Search

To translate and cross-culturally adapt the Northwick Park Neck Pain Questionnaire (NPQ) into Hausa and assess its psychometric properties. The NPQ was translated and cross-culturally adapted into Hausa using recommended guidelines. A consecutive sample of 92 Hausa-speaking patients with non-specific neck pain recruited from three tertiary hospitals in north-western Nigeria, completed the questionnaire to assess factorial validity (using confirmatory factor analysis), convergent validity (by correlating the Hausa-NPQ with the Numerical Pain Rating Scale [NPRS]), and internal consistency (using Cronbach’s α). A subsample of 50 patients completed the questionnaire again 3 days after the first administration to assess relative reliability using intraclass correlation coefficients (ICC) and absolute reliability using standard error of measurement (SEM), smallest detectable change (SDC), and 95% limits of agreement (LOA). The factor analysis confirmed a single-factor structure with excellent internal consistency (α = 0.94). The questionnaire showed a strong positive correlation with the NPRS (rho = 0.68). The ICC was 0.86, with SEM and SDC of 6.32 and 17.5, respectively. The LOA was − 29.3 to + 37.1 with no evidence of proportional bias. The Hausa-NPQ is a valid and reliable measure of disability due to neck pain. This study describes the translation, cross-cultural adaptation, and psychometric assessment of the Hausa-NPQ in Hausa-speaking patients with non-specific neck pain.The questionnaire demonstrated adequate psychometric properties in terms of factorial and convergent validity, internal consistency, and test-retest reliability.The questionnaire will be useful in clinical and research settings to assess disability due to neck pain for screening purposes, evaluation of treatment effectiveness, as well as cross-cultural comparisons involving Hausa-speaking individuals with neck pain. This study describes the translation, cross-cultural adaptation, and psychometric assessment of the Hausa-NPQ in Hausa-speaking patients with non-specific neck pain. The questionnaire demonstrated adequate psychometric properties in terms of factorial and convergent validity, internal consistency, and test-retest reliability. The questionnaire will be useful in clinical and research settings to assess disability due to neck pain for screening purposes, evaluation of treatment effectiveness, as well as cross-cultural comparisons involving Hausa-speaking individuals with neck pain.

Background: Awareness of activities that may result in low back pain (LBP) among adolescents is fundamental in preventing adulthood LBP. Objective: The aim of this study was to investigate adolescents' knowledge, attitude, and perception of LBP and activities that may prevent LBP in Kano, North-western, Nigeria.Methods: This was a cross-sectional survey involving 400 school-going adolescents recruited using a multistage random sampling technique. Data was analysed using descriptive statistics and Chi-square test with 0.05 set as level of significance. Results: The mean age of the respondents was 16.0±1.50 years. LBP annual prevalence was 34.2%, with more girls (31.1%) reporting having LBP compared to boys (28.4%). More than half (59.3%) of the respondents had poor knowledge of LBP and activities that may prevent it. However, they had a good attitude (63%) and perception (74%) of LBP and activities that may prevent it. There was no significant association of levels of knowledge, attitude, and perception of LBP and activities that may prevent LBP with gender, age, and class of study (p > 0.05). Conclusion: Adolescents in Kano, North-western Nigeria had poor knowledge of LBP and activities that may prevent it. Therefore, there is a need to embark on an LBP prevention program among adolescents in Kano, North-western Nigeria. Keywords: Low back pain; prevention; adolescents; knowledge; attitude; perception.

Introduction: In Nigeria, patients accessing Directory Observed Therapy (DOTS) treatment are exposed to resistance to anti-TB drugs, hence is considered a priority, only few studies have focused on the relevant risk factors, Factors leading to development of drug resistance need to be understood to develop appropriate control strategies for national programsMethod: The study was a cross sectional study design. Multistage sampling technique was employed in the selection of 403 tuberculosis patients in Ibadan North Local Government Area of Oyo State. Data were collected using self-administered structured questionnaire, and analyzed using SPSS version 25. Level of significance was set at P0.05). Education and Occupation shows a significant association with MDR-TB, (χ2=24.640, p =0.007) and (χ2=14.416, p = 0.006) respectively,risk factors such asprevious TB treatment and Adherence with treatment regimen (r=0.270, p 0,05). L'éducation et la profession montrent une association significative avec la TB-MR, (χ2 = 24,640, p = 0,007) et (χ2 = 14,416, p = 0,006) respectivement, des facteurs de risque tels que le traitement antituberculeux antérieur et l'observance du schéma thérapeutique (r =0,270, p

