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Background: Schoolboy rugby is a popular sport which forms the bedrock of rugby development in many African countries, including Zimbabwe. With burgeoning talent identification programmes, the development of multi-dimensional, logically- validated, and reliable test batteries is essential to inform the objective selection of potentially talented young rugby athletes. Objectives: This study sought evidence on the absolute and relative test-retest reliability of the component test items in the newly-assembled SCRuM test battery. Methods: Utilising a pragmatic test-retest experimental design, a sample of 41 Under-19 schoolboy players playing competitive rugby in the elite Super Eight Schools Rugby League in Harare, Zimbabwe, participated in the study. Results: Physiological and game-specific skills tests which showed good to excellent relative reliability and acceptable absolute reliability, included: 20 m and 40 m speed, L-run, Vertical Jump (VJ), 60 s Push-Up, 2 kg Medicine Ball Chest Throw test (2 kg MBCT), Wall Sit Leg Strength test (WSLS), Repeated High Intensity Exercise test (RHIE), One Repetition Maximum Back Squat (1-RM BS) and Bench Press tests (1-RM BP), Yo-Yo Intermittent Recovery Level 1 test (Yo-Yo IRT L1), Tackling Proficiency test, Passing Ability Skill test and Running and Catching Ability skill test. Conclusion: All these tests are reliable and warrant inclusion in the SCRuM test battery for possible profiling of U19 schoolboy rugby players during the ‘in-season’ phase provided there is adequate participant familiarisation and test standardisation. The test-retest ICCs and measurement errors are generalisable to other young athletes in this population, making the tests useful for the evaluation of training and developmental effects of the measured constructs.

Background: In 2019, the World Health Organization (WHO) released global guidelines for physical activity, sedentary behaviour and sleep for the early years. The International Study of Movement Behaviours in the Early Years, SUNRISE, aimed to assess the extent to which children aged three and four years meet the WHO global guidelines and its association with health and development. Objectives: To assess movement behaviours in pre-school children from low-income settings in Zimbabwe and to establish associations between these movement behaviours and adiposity, motor skills and executive function.Methods: Pre-school children/caregivers were recruited from two urban and two rural public schools respectively in Zimbabwe. The caregivers answered questions on the children’s physical activity, screen time, sedentary behaviour and sleep patterns. Children’s movement behaviours were objectively measured using accelerometers. Gross and fine motor skills and executive function were assessed using the Ages and Stages Questionnaire-3 and Early Years Toolbox, respectively. Focus group discussions were carried out with caregivers and teachers on the acceptability and feasibility of the study. Results: Eighty-one children participated in the study. The proportions of children meeting the guidelines were physical activity 92%, sedentary behaviour 70%, and sleep 86%, and all guidelines combined 24%. Boys and girls were similar (p>0.05 for all variables) for all executive function variables, but rural children had significantly lower inhibition scores (p=0.026) than urban children. Conclusion: The study adds to the growing literature on movement behaviours and associated risk factors in low-resourced settings. Further investigations of movement behaviours in this age group in Zimbabwe are recommended.

Introduction Despite play being widely used in occupational therapy practice as a means and ends in intervention, no research has explored how the play of children with HIV/AIDS is affected. Therefore, the specific processes through which play can be used in therapy with children with HIV/AIDS remains underexplored, especially in low resourced settings. This study aims to compare the level of playfulness of children with HIV/AIDS to that of age and gender matched typically developing children living in the same low resourced community. Methods The Test of Playfulness (ToP) was used to examine the differences and similarities of play between children aged 4-7 years who are typically developing children (n = 52) and children with HIV/AIDS who receive antiretroviral treatment (n = 44). Each child was video recorded playing with a familiar playmate both indoors and outdoors. The videos were scored by two independent raters who were blinded to all aspects of the study. Scores were subjected to Rasch analysis to calculate interval level measure scores. Independent t-tests were used to compare differences between the means of the groups. Results Typically developing children scored significantly higher when playing outdoors, as compared to children with HIV [t (94) = 3.57, p = .001]. There was no significant difference between mean measure scores for indoor play when comparing typically developing children and children with HIV. Children who are HIV positive scored significantly lower than typically developing children on items related to the ability to suspend reality and framing in both indoor and outdoor environments. Conclusions Children with HIV/AIDS exhibited lower levels of playfulness when compared to typically developing children. This study provides insight on the play profiles of children with HIV/AIDS, highlighting play deficits and differences between indoor and outdoor play. Occupational therapy can play a significant role in promoting playfulness in children with HIV/AIDS.

