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Introduction: Despite advances in physiotherapy care for Low Back Pain (LBP) worldwide, studies suggest that physiotherapists in Nigeria do not adhere to international guidelines, and it is not known whether recent treatment approaches developed for LBP are recognized or applied by physiotherapists in Nigeria., Objectives: To evaluate the current assessment and treatment practices used by physiotherapists in Nigeria for people with recent onset, recurrent and chronic LBP., Design: A descriptive cross-sectional electronic national survey., Participants: Two hundred and sixty-seven registered physiotherapists who treat LBP across all 36 states of Nigeria completed the survey anonymously via REDCap., Results: Two hundred and sixty-seven physiotherapists (mean age = 37.6 years, SD = 9.1; 53.6% female) completed the survey in full. Although most physiotherapists (> 95%) regularly applied traditional assessment methods (e.g., history of presenting complaint, observation for spinal deformity, palpation), only approximately 30% screened for red flag pathology. Very few physiotherapists assessed patients with LBP for psychological distress (< 8%) or risk stratification/prognostic factors (< 4%). For treatment, electrophysical agents and muscle techniques (e.g., massage) predominated (> 95%), while few physiotherapists used cognitive-behavioural strategies (< 2%), individualised multimodal treatment programs (e.g., cognitive functional therapy, StarT Back or STOPS, < 1.5%), validated outcome measures (< 15%), clinical practice guidelines (< 10%) or a clinical reasoning strategy/framework (< 20%). Most Nigerian physiotherapists (> 99%) expressed interest in learning evidence-based LBP assessment and treatment methods from international experts., Conclusion: There is very limited application of contemporary assessment and treatment practices for LBP by Nigerian physiotherapists; however, they are very interested in learning these methods from international experts., (© 2024 John Wiley & Sons Ltd.)

Context: The biopsychosocial approach to managing low back pain (LBP) has the potential to improve the quality of care for patients. However, LBP trials that have utilized the biopsychosocial approach to treatment have largely neglected sexual activity, which is an important social component of individuals with LBP., Objectives: The objectives of the study are to determine the effects of manual therapy plus sexual advice (MT+SA) compared with manual therapy (MT) or exercise therapy (ET) alone in the management of individuals with lumbar disc herniation with radiculopathy (DHR) and to determine the best sexual positions for these individuals., Methods: This was a single-blind randomized controlled trial. Fifty-four participants diagnosed as having chronic DHR (>3 months) were randomly allocated into three groups with 18 participants each in the MT+SA, MT and ET groups. The participants in the MT+SA group received manual therapy (including Dowling's progressive inhibition of neuromuscular structures and Mulligan's spinal mobilization with leg movement) plus sexual advice, those in the MT group received manual therapy only and those in the ET group received exercise therapy only. Each group received treatment for 12 weeks and then followed up for additional 40 weeks. The primary outcomes were pain, activity limitation, sexual disability and kinesiophobia at 12 weeks post-randomization., Results: The MT+SA group improved significantly better than the MT or ET group in all outcomes (except for nerve function), and at all timelines (6, 12, 26, and 52 weeks post-randomization). These improvements were also clinically meaningful for back pain, leg pain, medication intake, and functional mobility at 6 and 12 weeks post-randomization and for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at 6, 12, 26, and 52 weeks post-randomization (p<0.05). On the other hand, many preferred sexual positions for individuals with DHR emerged, with " side-lying " being the most practiced sexual position and " standing " being the least practiced sexual position by females. While " lying supine " was the most practiced sexual position and " sitting on a chair " was the least practiced sexual position by males., Conclusions: This study found that individuals with DHR demonstrated better improvements in all outcomes when treated with MT+SA than when treated with MT or ET alone. These improvements were also clinically meaningful for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at long-term follow-up. There is also no one-size-fits-all to sexual positioning for individuals with DHR., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