Introduction: MDR-TB poses a significant challenge to global management of TB. Laboratories in many countries among which include Nigeria are unable to evaluate drug resistance, and clinical predictors of MDR-TB might help target suspected patients.Method: The study was a cross sectional study design. Multistage sampling technique was employed in the selection of 403 tuberculosis patients. Data were analyzed using SPSS version 25. Level of significance was set at P0.05). Education and Occupation shows a significant association with MDR-TB, (÷2=24.640, p = 0.007) and (÷2=14.416, p=0.006) respectively, smoking (r=0.074, p0.05) show no significant association with occurrence MDR-TB.Conclusion: Previous TB treatment and Adherence with treatment regimen were found to be the major risk factor for MDR-TB. Targeted educational intervention for patients and their contacts may minimize the non-adherence with prescribed TB treatment and lessen MDR-TB magnitude. Key words: TB Patients, MDR-TB, tuberculosis, risk factors.

Background: This pilot study was conducted to determine the feasibility of a large-scale randomized controlled trial to examine the effectiveness of different weekly applications of kinesthesia, balance and agility (KBA) exercises for knee osteoarthritis (OA). Methods: Eighteen knee OA patients were randomly assigned to three groups of six patients: Twice-weekly KBA, thrice-weekly KBA, and control (conventional physical therapy) for six weeks. Feasibility outcomes included recruitment rate, retention/dropout rate, report of adverse events, pain (Visual Analog Scale for pain), and physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure). Descriptive statistics and a 3 × 2 (treatment group × time) mixed-model ANOVA were applied to analyze the data. Results: The recruitment rate was 66.6%. Retention rates for the three groups ranged from 90 – 100%. No serious adverse events were reported throughout the study. Pain and physical function significantly improved (P < 0.05) in all the groups post-intervention, except for the conventional physical therapy group, which showed no significant improvement in the physical function (P > 0.05). However, inter-group difference was not significant in all the clinical outcomes evaluated (all P > 0.05). Conclusions: This study suggests the feasibility of a large-scale randomized controlled trial to examine the effectiveness of different weekly applications of KBA exercises among knee OA individuals, with minor amendments.

Background: Impairments in the lumbar multifidus muscle such as reduced muscle thickness and fat infiltrations are evident in individuals with low back pain. Lumbar stabilization exercises (LSE) with real-time ultrasound imaging (RUSI) biofeedback has been reported to improve preferential activation of as well as retention in the ability to activate of the lumbar multifidus muscle, thus enhancing recovery. However, the effects of using this treatment approach in individuals with nonspecific chronic low back pain (NCLBP) seemed not to have widely reported. The purpose of this study is, therefore, to investigate the effects of LSE with RUSI biofeedback on lumbar multifidus muscle cross-sectional area in individuals with NCLBP patients. Method: This study is a prospective, single-center, assessor-blind three-arm, randomized controlled to be conducted at National Orthopedic Hospital, Kano State, Nigeria. Ninety-one individuals with NCLBP will be randomly assigned into one of the three treatment groups of equal sample size (n = 30); LSE group, LSE with RUSI biofeedback group, or control (minimal intervention). The participants in the LSE and LSE with RUSI biofeedback group will also receive the same intervention as the control group. All participants will receive treatment twice weekly for 8 weeks. The primary outcome will be lumbar multifidus muscles cross-sectional area while the secondary outcomes will be pain, functional disability and quality of life. All outcomes will be assessed at baseline, and at 8 weeks and 3 months post-intervention.Discussion: The outcome of the study may support the evidence for the effectiveness of LSE with RUSI biofeedback in the rehabilitation of individuals with NCLBP. It may also provide a rationale for the physiotherapists to make use of diagnostic ultrasound as a feedback mechanism in enhancing the performance and retention of LSE program as well as monitoring the patient’s recovery.Trial registration: Pan African Clinical Trials Registry, (PACTR201801002980602), Registered on 16 January 2018.

Background: Spine stability or core stability exercises are among the most recommended interventions in low back pain management. It is important to clarify whether physical activity and body adiposity affect lumbar muscle multifidus (LMM) among apparently healthy adults. Objectives: The current study aimed at investigating the effect of physical activity level (PAL) and body adiposity on fatty infiltration of LMM in apparently healthy individuals from an urban African setting. Methods: Fatty infiltration of LMM was visually graded as normal, slight, and severe using diagnostic ultrasound. Validated Hausa and English versions of IPAQ were employed to analyze PAL, and the bioelectrical impedance analysis machine was used to measure some of the body adiposity parameters and weight. Results: A slight fatty infiltration of LMM was observed in 40.3% of 196 participants. Slight fatty infiltration of LMM had a higher prevalence in female subjects (39.2%) than males (34.2%). Only two variables of age (P = 0.032; r = 0.153) and visceral fat (P = 0.0001; r = 0.308) had a relationship with fatty infiltration of LMM. Conclusions: Fatty infiltration of LMM was positively associated with visceral fat and weakly with age among the participants. However, fatty infiltration of LMM had no relationship with the PAL.

