participants were assessed using both English and Yoruba versions of SF-12 for the validation phase, and two weeks later were reassessed with the Y-SF-12 for the reliability phase., Results: Participants were 225 males and 171 females. The mean scores for each scale range from 73.4 to 86.1, with no gender difference. All scale and domain scores evidenced a negative skew and ranges from -1.79 to -0.62. Concurrent validity (0.879 - 0.938) and convergent validity (0.786 - 0.907) appeared to be good as reflected by their correlation values. The internal consistency of Y-SF-12 was good as Cronbach's Alpha ranged between 0.899 and 0.968, while the Intraclass Correlation Coefficient (ICC) ranged between 0.775 and 0.949.

Study Design: Cultural adaptation and psychometric analysis., Objective: This study determined the test-retest reliability, acceptability, internal consistency, divergent validity of the Yoruba pain self-efficacy questionnaire (PSEQ-Y). It also examined the ceiling and floor effects and the small detectable change (SDC) of the PSEQ-Y among patients with chronic low back pain (LBP)., Summary of Background Data: There are various indigenous language translations of the PSEQ and none adapted to African language. However, translations of the PSEQ into Nigerian languages are not readily available., Methods: The validity testing phase of the study involved 131 patients with LBP, while 83 patients with LBP took part in the reliability phase. Following the Beaton recommendation for cultural adaptation of instruments, the PSEQ was adapted into the Yoruba language. The psychometric properties of the PSEQ-Y determined comprised: internal consistency, divergent validity, test-retest reliability, and SDC., Results: The mean age of the participants was 52.96 ± 17.3 years. The PSEQ-Y did not correlate with the Yoruba version of Visual Analogue Scale (VAS-Y) scores (r = -0.05; P = 0.59). The values for the internal consistency and the test-retest reliability of the PSEQ-Y were 0.79 and 0.86, with the 95% confidence interval of the test-retest reliability ranging between 0.82 and 0.90. The standard error of measurement (SEM) and the SDC of the PSEQ-Y were 1.2 and 3.3, respectively. The PSEQ-Y had no floor or ceiling effect, as none of the respondents scored either the minimal or maximal scores., Conclusion: This is the first study in Nigeria to culturally adapt PSEQ. The PSEQ-Y showed adequate psychometric properties similar to existing versions. Therefore, the tool can be used to assess pain self-efficacy in clinical and research settings and help to improve the health outcomes of patients chronic LBP.Level of Evidence: 3., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Objective: Explosion in information technology knowledge and utilization among young people, referred to as digital natives, seems less explored in the health sector and training. This study was aimed to assess awareness, attitude and expectations of physiotherapy students on telerehabilitation., Methods: This cross-sectional survey employed systematic probability sampling technique to recruit 200 physiotherapy students. A self-developed questionnaire which was tested for its face and content validity was used to obtain data. Data was analysed using descriptive and inferential statistics. Alpha level was set at p  < 0.05., Results: The mean age of the respondents was 21.2 ± 2.04 years. There was higher prevalence of moderate awareness (43%) and positive attitude towards telerehabilitation (39%). Majority of the respondents (62%) had high expectation towards future telerehabilitation products and services. There was significant association between level of awareness of telerehabilitation and age ( X 2  = 7.119; p  = 0.001)., Discussion: The responding students in this study are by age in the class of digital natives, who should be conversant with technology. This could account for the higher moderate level of awareness of telerehabilitation. However, the higher rates of negative attitude towards telerehabilitation could be attributed to prevailing barriers to its utilization in Nigeria. Nonetheless, a large percentage of the students had high expectations for the future of telerehabilitation., Conclusion: Nigerian physiotherapy students have moderate awareness and high expectation for future telerehabilitation applications. However, a larger number of them hold negative attitude towards it use., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© International Association of Medical Science Educators 2021.)

Background: Telerehabilitation can facilitate multidisciplinary management for people with nonspecific chronic low back pain (NCLBP). It provides health care access to individuals who are physically and economically disadvantaged., Objective: This study aimed to evaluate the clinical and cost-effectiveness of telerehabilitation compared with a clinic-based intervention for people with NCLBP in Nigeria., Methods: A cost-utility analysis alongside a randomized controlled trial from a health care perspective was conducted. Patients with NCLBP were assigned to either telerehabilitation-based McKenzie therapy (TBMT) or clinic-based McKenzie therapy (CBMT). Interventions were carried out 3 times weekly for a period of 8 weeks. Patients' level of disability was measured using the Oswestry Disability Index (ODI) at baseline, week 4, and week 8. To estimate the health-related quality of life of the patients, the ODI was mapped to the short-form six dimensions instrument to generate quality-adjusted life years (QALYs). Health care resource use and costs were assessed based on the McKenzie extension protocol in Nigeria in 2019. Descriptive and inferential data analyses were also performed to assess the clinical effectiveness of the interventions. Bootstrapping was conducted to generate the point estimate of the incremental cost-effectiveness ratio (ICER)., Results: A total of 47 patients (TBMT, n=21 and CBMT, n=26), with a mean age of 47 (SD 11.6) years for telerehabilitation and 50 (SD 10.7) years for the clinic-based intervention, participated in this study. The mean cost estimates of TBMT and CBMT interventions per person were 22,200 naira (US $61.7) and 38,200 naira (US $106), respectively. QALY gained was 0.085 for TBMT and 0.084 for CBMT. The TBMT arm was associated with an additional 0.001 QALY (95% CI 0.001 to 0.002) per participant compared with the CBMT arm. Thus, the ICER showed that the TBMT arm was less costly and more effective than the CBMT arm., Conclusions: The findings of the study suggested that telerehabilitation for people with NCLBP was cost saving. Given the small number of participants in this study, further examination of effects and costs of the interventions is needed within a larger sample size. In addition, future studies are required to assess the cost-effectiveness of this intervention in the long term from the patient and societal perspective., (©Francis Fatoye, Tadesse Gebrye, Clara Fatoye, Chidozie E Mbada, Mistura I Olaoye, Adesola C Odole, Olumide Dada. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 24.06.2020.)