To determine and appraise the certainty of fracture liaison service (FLS) in reducing the risk of secondary fragility fractures in older adults aged ≥ 50 years and to examine the nature of the FLS and the roles of various disciplines involved in the delivery of the FLS. Medline, EMBASE, PubMed, CINAHL, SCOPUS, and The Cochrane Library were searched from January 1st, 2010, to May 31st, 2022. Two reviewers independently extracted data. The risk of bias was evaluated using the Newcastle-Ottawa Scale for cohort studies and the PEDro scale for randomized trials, while the GRADE approach established the certainty of the evidence. Thirty-seven studies were identified of which 34 (91.9%) were rated as having a low risk of bias and 22 (59.5%) were meta-analyzed. Clinically important low certainty evidence at 1 year (RR 0.26, CI 0.13 to 0.52, 6 pooled studies) and moderate certainty evidence at ≥ 2 years (RR 0.68, CI 0.55 to 0.83, 13 pooled studies) indicate that the risk of secondary fragility fracture was lower in the FLS intervention compared to the non-FLS intervention. Sensitivity analyses with no observed heterogeneity confirmed these findings. This review found clinically important moderate certainty evidence showing that the risk of secondary fragility fracture was lower in the FLS intervention at ≥ 2 years. More high-quality studies in this field could improve the certainty of the evidence. Review registration: PROSPERO-CRD42021266408., (© 2024. The Author(s).)

Objectives: To determine the long-term clinical effects of spinal manipulative therapy (SMT) or mobilization (MOB) as an adjunct to neurodynamic mobilization (NM) in the management of individuals with Lumbar Disc Herniation with Radiculopathy (DHR)., Design: Parallel group, single-blind randomized clinical trial., Setting: The study was conducted in a governmental tertiary hospital., Participants: Forty (40) participants diagnosed as having a chronic DHR (≥3 months) were randomly allocated into two groups with 20 participants each in the SMT and MOB groups., Interventions: Participants in the SMT group received high-velocity, low-amplitude manipulation, while those in the MOB group received Mulligans' spinal mobilization with leg movement. Each treatment group also received NM as a co-intervention, administered immediately after the SMT and MOB treatment sessions. Each group received treatment twice a week for 12 weeks., Outcome Measures: The following outcomes were measured at baseline, 6, 12, 26, and 52 weeks post-randomization; back pain, leg pain, activity limitation, sciatica bothersomeness, sciatica frequency, functional mobility, quality of life, and global effect. The primary outcomes were pain and activity limitation at 12 weeks post-randomization., Results: The results indicate that the MOB group improved significantly better than the SMT group in all outcomes ( p  < 0.05), and at all timelines (6, 12, 26, and 52 weeks post-randomization), except for sensory deficit at 52 weeks, and reflex and motor deficits at 12 and 52 weeks. These improvements were also clinically meaningful for neurodynamic testing and sensory deficits at 12 weeks, back pain intensity at 6 weeks, and for activity limitation, functional mobility, and quality of life outcomes at 6, 12, 26, and 52 weeks of follow-ups. The risk of being improved at 12 weeks post-randomization was 40% lower (RR = 0.6, CI = 0.4 to 0.9, p  = 0.007) in the SMT group compared to the MOB group., Conclusion: This study found that individuals with DHR demonstrated better improvements when treated with MOB plus NM than when treated with SMT plus NM. These improvements were also clinically meaningful for activity limitation, functional mobility, and quality of life outcomes at long-term follow-up., Trial Registration: Pan-African Clinical Trial Registry: PACTR201812840142310.