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

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

Additional file 1: The Hausa version of the Pain Catastrophizing Scale.

STUDY DESIGN Cross-cultural adaptation and cross-sectional study. OBJECTIVE The aim of this study was to translate and cross-culturally adapt the Roland-Morris Disability Questionnaire (RMDQ) into Hausa language, and evaluate its psychometric properties in mixed rural and urban populations with low back pain (LBP). SUMMARY OF BACKGROUND DATA The RMDQ is one of the most commonly used and recommended condition-specific measures of disability related to LBP. However, no formal adapted and validated Hausa version exists at the time our study was initiated. METHODS The Hausa version of the RMDQ (Hausa-RMDQ) was developed according to established guidelines. Psychometric properties were evaluated in 125 patients with LBP recruited from rural and urban Nigerian clinics. Internal consistency (Cronbach's α), test-retest reliability using Intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and limits of agreement using Bland-Altman plots were calculated to evaluate reliability. Using Spearman's correlation for a priori hypotheses, the Hausa-RMDQ was correlated with Oswestry Disability Index (ODI) to evaluate concurrent validity, Numerical Pain Rating Scale (NPRS) to evaluate convergent validity, and age, educational level, and occupational status to evaluate divergent validity. Reliability and validity analyses were also conducted separately for rural and urban subgroups. RESULTS The Hausa-RMDQ had no major translation problems. The questionnaire had adequate internal consistency (α = 0.70), test-retest reliability (ICC = 0.79), minimal SEM (1.30) and MDC (3.60), and good agreement between test-retest values. The Hausa-RMDQ had a strong correlation with ODI (rho = 0.59), a moderate correlation with NPRS (rho = 0.46), and a null correlation with age, educational level, and occupational status (P > 0.05), thus confirming all the (5:5) a priori hypotheses constructed. These reliability and validity results were also replicated in the rural and urban subgroups. CONCLUSION The Hausa-RMDQ was successfully developed and proved to be a reliable and valid measure of functional disability in Hausa culture. This questionnaire is recommended for future clinical and scientific research purposes.Level of Evidence: 3.

Background Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive training programs in the form of kinesthesia, balance and agility (KBA) exercises have been reported to be beneficial for individuals with knee OA. However, the most optimal training dosage of KBA exercises is still unclear. The aim of this study is to determine the effects of different frequencies of KBA training (i.e., twice-weekly or thrice-weekly) in adults with knee OA. Methods A single (assessor) blind, three-arm parallel, multi-center randomized controlled trial will be conducted. One hundred twenty adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; twice-weekly KBA (n = 40), thrice-weekly KBA (n = 40), and conventional physiotherapy (n = 40) in the ratio of 1:1:1. Participants in the conventional physiotherapy group will receive two sessions of brief patient education, and sixteen sessions of ultrasound therapy, and stretching and strengthening exercises for 8 weeks. Participants in the two different KBA groups will receive KBA training according to the designed sessions for 8 weeks in addition to the conventional physiotherapy program. All groups will be assessed pre-intervention, immediately post-intervention and at 3 months, 4 months, and 6 months post-randomization. The primary outcome will be physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure) whereas the secondary outcomes will be pain intensity (Visual Analogue Scale for pain), knee stability (Knee Outcome Survey-Activities of Daily Living Scale), proprioception (electronic goniometer), and quality of life (Osteoarthritis Knee and Hip Quality of Life Questionnaire). Discussion The findings of this study may provide evidence on the effectiveness of KBA exercise training and the ideal number of sessions needed to achieve the highest effectiveness in adults with knee OA. Trial registration Pan African Clinical Trials Registry (PACTR201810713260138). Registered on 28 November 2017.

