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Rationale: The structure, process and outcome (SPO) framework has been used to establish that improved structures of care influences an enhanced process of stroke care resulting in improved outcome. Although, both stroke and Parkinson's disease (PD) are neurological conditions that require prolonged period of care and rehabilitation, the SPO framework has not yet been used to describe the existing structures and processes of PD care and rehabilitation in Ghana., Aims and Objective: To describe the current structures and processes of PD rehabilitation across the three healthcare levels (primary, secondary and tertiary) in the southern sector of Ghana., Method: An online cross-sectional descriptive survey design was used via REDCap. Fifty-two therapists, including department heads, physiotherapists, occupational therapists and speech and language therapists from seven healthcare facilities were purposefully sampled and invited to complete the survey on structures and processes of PD rehabilitation. Descriptive statistical analysis was performed with SPSS v29.0. Comparative analysis was performed using Pearson's chi-square and Kruskal-Wallis test (H-test) as appropriate. Statistical significance was set at p < 0.05., Results: Forty-nine (94.2%) responses were received and four incomplete responses were excluded from analysis. Structure of rehabilitation: Most of the participants were physiotherapists (n = 36/45; 80.0%) and tertiary level professionals (n = 31/45; 68.9%). Only physiotherapy service was available across all the healthcare levels. Persons with PD were mostly referred for rehabilitation at Hoehn and Yahr stage III as reported by 55.6% (n = 20/36) of the therapists. Process of rehabilitation: Most therapists treated persons with PD two times weekly (n = 19/33; 57.6%) and on individual basis (n = 29/33; 87.9%). Only 9 (27.2%) and 7 (21.2%) therapists often used clinical guidelines or outcome measures respectively in managing PD and 93.9% of the therapists had no local protocols., Conclusion: The structures and processes needed for PD rehabilitation exist but differ across the healthcare levels and among therapists. Physiotherapy was the most common rehabilitation service available at all levels of healthcare., (© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Rationale: Rehabilitation has the potential to significantly improve the lives of people and, most importantly, for persons with Parkinson's disease (PD). Although numerous studies have reported the benefits of rehabilitation for persons with PD (PwPD), these services are still limited and underutilized even when patients exhibit problems that require rehabilitation., Aims and Objectives: This review aims to describe the (a) indication for referral for rehabilitation services, (b) patterns of referral for rehabilitation and (c) factors that facilitate or hinder the utilization and delivery of rehabilitation services among PwPD., Methods: A comprehensive literature search was conducted across selected databases, African Journals Online, EBSCOhost (CINAHL, Africa-wide), PubMed, SCOPUS and Web of Science. Studies published in English from January 2002 until December 2022 were applied as limiters. Reference and grey data sources tracking were also conducted. Two reviewers conducted the study selection, screening of titles, abstracts and full text and data charting. A descriptive analysis was performed. Findings were narratively presented and illustrated with tables, diagrams and descriptive formats as appropriate., Results: Twelve studies were included in the review; however, none were from Africa. Impairments and activity limitations were the key functioning problems indicated for rehabilitation. Age, gender, income, race, disease stage, specific functioning problems, quality of life and care by a neurologist were the main predictors for referral to rehabilitation. Physiotherapy, occupational therapy and speech and language therapy were the most utilized rehabilitation services and were sometimes utilized together. The rate of rehabilitation service utilization among PwPD ranged from 0.9% to 62.5%. Lack of referrals and limited rehabilitation units/professionals were the common barriers to rehabilitation service utilization., Conclusion: Per the studies reviewed, utilization of rehabilitation services is generally low among PwPD. Lack of referral and nonavailability of professionals are cited as barriers to access. Adequate measures are needed to improve rehabilitation services for all PwPD., (© 2024 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Allied health therapies refer to a range of healthcare professionals, including physiotherapists, occupational and speech-language therapists, who aim to optimize daily function and quality of life in conjunction with medical care. In this narrative review of literature on allied health therapies in people with Parkinson's disease (PD), we focused on the diversity in healthcare access, state of the art, current challenges in the African continent, and proposed solutions and future perspectives. Despite the increasing prevalence and awareness of PD in Africa, numerous challenges persist in its management. These include resource limitations, geographical barriers, sociocultural beliefs, and economic constraints. Nevertheless, innovative solutions, including telerehabilitation and community-based rehabilitation, offer hope. Collaborative efforts within the continent and internationally have shown potential in bridging training and resource gaps. Significant strides can be made with tailored interventions, technological advancements, and multifaceted collaborations. This review offers practical insights for healthcare professionals, policymakers, and caregivers to navigate and optimize PD care in the African context.