Objective Despite increasing rugby popularity among schoolboys’ worldwide, specific factors influencing their motivation to participate in rugby remain unclear. Therefore, this study was conducted in two parts with a dual purpose of exploring perceptions of rugby coaches on (i) factors motivating schoolboys to engage in competitive rugby, and (ii) criteria for selecting schoolboy rugby players for possible inclusion in school rugby teams. Results A qualitative study targeting Zimbabwean high school-based rugby coaches purposively-recruited during the 2017 Dairiboard Zimbabwe Rugby School Festival was conducted. Using the conventional approach to content analysis, the 22 recruited male coaches (median age = 45.5 years) felt that playing rugby is a choice largely influenced by either intrinsic or extrinsic motives for schoolboys. Additionally, coaches considered players’ characteristics (performance during training, attitude, physical qualities and skills) and match-related factors when selecting schoolboys for possible inclusion in school rugby teams. To effectively promote competitive rugby participation among schoolboys and promote sustainable and effective talent identification programmes in Zimbabwe, more recognition should be paid to factors motivating schoolboys to participate in rugby and also on the factors coaches consider when assembling school rugby teams which indirectly informs on what coaches think should be trained among schoolboy rugby players. Electronic supplementary material The online version of this article (10.1186/s13104-019-4138-y) contains supplementary material, which is available to authorized users.

Objective Globally, non-specific low back pain (NSLBP) is a common cause of morbidity in all people including physiotherapy students. However, no study has investigated the problem among undergraduate physiotherapy students in Zimbabwe. This study was conducted, therefore, to provide evidence of the prevalence, clinical characteristics and consequences of recurrent NSLBP among undergraduate physiotherapy students at the University of Zimbabwe. Results The final sample had 90 participants, giving a study response rate of 97.8%. The median age of the participants was 22 years. The lifetime prevalence of NSLBP was 56.7% (n = 51) and the mean age of onset for NSLBP was 19.7 years (SD = 1.64 years). The 12-month prevalence of recurrent NSLBP was 38.9% (n = 35). Of the 35, 20 (57.1%) experienced at least three episodes in the last 12 months. Each episode lasted for 1–7 days in most participants (n = 31, 88.6%). The mean intensity of recurrent episodes was 3.37 (SD = 1.43) measured on Visual Analogue Scale. Only 7 (20%) experienced at least one functional limitation due to recurrent NSLBP. Additionally, only 2 (5.7%) sought medical treatment for the pain. However, 6 (17.1%) had to be absent from the university secondary to recurrent NSLBP.

Objective: Use of highly active antiretroviral therapy has led to marked reductions in the incidence of HIV-associated opportunistic infections but has had comparatively less impact on the incidence of some pulmonary diseases. This study was done to determine the pulmonary conditions leading to hospital admissions in people living with HIV/AIDS at two central hospitals in Zimbabwe and the pulmonary rehabilitation intervention received. Results: A total of 92 participants were recruited of which 60 (65.2%) were females. The mean age of the participants was 41.3 years (SD = 9.1). The most common pulmonary condition leading to hospital admission was tuberculosis in 53 (57.6%). About 52 (56.6%) of the participants suffered from pulmonary complications in the last 6 months, 48 (92.3%) were admitted and 26 (50.0%) of the participants received physiotherapy treatment during their admission. None of the participants indicated that they once attended an outpatient pulmonary rehabilitation clinic. Respiratory complication is one of the leading causes of morbidity associated with HIV but no pulmonary rehabilitation services are being offered to these patients. There is need for introduction of pulmonary rehabilitation programs for people living with HIV/AIDS in the current setting.

Background Rugby is increasingly gaining popularity among school-aged male junior players in countries hardly known for dominating international rugby, such as Zimbabwe. Given rugby combativeness, participating adolescents should possess qualities or skills commensurate with the physical demands of the sport for effective participation. This study investigated the independent and interactive effects of age category and playing standard on anthropometric, physiological characteristics and rugby-specific game skills among Zimbabwean athletes. Methods Two hundred and eight elite, sub-elite and non-rugby players competing at Under 16 and Under 19 age categories were assessed using the School Clinical Rugby Measure (SCRuM) test battery. Participants underwent height, sitting height, mass, skinfolds, speed, agility, upper-and-lower muscular strength and power, prolonged high-intensity intermittent running ability, tackling, passing and catching assessments in a cross-sectional experimental design. Results Age categories had significant main effect on all SCRuM test items except sum of seven skinfolds (p = 0.45, η2p = 0.003). Playing standard had significant main effects for all variables except height (p = 0.40, η2p = 0.01) and sum of seven skinfolds (p = 0.11, η2p = 0.02). Specifically, upper-and-lower muscular strength and power, prolonged high-intensity intermittent running ability, tackling, passing and catching improved with increasing playing standards. However, two-way analysis of variance only demonstrated significant interactions between the effects of age category and playing standards for vertical jump height (VJ) test, 2-kg medicine ball chest throw (2-kg MBCT) test, Yo-Yo intermittent recovery test level 1 (Yo-Yo IRT L1), and tackling and catching tests. Yo-Yo IRT L1, VJ, tackling and catching tests demonstrated greater discriminative ability among Under 16 s, whereas the 2-kg MBCT test showed better ability in Under 19 s. Conclusion All SCRuM variables except skinfolds improved with age, highlighting relative sensitivity in differentiating older from younger athletes. However, the discriminative ability by playing standards for VJ, 2-kg MBCT, Yo-Yo IRT L1, tackling and catching ability tests was age-dependent. These findings informs on general attribute development in junior rugby players with age and on specific players attributes in need of monitoring for attainment of elite status at U16 or U19 level.