Introduction Negative attitudes and beliefs about low back pain (LBP) can lead to reduced function and activity and consequently disability. One self-report measure that can be used to assess these negative attitudes and beliefs and to determine their predictive nature is the Back Beliefs Questionnaire (BBQ). This study aimed to translate and cross-culturally adapt the BBQ into Hausa and assess its psychometric properties in mixed urban and rural Nigerian populations with chronic LBP. Methods The BBQ was translated and cross-culturally adapted into Hausa (Hausa-BBQ) according to established guidelines. To assess psychometric properties, a consecutive sample of 200 patients with chronic LBP recruited from urban and rural clinics of Nigeria completed the questionnaire along with measures of fear-avoidance beliefs, pain catastrophizing, functional disability, physical and mental health, and pain. One hundred of the 200 patients completed the questionnaire twice at an interval of 7–14 days to assess test-retest reliability. Internal construct validity was assessed using exploratory factor analysis, and external construct validity was assessed by examining convergent, divergent, and known-groups validity. Reliability was assessed by calculating internal consistency (Cronbach’s α), intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change at 95% confidence interval (MDC95), and limits of agreement using Bland-Altman plots. Reliability (ICC, SEM and MDC95) was also assessed separately for rural and urban subgroups. Results The factor analysis revealed a four-factor solution explaining 58.9% of the total variance with the first factor explaining 27.1%. The nine scoring items loaded on the first factor hence supporting a unidimensional scale. The convergent and divergent validity were supported as 85% (6:7) of the predefined hypotheses were confirmed. Known-groups comparison showed that the questionnaire discriminated well for those who differed in education (p < 0.05), but not in age (p > 0.05). The internal consistency and ICC (α = 0.79; ICC = 0.91) were adequate, with minimal SEM and MDC95 (1.9 and 5.2, respectively). The limits of agreements were –5.11 to 5.71. The ICC, SEM and MDC95 for the urban and rural subgroups were comparable to those obtained for the overall population. Conclusions The Hausa-BBQ was successfully adapted and psychometrically sound in terms of internal and external construct validity, internal consistency, and test-retest reliability in mixed urban and rural Hausa-speaking populations with chronic LBP. The questionnaire can be used to detect and categorize specific attitudes and beliefs about back pain in Hausa culture to prevent or reduce potential disability due to LBP.

Background:Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive (PR) and kinesthesia, balance and agility (KBA) exercises are two neuromuscular training reported to be beneficial for individuals with knee OA. However, their combined effects have not been systematically evaluated. Moreover, the most optimal dosage of knee OA exercise-based programremains unclear. The aim of this study is to determine the combined effects of PR and KBA exercise program with different frequency of treatment sessions(i.e. twice weekly or thrice weekly) in adults with knee OA.Methods:A single (assessor) blind, three-arm parallel, multi-centerrandomized controlled trial will be conducted. Eighty-four adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; group 1 (control or conventional physiotherapy; n = 28), group 2 (two sessions per week of combined PR and KBA exercise; n = 28), and group 3 (three sessions per week of combined PR and KBA exercise, n = 28). Participants in the conventional therapy group will receive two sessions of brief patient education, and 16 sessions of ultrasound therapy, and stretching, strengthening and aerobic exercise for 8 weeks. Participants in the two experimental groups will be treated for 8 weeks and will also receive the same conventional therapy. All groups will be assessed pre-intervention, immediately post-intervention and at 3-month, 4-month and 6-month post-randomization. The primary outcomes will be physical function and quality of life while the secondary outcomes will be pain intensity, knee stability and proprioception.Discussion:Findings of this study may provide evidence of effectiveness of combined PR and KBA exercise program for knee OA, which may serve as a basis for recommending the use of such multimodal exercise approachfor individuals with knee OA. The study may also provide evidence for the ideal number of sessions of knee OA exercise-based programsto achieve the highest effectiveness.Trial registration:Pan African Clinical Trials Registry, (PACTR201810713260138), Registered on 28 November 2017.

This pilot randomized clinical trial assessed the feasibility of implementing motor control exercise (MCE) and patient education (PE) program for the management of chronic low back pain (CLBP) in a low resource rural Nigerian community. Thirty patients with CLBP were recruited and randomly assigned to MCE, PE, or MCE plus PE groups. The MCE program was provided twice a week while the PE program was provided once a week all for 6 weeks. Feasibility was assessed through recruitment rate, treatment compliance, retention/dropout rate, report of adverse events, perceived helpfulness, overall satisfaction, and clinical outcome of pain (numeric pain rating scale) and functional disability (Oswestry Disability Index). Many patients were willing to participate in the study and the recruitment rate was 77%. Treatment compliance in all the three groups were >65% for supervised treatment sessions and

Background and objectives Many clinical practice guidelines (CPGs) for low back pain (LBP) management have been developed, but adherence to CPGs seems to be challenging as developing them in the first place. This cross-sectional survey study was carried out to determine the awareness level, the level of adherence, and barriers to adherence to CPGs of LBP among physiotherapists in Nigeria. Methods A total of 189 participants were recruited for this study using the convenience sampling technique. The data were collected using researcher-designed questionnaires, the data were analysed using SPSS Version 20, and barriers to adherence to CPGs of LBP was analysed using simple thematic analysis. Descriptive statistics, frequency, and percentage were used to summarize the data, whereas inferential statistic of chi square and Fisher's exact were used to test the association between sociodemographic variables and adherence. Results The results obtained showed that only a small percentage (27.50%) of the respondents adhered to LBP CPGs, whereas higher percentage (78.80%) was aware to the LBP CPGs. There were no significant associations between age (p = .90, χ2 = 0.72), certification courses (p = .476, χ2 = 0.508), place of practice (p = .380, χ2 = 0.845), and adherence to CPGs of LBP, respectively. However, there was a statistical significant association between specialization (p = .009, χ2 = 16.725), political zone (p = .007, χ2 = 15.243), awareness (p = .003, χ2 = 8.957), and adherence to CPGs of LBP, respectively. Conclusion Small proportions of the respondents adhered to the LBP CPGs, whereas higher population were aware of the LBP CPGs, and some of the characteristics of the physiotherapists influence adherence to LBP CPGs.