Study Design: A systematic review and meta-analysis of clinical trials., Objectives: To determine the effect of non-invasive transcutaneous spinal direct current stimulation (tsDCS) on spasticity, activity limitations and participation restrictions in various upper motor neuron diseases., Methods: Six databases including CINAHL plus, Cochrane CENTRAL, Embase, MEDLINE, SCOPUS and Web of Science were searched for the relevant records from January 2008 to December 2022. Two reviewers independently selected and extracted data on spasticity, activity limitations and participation restrictions. The risk of bias was evaluated using the PEDro scale while the GRADE approach established the certainty of the evidence., Results: Eleven studies were identified of which 5 (45.5%) were rated as having a low risk of bias and 8 (72.7%) were meta-analyzed. The meta-analyses did not show any significant differences between cathodal (SMD = -0.67, 95% CI = -1.50 to 0.15, P = 0.11, I 2  = 75%, 6 RCTs) or anodal (SMD = 0.11, 95% CI = -0.43 to -0.64, p = 0.69, I 2  = 0%, 2 RCTs) and sham tsDCS for spasticity. There was also no significant difference between active and sham tsDCS for activity limitations (SMD = -0.42, 95% CI = -0.04 to 0.21, p = 0.2, I 2  = 0%, 2 RCTs) and participation restrictions (MD = -8.10, 95% CI = -18.02 to 1.82, p = 0.11, 1 RCT)., Conclusions: The meta-analysis of the available evidence provides an uncertain estimate of the effect of cathodal tsDCS on spasticity, activity limitation and participation restriction. It might be very helpful, or it may make no difference at all. However, considering the level of the evidence and the limitation in the quality of the majority of the included studies, further well-designed research may likely change the estimate of effect., Trial Registration: PROSPERO CRD42021245601., (© 2023. The Author(s), under exclusive licence to International Spinal Cord Society.)

Background: Recently, there has been a marked increase in the incidence of cancer, HIV, and other noncommunicable diseases globally. Thus, the demand for palliative care (PC), including end-of-life care, continues to grow worldwide. Physiotherapy has an important role in PC as it aims to alleviate symptoms and improve quality of life by optimising independent levels of function., Objective: To assess the level of knowledge, awareness and current practice of PC amongst Nigerian physiotherapists in clinical practice., Method: Our study used a cross-sectional descriptive census-based method and recruited practising physiotherapists in Nigeria. An electronic questionnaire was used to collect data over 12 weeks, comprising 36 semistructured questions in four domains: personal information, knowledge, awareness and current practices regarding PC. Data were analysed using a pragmatist paradigm., Results: Of the 426 physiotherapists who participated, 50% ( n = 213) had a postgraduate degree, 49.5% ( n = 211) had a bachelor's degree and 0.5% ( n = 2) had a Doctor of Physical Therapy degree. The results also indicate that 73.9% ( n = 315) of the participants had sufficient knowledge about PC, 80.5% ( n = 343) had a sufficient level of awareness about PC and 66.7% ( n = 284) were using current clinical practices in the rehabilitation of critically ill patients or those with chronic conditions., Conclusion: It was concluded that most Nigerian physiotherapists had sufficient knowledge and awareness about PC and were involved in the management of patients requiring PC physiotherapy., Clinical Implication: It can be understood that a large proportion of Nigerian physiotherapists have clinical experience managing patients requiring PC, despite inadequate formal training in this field., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2023. The Authors.)

Background: Mental health in medical students is well researched, with physiotherapy students receiving less attention even though psychiatry is a recognised specialty within physiotherapy., Objectives: To assess the prevalence and correlates of depression, anxiety and stress among physiotherapy clinical students., Methods: A descriptive cross-sectional study design was employed on 402 physiotherapy clinical students aged 17-40 years using a convenience sampling method. The data were collected using the self-administered 42-items Depression, Anxiety and Stress scale (DASS) and the data were analysed using a Chi-square test and binary logistic regression analysis., Results: The prevalence of depression, anxiety and stress among these students was 79.9%, 85.6% and 81.6%, respectively. The results indicate that financial status and social life influenced depression by 20.6% (odds ratio [OR] [95%] = 1.206 [1.110, 1.311]) and 36% (OR [95%] = 1.360 [1.050, 1.764]), respectively. Fear of repeating a class influenced anxiety by eight times (OR [95%] = 8.330 [6.643, 10.422]). Fear of repeating a class, financial status and academic performance influenced stress by eight times (OR [95%] = 8.360 [6.677, 10.470]), 17.5% (OR [95%] = 1.175 [1.083, 1.275]) and 18.1% (OR [95%] = 1.181 [1.083, 1.276]), respectively., Conclusion: Our study concluded that there was a high prevalence of depression, anxiety and stress among physiotherapy clinical students. These outcomes suggest that more attention needs to be given to improving physiotherapy clinical students' mental health, which will ultimately improve learning outcomes., Clinical Implications: The long-term effects of psychological distress could potentially impact students' academic performance. It may also have long-lasting effects after graduation. Therefore, students who are at risk of developing psychological symptoms are needed to be thoroughly examined and then receive early required interventions., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2022. The Authors.)