Objective Although schoolboy rugby is growing in popularity and played at different competitive levels in Zimbabwe, the influence of playing standard on qualities or skills of older male adolescent rugby players is unknown. Utilising a cross-sectional design, this study determined anthropometric, physiological characteristics and rugby-specific game skills defining elite under 19 (U19) schoolboy rugby players. Following development and subsequent assessment of test–retest reliability of School Clinical Rugby Measure (SCRuM) test battery, this study compared performance outcomes of elite rugby players (n = 41), sub-elite rugby players (n = 46) and non-rugby athletes (n = 26) to identify qualities or skills discriminating (i) elite from sub-elite and non-rugby players, and concomitantly (ii) sub-elite from non-rugby players. Results 40 m speed test (p

Objective Competitive rugby is increasingly becoming popular among adolescent players even in countries hardly known for rugby such as Zimbabwe. Given the increased participation rates, burgeoning talent identification (TID) programs and the reportedly high injury-risk associated with competitive youth rugby, the minimal qualities or skills needed for effective performance by all young players need further clarification. Therefore, this qualitative study was conducted to explore the perceptions of high-school based rugby coaches on the key qualities or skills defining good adolescent rugby players and should be considered for player recruitment in TID programs. Currently, there is no consensus in literature from the coaches’ perspective on these qualities. Results The final sample had 22 coaches (median age = 45.5 years) with years of coaching high-school rugby ranging from 6 to 17 years. Using the conventional approach to inductive content analysis four broad themes emerged suggesting the multifaceted nature of the requirements imperative for effective and optimal rugby performance among adolescent rugby players as perceived by the coaches. Themes identified included: physiological characteristics, anthropometric attributes, psychological qualities and game-specific skills. Possibly, training approaches or design of rugby-specific test-batteries should consider all these important qualities and be multi-dimensional in composition. Electronic supplementary material The online version of this article (10.1186/s13104-019-4170-y) contains supplementary material, which is available to authorized users.

Objective The burden of diabetes mellitus has exponentially increased in low resource settings. Patients with diabetes are more likely to exhibit poor mental health which negatively affects treatment outcomes. However, patients with high levels of social support (SS) are likely to report optimal mental health. We sought to determine how SS affects the report of psychiatric morbidity and health-related quality of life (HRQoL) in 108 diabetic patients in Harare, Zimbabwe. Results The average age of participants was 54.1 (SD 18.6) years. Most of the participants were; females (69.4%), married (51.9%), and were of low level of income (43.5%). 37.1% of the participants exhibited signs of psychiatric morbidity [mean Shona Symptoms Questionnaire score—6.7 (SD 3.2)]. Further, patients also reported lower HRQoL [mean EQ-5D-VAS score—64.1 (SD 15.3)] and high levels of SS [mean Multidimensional Scale of Perceived Social Support score—43.7 (SD 11.5)]. Patients who received greater amount of SS had optimal mental health. Being female, unmarried, lower education attainment, having more comorbid conditions, being diagnosed with type 2 diabetes and having been diagnosed of diabetes for a longer duration were associated with poorer mental health. It is important to develop context-specific interventions to improve diabetic patients’ mental health. Electronic supplementary material The online version of this article (10.1186/s13104-018-3881-9) contains supplementary material, which is available to authorized users.