Background: Spinal cord injury (SCI) is impairment of the spinal cord resulting in numerous health problems that considerably affect the quality of life (QOL) of the patients. Moreover, a number of sociodemographic and clinical characteristics may influence the persons’ health-related quality of life (HRQOL). However, there is limited information on the HRQOL and related characteristics among affected persons living in Nigeria. This study explores the HRQOL and related characteristics of persons with SCI in Kano, Northwestern Nigeria. Methods: A prospective cross-sectional survey of 41 subjects with SCI and 40 age and gender matched healthy subjects was conducted from January to December 2016. Subjects' sociodemographic and clinical characteristics and HRQOL (using the SF-36 questionnaire) were collected and analyzed. Results: The majority of the subjects were men in both the SCI (85.4%) and healthy (82.5%) groups. The mean injury duration was 28.4 ± 20.2 months. Road traffic accident (46.3%) was the leading cause of injury with paraplegia (70.7%) being the most frequent level of injury. A greater number of the subjects (43.9%) had a complete impairment. Subjects with SCI had significantly lower HRQOL in the domains of general health, physical functioning, bodily pain, social functioning, role-emotional, and mental health compared to healthy controls. Gender, level of injury, and severity of injury were commonly found to be related to lower HRQOL scores. Conclusion: Persons with SCI from Kano, Northwestern Nigeria have lower HRQOL across various domains compared to healthy controls. Common factors related to lower HRQOL scores were gender, level of injury, and severity of injury. There is a need for optimal rehabilitation for persons with SCI in Kano, Northwestern Nigeria.

STUDY DESIGN Validation of a translated, culturally adapted questionnaire. OBJECTIVE To translate the Oswestry Disability Index (ODI) version 2.1a into Hausa Language and to validate its use in a cohort of patients with low back pain (LBP). SUMMARY OF BACKGROUND DATA The ODI is one of the most commonly used condition-specific questionnaires for assessing functional disability in patients with LBP, yet, no formal cross-culturally adapted and validated Hausa version exists. METHODS The Hausa version of the ODI 2.1a (ODI-H) was developed according to established guidelines. Validation was performed among 200 patients with LBP recruited from both rural and urban Nigeria. Reliability was assessed using internal consistency (Cronbach α), test-retest reliability by computing intraclass correlation coefficient, standard error of measurement, and minimal detectable change. Convergent validity was assessed by correlating the ODI-H with Visual Analogue Scale for pain, Fear-Avoidance Beliefs Questionnaire, and finger-floor distance test. Divergent validity was assessed by correlating the ODI-H with age, educational level, and occupational status. Exploratory factor analysis (EFA) and confirmatory factor analysis were also performed. Confirmatory factor analysis was performed with three models: 1) one-factor theory-driven model, 2) two-factor theory-driven model (dynamic and static factors), and 3) a model based on our EFA. RESULTS The ODI-H had high internal consistency (Cronbach α = 0.87) and excellent test-retest reliability (intraclass correlation coefficient = 0.937) with standard error of measurement and minimal detectable change being 3.69 and 10.2 respectively. The construct validity (convergent and divergent validity) is supported as all (6:6, 100%) the a priori hypotheses were confirmed. The EFA yielded a two-factor model explaining 54.3% of the total variance but demonstrated poor fit. The one-factor and two-factor theory-driven model had acceptable fit but the one-factor theory-driven model was better. CONCLUSION The ODI-H version 2.1a was transculturally equivalent, reliable, and valid tool for assessing functional disability among Hausa-speaking patients with LBP. The use of this tool can be recommended for future clinical and research purposes. LEVEL OF EVIDENCE 3.