Background: Transcranial direct current stimulation (tDCS) is effective in the management of patients with central post-stroke pain (CPSP) and post-stroke depression (PSD) individually. However, it is not known if tDCS delivered via dorsolateral prefrontal cortex (DLPFC) can be used to ameliorate both symptoms., Objective: The purpose of this case report was to share the effectiveness of using tDCS of the DLPFC with short inter-session intervals to reduce central pain and depression in a stroke survivor., Case Description: A 45-year-old patient presented with CPSP and depression following a stroke. The CPSP and depression were diagnosed using the Douleur Neuropathique 4 Questionnaire (DN4Q) and the Beck Depression Index (BDI) respectively. The pain score was 10 on a visual analogue scale (VAS) and it was a hemi-body burning sensation, with a score of 7 on DN4Q, and the depression score was 25 on the BDI. The patient received anodal tDCS to the left DLPFC using two different application protocols. Initially, a stimulation session of 2 milliamperes (mA) intensity for 20 minutes was given every working day for 2 weeks. After 3 weeks, she then received 7 daily sessions of periodic stimulations of 2 mA intensity for 13 minutes each with 20 minutes inter-session intervals for 1 week. The patient was followed up for 6 months post-intervention., Outcomes: Immediately following the last session of the initial protocol of stimulation, the BDI score reduced from 25 to 7 and the pain became abolished. However, the symptoms relapsed at 3 weeks post-intervention to the initial BDI score of 25, VAS score of 10 and DN4Q score of 7. Following the application of the second protocol of stimulation, the BDI score improved to 18 at three weeks and later to 7 at six months post-intervention while the pain (both VAS and DN4Q) became completely abolished., Conclusions: Further research is needed to determine if a series of periodic tDCS with short-intersession intervals applied to the DLPFC may be more effective than a single tDCS with long inter-session intervals, in decreasing pain and inducing long-term improvement in mood in people with stroke.

Objectives: The study aimed to determine the knowledge and current practices of Nigerian physiotherapists on the physical activity and exercise training in the rehabilitation of patients with asthma and to determine if any difference exists between novice and expert professionals., Methods: This was designed as a cross-sectional study. A total of 311 practicing physiotherapists in Nigeria participated in the study. An electronic questionnaire comprising 34 semi-structured questions with three domains; personal information, knowledge, and current practices, was used to collect data throughout 4-months. Data were analyzed using a pragmatist paradigm., Results: Out of the physiotherapists, 51.8% ( n  = 161) had postgraduate degrees, 46.9% ( n  = 146) had bachelor's degrees, and 1.3% ( n  = 4) had a doctor of physiotherapy degrees. The result also indicates that 45.3% ( n  = 141) of the physiotherapists had insufficient knowledge about asthma, and 39.5% ( n  = 123) were not using current clinical practice in the rehabilitation of patients with asthma. The results also indicate that expert physiotherapist has more knowledge and also uses current practices when compared to novice physiotherapist., Conclusions: Even though expert physiotherapists have better knowledge and current practices when compared to the novice physiotherapists, the overall outcomes indicate that Nigerian physiotherapists had insufficient knowledge about asthma and were not using current clinical practice in the rehabilitation of patients with asthma.