Objective Worldwide, work-related musculoskeletal disorders (WMSDs) are a common cause of morbidity affecting occupational individuals such as health-care professionals. However, nothing is known about WMSDs in hospital nurses in Zimbabwe. This study was conducted to provide cross-sectional evidence of the 12-month prevalence, consequences and factors associated with WMSDs among 208 nurses at Parirenyatwa Group of Hospitals (PGH). Results The response rate for the study was 55.7%. The median age for the participants was 32.0 years (interquartile range = 29–36 years). The lifetime prevalence of WMSDs in nurses was 95.7% (n = 112). The first episodes were experienced in the first 5 years of working (n = 59, 52.7%). However, 82.1% (n = 96) nurses experienced WMSDs in the last 12 months. Low back pain was the most common WMSDs reported (n = 55, 67.9%). WMSDs were significantly associated with qualification attained, postgraduate ergonomic training and working experience. Overall, 87.5% (n = 84) nurses experienced at least one of the consequences of WMSDs. Cognisant of the limitations of the study, the present study found that WMSDs are a common occurrence among nurses at PGH. This creates a need for prompt hospital education programs aimed at raising awareness among nurses on the existence of WMSDs and the consequences at PGH. Electronic supplementary material The online version of this article (10.1186/s13104-018-3412-8) contains supplementary material, which is available to authorized users.

There is a growing impetus towards usage of test batteries in talent identification (TID) programmes in rugby. Consequently, there are many test batteries in existence profiling anthropometric, physiological characteristics and rugby-specific skills. There is no consensus in the literature on the constituent variables and corresponding tests required to inform TID programs. Following development of a new test battery called the SCRuM (School Clinical Rugby Measure), this study aimed at establishing face, logical validity and practical feasibility of included tests. The test battery, initially comprised of 23 items, had its face and logical validity evaluated by five (5) adolescent rugby coaches and 20 rugby experts, respectively. Logical validation was conducted in two questionnaire-based rounds with Content Validity Index (I-CVI) calculated for each variable. Subsequently, a cross-sectional study targeting 30 local rugby coaches was conducted to determine the perceived practical feasibility of each test item. The results showed excellent I-CVI (>0.78) for 17 variables (speed, weight, height and skin fold measures, repeated high-intensity exercise performance ability, prolonged high-intensity intermittent running ability, change of direction speed, anaerobic capacity, lower-and upper body muscular power and strength, muscular flexibility, reactive agility, passing for accuracy, tackling proficiency, and catching). However, three tests, namely, Reactive Agility, One Repetition Maximum Back Squat and One Repetition Maximum Bench Press had low test-feasibility indices (T-FI< 35) suggesting practicality concerns with implementation in the Zimbabwean context. Thus, these findings suggest the need for substitution or development of new practically feasible tests for upper-and lower body muscular strength and reactive agility.

Objectives To (1) give an overview of commonly used game-specific skills tests in rugby and (2) evaluate available psychometric information of these tests. Methods The databases PubMed, MEDLINE CINAHL and Africa Wide information were systematically searched for articles published between January 1995 and March 2017. First, commonly used game-specific skills tests were identified. Second, the available psychometrics of these tests were evaluated and the methodological quality of the studies assessed using the Consensus-based Standards for the selection of health Measurement Instruments checklist. Studies included in the first step had to report detailed information on the construct and testing procedure of at least one game-specific skill, and studies included in the second step had additionally to report at least one psychometric property evaluating reliability, validity or responsiveness. Results 287 articles were identified in the first step, of which 30 articles met the inclusion criteria and 64 articles were identified in the second step of which 10 articles were included. Reactive agility, tackling and simulated rugby games were the most commonly used tests. All 10 studies reporting psychometrics reported reliability outcomes, revealing mainly strong evidence. However, all studies scored poor or fair on methodological quality. Four studies reported validity outcomes in which mainly moderate evidence was indicated, but all articles had fair methodological quality. Conclusion Game-specific skills tests indicated mainly high reliability and validity evidence, but the studies lacked methodological quality. Reactive agility seems to be a promising domain, but the specific tests need further development. Future high methodological quality studies are required in order to develop valid and reliable test batteries for rugby talent identification. Trial registration number PROSPERO CRD42015029747.