Background: Musculoskeletal disorders are prevalent in communities across the world and their impact is affecting people in almost all occupational settings. Aim: The aim of this study was to determine the prevalence of self-reported musculoskeletal disorders among urban dwellers, Kano metropolis. Method: A total of 206 participants were recruited using a stratified sampling technique in a cross-sectional survey. The data was collected using a standard Nordic Musculoskeletal Questionnaire (NMQ) and International Physical Activity Questionnaire (IPAQ) to measure work-related musculoskeletal disorders and physical activity levels of the participants. Results: The results showed that the majority of the participants (63.9%) were males and 36.9% were females between the ages of 18 and 65 years, with the majority of them between 18 and 34 years, singles and self-employed. Also, the majority of the participants had moderate physical activity levels, normal body mass index and low risk of cardiovascular diseases using the waist to hip ratio classifications. About 78.2% of the participants reported 12-month musculoskeletal disorders while 37.4% reported 7-day musculoskeletal disorders. Low back was the most common site affected by 45.6% of the respondents. Also, the result showed no significant relationship between 12-month musculoskeletal disorder and BMI, physical activity level and waist/hip ratio but a relationship between 7 Days musculoskeletal disorder and BMI, physical activity level and waist/hip ratio. Conclusion: It was concluded that there was a high prevalence of musculoskeletal disorders among urban community dwellers in Kano metropolis, with low back pain the most reported while upper back has the least prevalence. Clinical Rehabilitation Impact: There was a high prevalence of WMSD among the general populace irrespective of the sociodemographic affiliations. Lower back was the most reported anatomical site among our participants. Men had a higher number of WMSD than women. There was an association between WMSD and WHR and BMI. Excess weight management might be helpful especially in individuals with high BMI and WHR.

This study investigated the relationships among exercise capacity (EC), dynamic balance (DB), and gait characteristics (GCs) of patients with type-2 diabetes (T2D) and healthy controls (HCs). This observational controlled study involved 125 patients with T2D receiving treatment at a Nigerian university teaching hospital and 125 apparently healthy patients’ relatives and hospital staff recruited as controls. EC maximum oxygen consumption (VO2max) was estimated following a 6-min walk test. DB and GC were assessed using the Time Up to Go Test and an accelerometer (BTS G-Walk) assessing gait speed, step length, stride length, and cadence respectively during a self-selected walk. Data were analyzed using descriptive and inferential statistics. Alpha level was set at P0.05). There were significant differences in the VO2max and DB between patients with T2D and HCs; 7.6±0.6 mL/kg/min vs. 9.6±0.6 mL/kg/min (t=−16.6, P=0.001) and 14.2±2.1 sec vs. 10.4±1.5 sec (t=−6.37, P=0.001), respectively. Furthermore, significant differences were found in GC between patients with T2D and HCs; gait speed: 0.7±0.1 m/sec vs. 1.2±0.1 m/sec (t=−16.60, P=0.001), step length: 0.6±0.2 m vs. 0.9±0.3 m (t=−7.56, P=0.001) and stride length: 0.9±0.1 m vs. 1.1±0.5 m (t=−6.09, P=0.001). There were significant correlations between EC and gait speed in both groups (T2D: r=−0.26, P=0.032 and HCs: r=0.51, P=0.003). In conclusion, patients with T2D demonstrated lower EC, unstable DB, and altered GCs compared with HCs. Exercise interventions to improve EC and gait balance are recommended.

Globally, chronic diseases of lifestyle account for millions of dollars spent annually on health. These diseases share similar risk factors including: physical inactivity, obesity, cigarette smoking, and hypertension among others. This study sought to assess risk factors for chronic diseases of lifestyle of a rural community in South Africa. This study used a survey design with data randomly collected using the WHO STEPS Instrument for Chronic Disease Risk Factor Surveillance from participants who attended routine checks from February to October 2018 from a trained healthcare practitioner. Informed consent was sought from all participants before the administration of the instrument. The research setting was the community Primary Health Center. About 54.0% of participants presented with no family history of hypertension but 19.7% had a family history of type II diabetes mellitus. More women were found to be hypertensive, with the majority (93.4%) monitoring their blood pressure. The study revealed that more men were current smokers. A large number of participants were engaged in a sedentary lifestyle with about one-third of the participants reported being obese. Physical inactivity, sedentary lifestyle, and hypertension were among the lifestyle-related risk factors for chronic diseases among residents of this rural community.