Objective: This study aimed to examine the effect of Kinesio taping as an adjunct to combined chain exercises compared with combined chain exercises alone in the management of individuals with knee osteoarthritis., Methods: A total of 60 (27 male, 33 female) individuals (age range = 50-71 yrs and mean age = 54.26 ± 8.83 yrs) diagnosed as having mild to moderate knee osteoarthritis (based on the Kellgren and Lawrence grade I-III classification) were randomly allocated into two groups with 30 participants each in the Kinesio taping + combined chain exercises and combined chain exercises groups. Participants in the Kinesio taping + combined chain exercises group received Kinesio taping plus combined chain exercises and those in the combined chain exercises group received only combined chain exercises. Each participant was assessed for pain, range of motion, functional mobility, and quality of life at baseline and after 8 wks of intervention. A mixed-design multivariate analysis of variance was used to analyze the treatment effect., Results: No significant differences were observed in the baseline characteristics of participants in both groups. The result indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (P < 0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the Kinesio taping + combined chain exercises group improved significantly better than the combined chain exercises group in all outcomes, pain (mean = 2.01 [0.64] vs. 3.94 [1.12], F[df] = 5.466[1,58], P = 0.011), flexion range of motion (mean = 121.15 [2.07] vs. 104.28 [3.24], F[df] = 26.722[1,58], P < 0.001), functional mobility (mean = 19.47 [1.95] vs. 31.01 [2.39], F[df] = 29.436[1,58], P < 0.001), and quality of life (mean = 68.76 [3.19] vs. 45.62 [2.87], F[df] = 71.984[1,58], P < 0.001), after 8 wks of intervention., Conclusions: The findings of this study concluded that Kinesio taping + combined chain exercises and combined chain exercises were both effective but Kinesio taping plus combined chain exercises was more effective in the management of individuals with knee osteoarthritis., Trial Registration: Pan African Clinical Trial Registry: PACTR201810603949411., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: HIV-associated peripheral neuropathy (PN) is a common neurological complication associated with HIV infection. Distal symmetrical polyneuropathy (DSPN) is the most commonly occurring type, which is associated with symptoms such as numbness, unsteady gait and, in some cases, muscle atrophy and weakness when myelinated nerve fibres are affected. If unmyelinated nerve fibres are affected, a painful neuropathy and autonomic symptoms may occur., Objectives: This research study assessed the effects of a strength exercise intervention on balance impairment and gait disturbance amongst individuals living with HIV-associated DSPN., Method: The study was a single-blinded, randomised controlled trial (RCT) with participants sourced from four HIV centres in Kano metropolis, Nigeria. The intervention was supervised and included progressive resistance exercise (PRE) (three 40-min sessions per week for 12 weeks) using a quadriceps bench ( n = 44). The control group (CG) included the non-exercise group ( n = 47). The two groups continued to receive routine care. Data were summarised and analysed using inferential statistics (SPSS version 20 program) with the alpha level set at < 0.05., Results: At 12 weeks, the results revealed significant improvement with regard to balance performance ( p = 0.001) and walking ability ( p = 0.001) in the training group. In contrast, no significant differences in balance ( P = 0.677) or gait ( P = 0.578) were observed in the CG., Conclusion: The findings suggest that PRE is beneficial for balance impairment and gait disturbance caused by neuropathy in persons living with HIV and receiving antiretroviral drugs., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2021. The Authors.)