Background In Zimbabwe, a recent increase in the volume of research on recurrent non-specific low back pain (NSLBP) has revealed that adolescents are commonly affected. This is alarming to health professionals and parents and calls for serious primary preventative strategies to be developed and implemented forthwith. Early identification initiatives should be prioritised in order to curtail the condition and its progression. In an attempt to be proactive in minimising the prevalence of recurrent NSLBP, this study was conducted to evaluate the content validity and test-retest reliability of a survey questionnaire with the aim of proffering a valid and reliable questionnaire which can be used in non-clinical settings to identify adolescents with recurrent NSLBP in Harare, Zimbabwe and determine the possible factors associated with the condition. Methods The study was conducted in two parts. The first part assessed content validity of the questionnaire using four experts derived from academia and clinical practice. The second part evaluated the reliability of the questionnaire among 125 high school-children aged between 13 and 19 years in a test-retest study. Results Twenty-six (26) out of thirty questions in the questionnaire had an Item Content Validity index of 1.00, demonstrating complete agreement among content experts. Overall, the Scale Content Validity Index for the questionnaire was 0.97. Item completion for the reliability study was satisfactory. The questionnaire items had kappa values ranging from 0.17 (slight agreement) to 1 (perfect agreement). High levels of reliability were found for the questions on school bag use (k=0.94), sports participation (k=0.97), and lifetime prevalence (k=0.89). Conclusion Excellent content validity and slight to perfect test-retest reliability was found for the Low Back Pain (LBP) questionnaire. These results are comparable to findings of other studies evaluating the psychometric properties of LBP questionnaires. Cognisant of the limitations of the study, the results of this study suggest that the LBP questionnaire could be used in local studies investigating LBP among adolescents although questions enquiring on functional limitations and sciatica may need further consideration. Electronic supplementary material The online version of this article (doi:10.1186/s40945-017-0031-y) contains supplementary material, which is available to authorized users.

Background Scientific focus on rugby has increased over the recent years, providing evidence of the physical or physiological characteristics and game-specific skills needed in the sport. Identification of tests commonly used to measure these characteristics is important for the development of test batteries, which in turn may be used for talent identification and injury prevention programmes. Although there are a number of tests available in the literature to measure physical or physiological variables and game-specific skills, there is limited information available on the psychometric properties of the tests. Therefore, the purpose of this study is to systematically review the literature for tests commonly used in rugby to measure physical or physiological characteristics and rugby-specific skills, documenting evidence of reliability and validity of the identified tests. Methods/design A systematic review will be conducted. Electronic databases such as Scopus, MEDLINE via EBSCOhost and PubMed, Academic Search Premier, CINAHL and Africa-Wide Information via EBSCOhost will be searched for original research articles published in English from January 1, 1995, to December 31, 2015, using a pre-defined search strategy. The principal investigator will select potentially relevant articles from titles and abstracts. To minimise bias, full text of titles and abstracts deemed potentially relevant will be retrieved and reviewed by two independent reviewers based on the inclusion criteria. Data extraction will be conducted by the principal investigator and verified by two independent reviewers. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist will be used to assess the methodological quality of the selected studies. Discussion Choosing an appropriate test to be included in the screening test battery should be based on sound psychometric properties of the test available. This systematic review will provide an overview of the tests commonly used in rugby union and other related high intermittent team sports characterised by skill executions using the hands and legs such as Rugby League and Australian Rules Football. In addition, the review will highlight the psychometric properties of the identified tests. This information is crucial in developing a sport-specific test battery which can be used for talent identification, especially among young adolescent players, and injury prevention programmes. Systematic review registration PROSPERO CRD42015029747 Electronic supplementary material The online version of this article (doi:10.1186/s13643-016-0298-1) contains supplementary material, which is available to authorized users.

Background The Ponseti method of managing clubfoot was introduced in Zimbabwe in 2011. This followed massive training of health workers such as medical rehabilitation practitioners through a programme called the Zimbabwe Sustainable Clubfoot Programme. Today, the Ponseti method is the technique of choice for managing clubfoot in hospitals. However, since then, there is no published evidence documenting the efficacy and the relevance of the technique especially comparing to previously used methods. This is a significant shortcoming if sustainability issues are to be considered. Therefore, this study was designed to investigate the impressions and opinions of medical rehabilitation practitioners on the method in terms of its effectiveness, perceived challenges and possible recommendations for improvement of the technique application in their setting. Methods A descriptive cross-sectional study was conducted targeting medical rehabilitation practitioners previously trained on the method and working in public or private clinics that offer clubfoot management in Harare. A questionnaire was self-administered to 41 participants who volunteered to participate in the study. Data from open-ended questions was analysed thematically. Statistica version 12 was used for analysis for quantitative data. Results The Ponseti method was perceived as an effective method in the treatment of children with clubfoot by all the participants. All the participants 41 (100 %) felt that the method was relevant because of better clinical outcomes. Amongst challenges faced when using Ponseti method, 25 (61 %) participants agreed that caregivers to the children with clubfoot were not compliant to treatment. A total of 22 (54 %) participants felt that lack of adequate insight by the caregivers of this new method was a challenge which hinder progress in treating clubfoot. Conclusions The medical rehabilitation professionals in Harare, Zimbabwe trained to use the Ponseti technique for the management of clubfoot, perceived the method as an effective method resulting in better clinical outcome than previous methods. This probably highlights the need to continue training medical rehabilitation professionals so that there is widespread use of the technique in the country. However, there is need to increase awareness of the method among caregivers to improve compliance, which is key to successful rehabilitation of the clubfoot.