Background and aims The Fear-Avoidance Beliefs Questionnaire (FABQ) is the most widely used self-reported measure of fear-avoidance beliefs about work and physical activity in low back pain (LBP). However, there is no Hausa version for use in patients with LBP. This study aimed to translate, cross-culturally adapt, and test the psychometric properties of the Hausa version of the FABQ in patients with LBP. Methods The Hausa form of FABQ was developed using a forward-backward translation procedure according to recommended guidelines. The pre-final version of the questionnaire was pre-tested on 10 patients with acute LBP and 10 patients with chronic LBP. Psychometric testing was performed in 70 patients with acute LBP and 130 patients with chronic LBP. Reliability was assessed using internal consistency (Cronbach α) and test-retest reliability through intraclass correlation coefficient (ICC). Construct validity was assessed by exploratory factor analysis and divergent validity (Spearman rank correlation coefficient). Responsiveness was also investigated on 40 patients with chronic LBP. Results The Hausa version of the FABQ was successfully translated and proved to be well-understood. The internal consistency was adequate for the questionnaire (0.773) and its physical activity (0.816) and work (0.606) subscales. Test-retest reliability was excellent with an ICC value of 0.928 for the questionnaire and values of 0.901 and 0.863 for the physical activity and work subscales, respectively. Exploratory factor analysis yielded a three-factor structure in both acute and chronic LBP samples explaining 66.4% and 58.6% of the total variance, respectively. The first factor represents fear-avoidance beliefs due to work, the second factor represents fear-avoidance beliefs due to physical activity whereas the third factor represents the fear that pain aggravates due to work. Divergent validity showed moderate to weak correlation between the questionnaire and pain intensity (r=0.502), disability (r=0.415), lumbopelvic motion (r=0.00). The physical activity and work subscales weakly correlated (r=0.280). The effect size and standardized response mean were moderate to small with the work subscale having the lowest effect size (0.34) and standardized response mean (0.34) values. The MDC of the questionnaire was 5.4 points. The questionnaire had no ceiling or floor effects. Conclusions The FABQ was successfully translated into Hausa and cross-culturally adapted with acceptable psychometric properties similar to those of existing versions. The results suggest that the Hausa FABQ can be used to evaluate fear-avoidance beliefs about LBP in Hausa-speaking population for both clinical and research purposes.

Introduction Sagittal spine malalignment has been linked with a number of health consequences including pain, disability, and suboptimal quality of life. Case Presentation We present a 19-year-old male with 3 years history of chronic back pain associated with kypholordotic posture. Upon examination, lumbar hyperlordosis and thoracic hyperkyphosis were mainly associated with muscular imbalance around the chest, upper back, and lumbopelvic-hip region. The patient received treatment comprising postural education (PE), therapeutic massage (TM), segmental stretching exercise (SSE), and motor control exercise (MCE) twice a week for 8 weeks. The patient demonstrated a significant improvement in lumbar lordotic (83.80 to 76.30) and thoracic kyphotic (65.20 to 60.60) curves as measured by flexible ruler, back pain (7.0 cm to 1.0 cm) as measured by visual analogue scale, spine ranges of motion (flexion: 5.2cm to 7.5cm; extension: 3.5cm to 4.7cm) as measured by modified Schober’s test, and functional disability (46.7% to 20.0%) as measured by modified Oswestry disability index. Conclusions The results showed that the combination of PE, TM, SSE, and MCE was effective in improving sagittal spine alignment, back pain, spine range of movement, and function.

Objective: This study investigated the effects of cardiac rehabilitation exercise protocols on physical function (PF) in patients with chronic heart failure (CHF). Study Design and Setting: This randomized controlled trial recruited 70 patients who are in stage II CHF with ejection fraction (≤40%) from a Nigerian university teaching hospital. They were randomly assigned into Exercise Group (EG: n = 35) or Control Group (CG: n = 35). Physical function, activity of daily living (ADL), distance walked in six minutes and grip strength were assessed using a validated ADL questionnaire, six minute walk test and a hand dynamometer respectively. In addition to medication, EG underwent aerobic and upper extremity resistance exercises thrice weekly for eight weeks while CG used medications only. Data were analyzed using descriptive and inferential statistics. Alpha level was at p 0.05). Significant improvements were noticed at fourth week among participants’ ADL (30.0% ± 6.0%), 6MWD (321.7 ± 26.3 m) and VO2 max (8.9 ± 0.4 mL/kg/min) variables within the exercise EG but no significant changes were observed in the CG (p > 0.05). Participants in EG demonstrated more significant improvements in ADL (15.0% ± 5.0%), 6MWD (406.0 ± 29.7 m) and VO2 max (10.3 ± 0.5 mL/kg/min) (p 0.05). Conclusions: Cardiac rehabilitation exercise protocols involving self-paced walking, sit-to-stand and upper extremity dynamic strength training improved activity of daily living, walking and functional capacity in patients with stable chronic heart failure.