Context: Studies have indicated that the muscle energy technique (MET) and the positional release technique (PRT) are effective in the management of piriformis syndrome (PS); however, evidence is scarce regarding the combination of these techniques in the form of an integrated neuromuscular inhibition technique (INIT) in the management of individuals with PS. Although a previous trial investigated the effect of INIT for PS, that study did not integrate Ruddy's reciprocal antagonist facilitation (RRAF) method into the INIT protocol, nor did the authors diagnose PS according to established criteria., Objectives: To examine the effects of INIT with integrated RRAF compared with PRT in the management of patients diagnosed with PS., Methods: This study was designed as a single blind randomized clinical trial in which participants diagnosed with PS were randomly allocated into INIT and PRT groups. Each group attended two treatment sessions per week for 8 weeks. Patients in the INIT group received a protocol in which the patient's tender point or trigger point was palpated in the belly of the piriformis approximately halfway between the inferior lateral angle of the sacrum and the greater trochanter, at which point the therapist applied an intermittent or sustained pressure and maintained the pressure for 20-60 seconds (depending on the participant's response to pain reduction). For INIT patients, that protocol was also followed by RRAF, a method in which a patient introduces a series of tiny/miniature contractions or efforts (20 times per 10 seconds) against a therapist's resistance. Patients in the PRT group were treated by palpating the same trigger point described in the INIT group, followed by application of light pressure at the location of the trigger point, which was maintained the pressure for 2 minutes or until the pain subsided (determined by asking the participant to report a pain score using a visual analog scale at 30 second intervals). For both groups, three repetitions of the INIT or PRT treatment were performed over 10 minutes at each clinical visit. Additionally, each group also received stretching exercises immediately after the INIT or PRT treatment session. Each participant was assessed at baseline, immediately posttreatment, and at 4 months posttreatment for pain, sciatica, functional mobility, quality of life, hip abduction, and internal rotation. A repeated measures analysis of variance (ANOVA) of within-between group interactions was used to analyze the treatment effect., Results: Forty eight participants (age range, 25-47 years; mean age ± standard deviation, 32.81 ± 3.27 years) were randomized into the INIT and PRT groups, with 24 participants in each group. No significant between-group differences (p>0.05) were observed in the baseline demographic and clinical variables of the participants. A repeated-measures ANOVA indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (p<0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the INIT group improved significantly compared with the PRT group in all outcomes (p<0.05) immediately posttreatment and at the 4 months follow up period., Conclusions: INIT was more effective than PRT in the management of individuals with PS. It should be noted the significant improvement achieved in both the groups may have also been contributed to by the stretching exercises that were used as adjunct therapies by both groups., (© 2021 Musa S. Danazumi et al., published by De Gruyter, Berlin/Boston.)

Context: Evidence has shown that spinal mobilization with leg movement (SMWLM) and progressive inhibition of neuromuscular structures (PINS) are individually effective in the management of lumbar radiculopathy. However, previous evidence reported data for only a short-term study period and did not investigate the effect of the combined manual therapy techniques., Objectives: To compare the combined effects of two manual therapy techniques (SMWLM and PINS) with the individual techniques alone (SMWLM or PINS) in the management of individuals with lumbar radiculopathy., Methods: A total of 60 patients diagnosed with unilateral lumbar radiculopathy secondary to disc herniation were randomly allocated into three groups: 20 participants each in the SMWLM, PINS, and combined SMWLM + PINS groups. Each group attended two treatments per week for 30 min each, for three months. Participants were assessed at baseline, immediately posttreatment, and then at three, six, and nine months follow-up using the Visual Analog Scale (VAS), Rolland-Morris Disability Questionnaire (RMDQ), and Sciatica Bothersomeness Index (SBI)., Results: Between-groups analyses using a two-way repeated-measures analysis of variance indicated significant interactions between groups and follow-up times for all outcomes (p=0.001). Participants receiving combined SMWLM + PINS treatment experienced greater improvement in leg pain, back pain, disability, and sciatica at all timelines (immediately posttreatment, and three, six, and nine months follow-up) than the participants receiving SMWLM or PINS alone (p<0.05). However, participants receiving SMWLM alone showed better improvement than the participants receiving PINS alone at all timelines (p<0.05)., Conclusions: A combined SMWLM + PINS treatment protocol showed greater improvement than the individual techniques alone in the management of individuals with LR in this study., (© 2020 Musa S. Danazumi et al., published by De Gruyter, Berlin/Boston.)