Background: Rugby is a popular sport played in many countries worldwide. There has been recent growing interest for the sport in Zimbabwe especially among adolescents. However, no study has been done to documentthe profile of rugby-related injuries among Zimbabwean adolescents between the ages of 10 and 19 years. The goal of the present study is to describe the injuries sustained by adolescent males during the 2014 high school rugby season. Methods: A cross-sectional survey was conducted involving 275 male adolescents’ rugby players who competed in the Super Eight School Rugby League in Harare, Zimbabwe. Results: The mean age of the sample was 16 years (SD = 1.4). 58.2% of participants sustained at least one rugby-related injury. There were 561 injuries reported in total, of which 63.3% (n = 355) were new injuries and the remainder were recurrent cases. 7.7% (n = 43) of the injuries were graded as severe with participants missing rugby activities for more than 28 days. Of the 561 injuries that occurred, 59.4% (n = 333) occurred during competitive matches in the second half (59.5%). Injuries due to tackles were the most frequent accounting for 48.3% (n = 271) of all injuries sustained. The lower limbs were the most frequent body region affected (38.6%, n = 217). When comparing position of play, flankers sustained the most injuries (14.1%) and there were no differences in incidence of injury between forward and backline players. Conclusion: Our findings on the profile of rugby injuries among male Zimbabwean adolescents were similar to those of other studies in certain aspects but differed in others. Most injuries occurred in competition during the second half of the game mainly from tackles. Both junior and senior players were equally affected. The lower limbs were frequently injured especially the knee region.

Background Non-specific low back pain is a prevalent symptom in adolescents and is recurrent in some instances. Recent studies have highlighted the marked impact the condition has on daily life of adolescents. However, it is unclear if parents of adolescents reporting recurrent non-specific low back pain know about their child’s status. The purpose of the study was to determine the level of agreement between adolescents and their parents in reporting recurrent non-specific low back pain in Harare, Zimbabwe. Methods This cross-sectional study formed part of a large study carried out to ascertain the prevalence of non-specific low back pain in Zimbabwean adolescents. Six hundred and twenty (n = 620) Medical Health Questionnaires were sent to parents. School-children with returned questionnaires and informed consents signed were subsequently eligible to participate. A reliable and validated low back pain study questionnaire was administered to 544 adolescents between the ages of 13 and 19 years randomly selected from government-administered schools. The questionnaire sought to determine adolescents with recurrent NSLBP. The Kappa statistic (k) was used to analyse agreement between adolescents and parental reports on recurrent NSLBP status. Results Parental and school-children response rates were acceptable (90.3 and 97.8 %, respectively). The prevalence of recurrent NSLBP was 28.8 % [95 % Confidence Interval, CI = 26.0–31.6]. Both sexes were equally affected [χ2(1) =0.19, p = 0.67]. The prevalence increased with age in both sexes [χ2trend =90.9, p

Background: Recurrent non-specific low back pain (NSLBP) is increasingly becoming common among adolescents worldwide. A recent study in Zimbabwe showed a relatively high prevalence (28.8 %) among high school students. Influential associated factors, however, remain unclear. This is a significant shortcoming. The aim was to determine personal or lifestyle-related factors associated with recurrent NSLBP among high school adolescents in Harare, Zimbabwe. Methods: This study was part of a large epidemiological study conducted in two continuous parts. Part one sought to determine self-reported associated factors among 532 participants (mean age =16 ± 1.72 years) drawn randomly from selected government schools using a reliable and content-validated questionnaire (Kappa coefficient, k = 0.32–1). Part two purposively identified adolescents (N = 64, median age =17 years, interquartile range, IQR = 15–18 years) with a history of ‘severe’ recurrent NSLBP from part one based on a specific eligibility criteria and compared body mass index, relative school bag weight and hamstring flexibility with matched adolescents without NSLBP. Data was analysed using Statistica version 11. Independent t-tests or χ 2 tests of association were used for continuous and categorical data, respectively. The statistical significance was set at p < .05. Results: Recurrent NSLBP was associated with self-reported factors such as perceptions of a heavy school bag [χ 2 (1) = 85.9, p < 0.001]. A significant proportion of adolescents with recurrent NSLBP spent over 30 min carrying the school bag to and from school [χ 2 (1) =32.2, p < 0.001]. It was also associated with prolonged sitting (p < 0.001), not playing sports [χ 2 (1) =5.85, p = 0.02] and tight hamstrings [χ 2 (1) =7.6, p = 0.006]. Conclusions: Although conclusions from this study are hesitant because of the cross-sectional nature of the study and the relatively small sample size in follow-up study, recurrent NSLBP is associated with perceptions of a heavy school bag, duration of school bag carriage, no sports participation, prolonged sitting on entertainment activities, and tight hamstrings. These findings add to the importance of promoting physical activity at school or home especially aimed at improving muscle flexibility.