The increase in the prevalence of overweight and obesity in both developed and developing countries is associated with musculoskeletal and other non-communicable diseases. To address this, an accurate measure of body adiposity, bearing in mind several shortcomings of body mass index (BMI), should be used. This study determined the relationship between BMI and body fat (BF)% among adult Nigerians of different ethnic groups residing in an urban setting. Using multistage cluster sampling technique were recruited 1571 subjects (>18 years; male=51.2%) in a cross-sectional study. Body adiposity indices were assessed using BMI and BF%. Using BF%, the result shows that a total number of 156 (9.9%) had low BF% while 291 (18.5%) had very high BF%, while the BMI classifications of body adiposity, 68 (4.3%) were underweight while 271 (17.3%) were obese. There was a strong and positive statistical relationship between BF% and BMI when both were paired without controlling for gender and age (r=0.81, P

Background: The prevalence of type 2 diabetes mellitus has been on the increase both in high and medium/low income countries. This increase is associated with health and economic consequences, especially in low sub-Saharan Africa that is resource stricken. Availability of affordable and easy to implement treatment intervention will surely reduce these health and economic sequealae of type 2 diabetes mellitus. This study was carried out to investigate the effects of plyometric exercise on concomitants of fitness and metabolic profile in type 2 diabetes patients. Methods: Simple random sampling technique was employed to recruit participants (n=27) for this study after meeting the inclusion criteria. Physical and physiological measurements were taken from the participants before and after six weeks of plyometric exercise for the experimental group and the control who did not participate in plyometric exercise. Results: A total number of twenty seven (control= 13) participated in the study and there are not significant differences in the physical and physiological parameters of the two groups. There are significant differences in the physiological parameter after six (6) weeks of plyometric exercise among the experimental groups while there are no significant dif ferences among the control group. The eta squared statistics of few parameters show that the effect sizes range between medium and large association. Conclusion: It is concluded that among the concomitants of fitness, plyometric exercise is effective only in improving muscle fitness and body composition.

Osteoarthritis (OA) of the knee is one of the most frequent musculoskeletal disorders that physicians do attend to in healthcare facilities. Knee OA is associated with psychological and medical challenges like depression, life-stressing events and pain. This study was carried out to determine the relationship between knee OA and life-stressing events among adults Nigerians with knee OA. Participants with knee OA were recruited consecutively from selected hospitals in Kano State, Nigeria. Western Ontario Macmaster Universities Index of Osteoarthritis (WOMAC), the Modified Somatic Perception Questionnaire and Social Readjustment Rating Scale Questionnaire were administered on the participants to access their pain, somatic complaints and lie-stressing events. Test of normality was carried out using Shapiro Wilk test and showed that the data was not normally distributed. The data was further subjected to descriptive statistics of mean, standard deviation, Spearman Rho and linear regression. A total number of 108 OA of the knee individuals consented and participated in the study of which 62.04% (67) were females while 37.96% (41) were males. The mean WOMAC scores for the whole group was 15.8 (SD=10.6) and there were significant differences in WOMAC score, SES and Somatic perception between male and female. There was positive significant relationship between SRS and emotional function (r=0.331) among male participants. Although, there was no significant association between WOMAC and life stressing events among female participants, but there were positive significant relationships between emotional function and pain (r=0.376), emotional function and stiffness (r=0.328), somatic perception and pain (r=0.286), somatic perception and emotional function (r=0.588) as well as SRS and emotional function (r=0.257). This study shows that there was relationship between somatic perception, life-stressing event and OA of the knee among adult Nigerians with knee osteoarthritis. There were also differences in knee OA, SES and somatic perception between male and female participants. Keywords: Osteoarthritis, life stressing, somatic, perception, knee

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

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

The physiotherapy profession has emerged not only as an important medical and rehabilitation complement in health care delivery but also as a vital therapeutic tool with defined scientifically based protocols. In Nigeria, it is used as a prescription rather than as a referral, on a consultation basis, but its use as a prescription is gradually being discouraged in some developed countries. There seems to be a low level of awareness of this development, particularly in the developing countries. This study was therefore designed to evaluate the physicians’ mode of referral of patients for physiotherapy in Nigeria. A total of 1192 physicians participated in the survey, a 78 per cent response rate. They were required to complete a 22-item self developed closed-ended questionnaire using a sample of opportunity. The questionnaire obtained information on demographic data, educational attainment, university of graduation, year of graduation and mode of referral for physiotherapy. A total of 1054 (88.4%) respondents agreed that physiotherapists were trained enough to make clinical decisions on the treatment of their patients and 678 (56.9%) referred patients for physiotherapy. Of the respondents who agreed that physiotherapists are trained well enough to make clinical decisions on the treatment of their patients, 786 (74.6%) graduated from universities that also have a physiotherapy training programme. The majority 442 (68.2%) of these respondents and 603 (79.4%) of the respondents who received some form of lectures in physiotherapy during their medical training or whose universities had a physiotherapy training programme did not include prescriptions in their referrals. KEY WORDS: physicians, mode of referral, physiotherapy