Objectives: To investigate the knowledge about physical activity, physical activity levels and waist-to-hip ratio among persons living with diabetes in the Ho Municipality., Design: Cross-sectional observation study., Setting: The researcher collected data from two diabetes clinics in the Ho Municipality of Ghana., Participants: Consenting persons living with diabetes who attended the diabetes clinics., Main Outcome Measures: Participants' waist-to-hip ratio, knowledge of the physical activity and level of activity according to the International Physical Activity Questionnaire., Results: There were 106 participants, and the modal age was 60 years or older (50.94% (n= 54)). Of the total, 62.3% (n = 66) were women, and the mean knowledge level was 12.7±1.58 (range: 0-17). Mean waist-to-hip ratio was 0.92 ± 0.10) with 25.5% (n = 27) men and 48.1% (n = 51) women recording abnormally increased waist-to-hip ratios. Additionally, 44% of participants engaged in low physical activity levels, whereas 10% participated in high levels. There were no significant associations between physical activity levels and waist-to-hip ratios (r = 0.176, p=0.071)., Conclusion: Persons with diabetes in the Ho Municipality mostly engaged in low and moderate physical activity levels and had abnormally increased waist-to-hip ratios suggesting abdominal obesity. Knowledge of physical activity may be associated with physical activity performance and waist-to-hip ratio, bearing an inverse association with physical activity levels., Funding: None declared., Competing Interests: Conflict of interest: None declared, (Copyright © The Author(s).)

Objectives: To examine the feasibility and within-session reliability of Myoton technology to measure muscle stiffness objectively in people with Parkinson's disease in an outpatient setting., Design: An exploratory quantitative study design was used., Setting: The study was conducted in the outpatient physiotherapy department of a Teaching Hospital in Ghana. Participants were recruited from three sites., Participants: Thirty adults with Parkinson's disease over 18 years with increased tone (muscle stiffness) and at Hoehn and Yahr Stages I-III were studied. Persons with severe comorbidities were excluded., Intervention: There was no intervention before testing. The MyotonPRO device measured the mechanical properties of the biceps brachii, flexor carpi radialis and tibialis anterior muscles in a relaxed supine position. The probe applied mechanical impulses to the skin, eliciting tissue oscillations. The muscles' three parameters (stiffness, non-neural tone and elasticity) were recorded bilaterally. The reliability of two sets (of 5 impulses) of Myoton data on all three muscles was examined., Results: All 30 participants (66.3±8.9 years) were recruited and tested within eight weeks. Intraclass correlation coefficients (ICC 3,2) were above 0.92 for biceps brachii and tibialis anterior and above 0.86 for flexor carpi radialis., Conclusion: The MyotonPRO was reliable for measuring two sets of data within the same session, indicating that only one set of measurements is needed. The technique is feasible and easy to use in a clinical setting in Ghana, with the potential to assess the effect of medical and physiotherapy interventions on muscles in people with Parkinson's disease., Funding: M.S discloses a grant from the Science and Technology Facilities Council Impact Acceleration Account at the University of Southampton to support this collaborative research (no personal finance received). All other authors, M.W.A, P.E.M, C.O.Y, B.E.A.S, S.A.-B, and A.A have no financial disclosure., Competing Interests: Conflict of interest: None declared, (Copyright © The Author(s).)

COVID-19 is the disease caused by SARS-CoV-2, one of a large family of coronaviruses. Severe forms of the disease can lead to respiratory failure with multiple organ failure necessitating rehabilitation in both acute and long-term care. With the increasing prevalence of COVID-19 and rehabilitation needs, the African Rehabilitation Network (AFRENET) produced a guidance document to assist in reducing variation in clinical practice among rehabilitation professionals in the Africa Region. This report outlines the process of the guideline development., Competing Interests: The authors declare no competing interest., (Copyright: Etienne Ngeh Ngeh et al.)