The purpose of the study was to investigate the consequences of recurrent non-specific low back pain in Zimbabwean adolescents. Recurrent non-specific low back pain is a common cause of adult disability in low-income countries. However, its impact in adolescents has been a matter of debate in the literature. A survey was conducted using a cluster sample of 544 school children between the ages of 13 and 19 years. The school children were randomly selected from government-administered secondary schools in Harare, Zimbabwe. Parental and students’ response rate were 90.3 and 97.8 %, respectively. Almost a third (28.8 %) of school children reported recurrent symptoms (CI 27.8–31.6). However, the majority (84 %) of these cases were unknown to parents. Twenty-seven percent reported having sought medical treatment. On the nine-item Hanover Low Back Pain Disability Questionnaire, 71.2 % of school children had at least one activity of daily living compromised by recurrent NSLBP, especially sports participation. However, severe disability was reported in 28 % of the adolescents. Health-care seeking behaviour was not associated with the level of disability [χ 2(1) = 0.36, p = 0.55]. Although most parents are unaware, recurrent NSLBP is common in Zimbabwean school children. However, treatment is rarely sought for the symptoms. A preponderance of adolescents with recurrent NSLBP experiences some degree of functional consequences, although severe disability is rare. There is need to raise awareness of the condition in schools and to parents. Spinal health educational programmes may need to be implemented to avert the functional consequences. Further studies are needed in the future to investigate the coping strategies for pain in adolescents.

Background The diagnosis of a child with a life-long disability, such as cerebral palsy (CP), can be catastrophic to parents. It is often accompanied by feelings of despair, anxiety, hopelessness, and the fear of the unknown. Knowledge about CP is thus essential for caregiver adjustment and preparation for the caregiving role. However, there is a paucity of empirical evidence regarding the best method for educating caregivers. The aim of this study was therefore to evaluate the impact of an educational intervention on caregivers’ knowledge about cerebral palsy. Methods This cross-sectional survey included 49 caregivers of children with cerebral palsy. Convenience sampling was used to select participants from two central hospitals in Harare, Zimbabwe. The caregivers were divided into two groups based on whether or not they had attended an educational workshop. The knowledge of cerebral palsy questionnaire (KCPQ) was administered once to assess the caregivers’ CP knowledge. Results The caregivers were comparable in terms of sociodemographic characteristics. The mean KCPQ scores for caregivers who attended workshops was 17.4 (SD 1.5), versus 13.8 (SD 2.5) for those without exposure to workshops. The differences between the two groups was statistically significant (U =77.0, Z = -4.45, and P < 0.001). Conclusions Our findings suggest that educational workshops may lead to improved CP knowledge among caregivers. This may better equip parents and guardians to meet the extra caregiving demands associated with CP, leading to improved health outcomes for children with CP and their caregivers.

Objective: Recurrent non-specific low back pain (NSLBP) is a common occurrence in adolescents. There is limited data on the factors associated with the condition in Zimbabwe. The study sought to determine the association between physical activity and psychological status with recurrent non-specific low back pain among high school adolescents. Methods: An analytical cross sectional study was conducted among 199 randomly selected adolescents between the ages of 12-19 years from government schools in Harare. Recurrent non-specific low back pain data was collected using a reliable and validated questionnaire. Level of physical activity and psychological status were evaluated using the Physical Activity Questionnaire for Adolescents (PAQ-A) and the Mental Health Inventory-5 (MHI-5), respectively. Results: The students’ response rate was 98.5%. The 12-month prevalence of recurrent NSLBP was 30.7 % [95% CI = 24.3%-37.1%]. Girls were significantly affected than boys [X2(1) =4.73, p= 0.03]. The majority with recurrent NSLBP (68.9%) reported between 2-7 episodes, with an average duration per episode of less than thirty minutes in 62% of cases. There was no association between level of physical activity and recurrent NSLBP [X2 (1) =0.86, p= 0.35]. However, the majority (n=42) of those who reported recurrent NSLBP reported a low level of physical activity. Psychological status was not found to be associated with recurrent NSLBP [X2 (1) =0.76, P= 0.38]. Conclusion: Recurrent non-specific low back pain is a common condition among Zimbabwean adolescents affecting mainly girls. However, the episodes are of a short duration and are not significantly associated with the level of physical activity and psychological status