Purpose: This study aimed to identify the needs and priorities of parents of children with cerebral palsy (CP) in order to improve care by increasing family participation in rehabilitation programmes., Methods: This cross-sectional questionnaire-based study was conducted between January to March 2019. Convenience sampling was used to recruit 43 family members (18 years and above) of children with CP who came to the physiotherapy departments for rehabilitation services for their children. Fisher's exact test was used to analyse the association between socio-demographic characteristics and each of the need items., Results: Five different items were identified to be the family needs that were most frequently met: a) 'need for active involvement in the child's treatment and therapies' (n= 40; 93.0%), b) 'need for the provision of standard medical care (n= 39; 90.7%), c) 'need for questions to be answered honestly' (n= 38; 88.4%), d) 'need for healthcare professionals to respect the child's wishes' (n= 36; 83.7%), e) 'need for mothers to discuss their feelings (depression, stress etc.) with someone who has similar experience' (n= 36; 83.7%). Conversely, three items were the most unmet family needs: a) 'need to have professionals to consult whenever the child needs help' (n= 39; 90.7%), b) 'need to be informed about the child's prognosis' (n= 41; 95.3%), and c) 'need to have financial support to provide the child with adequate care' (n= 43; 100%)., Conclusion: All participants overwhelmingly reported that their financial needs were their highest priority. The multiple needs of families of children with disabilities must be assessed and considered in rehabilitation services when treating children with CP.

Background: The most common HIV neurological comorbidity, Distal Symmetrical Peripheral Neuropathy (DSPN), is characterized by severe symptoms and reduced quality of life. Exercise has consistently been mentioned as one of the non-pharmacological therapies for the rehabilitation of individuals with HIV, but little is known about an exercise program to recommend to people living with HIV (PLWHIV)-related DSPN. The purpose of this study was to investigate the effectiveness of aerobic (AE) or progressive resisted exercise (PRE) on quality of life (QOL) in a person living with HIV-related DSPN., Method: A randomized controlled trial was conducted with 136 persons living with HIV-related Neuropathy, including 6 domains of QOL within WHOQOL-BREF, 45 in the AE (used ergometer), 44 in the PRE (used quadriceps bench), and 47 in the control group (CG). The outcome measures (QOL) data were analyzed using the inferential statistic of Friedman for within-group with post hoc analysis of Wilcoxon signed Test. A Kruskal-Wallis test was carried out for between-groups with post hoc analysis of Mann-Whitney to find where significant differences exist., Results: The results indicated significant differences within experimental groups in all six domains p < 0.05. Similarly, the result indicated significant differences within the CG in Physical, level of independence, and Spirituality/Religions domains (p = 0.002, p = 0.035, p = 0.006). However, the results indicated significant differences between experimental groups and CG., Conclusion: These findings indicated that strength and endurance exercise of moderate intensity have a positive effect on QOL in PLWHIV-related DSPN. Clinical trial No. http://apps.who.int/trialsearch/default.aspx (PACTR201707002173240).

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 domains: 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 of Physical Therapy (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., Competing Interests: Declaration of competing interest The authors do not have any conflict of interest., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: The purpose of this study was to compare the effectiveness of Dowling's and Mulligan's manual therapy techniques on pain and disability in the management of lumbar disc herniation with radiculopathy (LDHR)., Methods: A total of 40 individuals with LDHR were randomly allocated into 2 groups, 20 participants each in PINS and SMWLM groups. Each participant was assessed at baseline, 4 weeks, and 8 weeks postintervention. The primary outcomes measured were pain (visual analog scale) and disability (Roland-Morris Disability Questionnaire). Secondary variables were quality of life (Short-Form 36 Health Survey), sciatica bothersomeness (Sciatica Bothersomeness Index), sciatica frequency (Sciatica Frequency Index), and general perception of recovery (Global Rating of Change Scale). Repeated-measures analysis of variance was used to compute within-group and between-groups interactions., Results: No significant differences were observed in the baseline characteristics of participants in both groups. The results indicate that there were significant time effects for all outcomes in the study ( P < .001) within each group. However, there was no significant difference between the 2 groups on any outcome variable (P > .05)., Conclusion: The findings indicate that there was no difference in pain or disability between the 2 manual therapy techniques in the management of LDHR., (© 2020 by National University of Health Sciences.)