Background Over the years, family-centered care has evolved as the “gold standard” model for the provision of healthcare services. With the advent of family-centered approach to care comes the inherent need to provide support services to caregivers in addition to meeting the functional needs of children with physical disabilities such as cerebral palsy (CP). Provision of care for a child with CP is invariably associated with poor health outcomes in caregivers. As such, there has been a surge in the development and implementation of interventions for improving the health and well-being of these caregivers. However, there is a paucity of the collective, empirical evidence of the efficacy of these interventions. Therefore, the broad objective of this review is to systematically review the literature on the effectiveness of interventions designed to improve caregivers’ well-being. Methods/design This is a systematic review for the evaluation of the effectiveness of interventions designed to improve caregivers’ well-being. Two independent, blinded, reviewers will search articles on PubMed, Scopus, Web of Science, CINAHL, Psych Info, and Africa-Wide Information using a predefined criterion. Thereafter, three independent reviewers will screen the retrieved articles. The methodological quality of studies meeting the selection criterion will be evaluated using the Briggs Institute checklists. Afterwards, two independent researchers will then apply a preset data-extraction form to collect data. We will perform a narrative data analysis of the final sample of studies included for the review. Discussion The proposed systematic review will provide the empirical evidence of the efficacy of interventions for improving the well-being of caregivers of children with physical disabilities. This is important given the great need for evidenced-based care and the greater need to improve the health and well-being of caregivers. Systematic review registration PROSPERO CRD42016033975 Electronic supplementary material The online version of this article (doi:10.1186/s13643-016-0287-4) contains supplementary material, which is available to authorized users.

Background Cerebral palsy (CP) is the most common, life-long paediatric disability. Taking care of a child with CP often results in caregiver burden/strain in the long run. As caregivers play an essential role in the rehabilitation of these children, it is therefore important to routinely screen for health outcomes in informal caregivers. Consequently, a plethora of caregiver burden outcome measures have been developed; however, there is a dearth of evidence of the most psychometrically sound tools. Therefore, the broad objective of this systematic review is to evaluate the psychometrical properties and clinical utility of tools used to measure caregiver burden in caregivers of children with CP. Methods/design This is a systematic review for the evaluation of the psychometric properties of caregiver burden outcome tools. Two independent and blinded reviewers will search articles on PubMed, Scopus, Web of Science, CINAHL, PsychINFO and Africa-Wide Google Scholar. Information will be analysed using predefined criteria. Thereafter, three independent reviewers will then screen the retrieved articles. The methodological quality of studies on the development and validation of the identified tools will be evaluated using the four point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Finally, the psychometric properties of the tools which were developed and validated from methodological sound studies will then be analysed using predefined criteria. Discussion The proposed systematic review will give an extensive review of the psychometrical properties of tools used to measure caregiver burden in caregivers of children with CP. We hope to identify tools that can be used to accurately screen for caregiver burden both in clinical setting and for research purposes. Systematic review registration PROSPERO CRD42015028026.

Background Physiotherapy is an integral part of treatment for paediatric burns. In Zimbabwe, children are admitted in paediatric burn unit with their caregivers, who play important roles such as providing explanation and obtaining cooperation of the child during physiotherapy, which is often uncomfortable or painful to the patient. The aim of this study was to determine the perspectives of caregivers towards physiotherapy interventions administered to hospitalized children at central hospitals in Harare, Zimbabwe. Methods A descriptive cross-sectional study was conducted using self-administered questionnaires. The study was carried out at two large central hospitals (Parirenyatwa Hospital and Harare Central Hospital). The study targeted all the caregivers of children below the age of 12 years with a diagnosis of burns, irrespective of severity or area affected, who were admitted in the two paediatric burn units. Of the 34 caregivers eligible to participate, 31 (91.1 %) questionnaires had complete data and were analysed. The analyses were done using Statistica version 12.0. Results The median age of the caregivers was 28 years (IQR = 24–33 years). Female caregivers constituted 90.3 % of the sample. The majority of the caregivers (n = 26, 83.9 %) were biological mothers to the hospitalised child. The majority of children (n = 20, 64.5 %) hospitalised were between 0 and 4 years. The commonest cause of burns was scalding (n = 19, 61.2 %). The burns were mainly in the upper extremities (n = 11, 35.5 %). Physiotherapy for the burns was mainly active and passive joint range of motion exercises (n = 30, 96.8 %). The caregivers’ perceptions towards physiotherapy were mainly positive (n = 20, 64.5 %) indicating that physiotherapy plays an important role in burn management. Of the 21 caregivers given a ward exercise programme, 13 (61.9 %) were not compliant. Conclusions Caregivers’ perspectives towards physiotherapy were largely positive and are similar to those found in other studies. The majority of the caregivers indicated that physiotherapy was important in the overall management of burns leading to proper healing of the wounds without complications.