Neuro-Physiotherapy at the Primary Health Care Level: Perception of Public Health Physicians

Background: There is consistent increase in chronic neurological conditions presenting at primary health care settings across the world. However, there is paucity of neuro-physiotherapy services and research on integrating neuro-physiotherapy to promote independence among thispopulation at primary health care settings. This study determined the perception of public health physicians on the integration of neuro-physiotherapy at the primary health care (PHC) level in Nigeria.Methods: A descriptive cross-sectional survey using a validated and pre-tested questionnaire to retrieve data from 149 Public Health Physicians in Nigeria to determine their perception of neuro-physiotherapy at the primary health care level.Results: Majority of the participants 133 (89.3%) agreed to the need for neuro-rehabilitation care at primary health care level. 83 (55.7%) believed that the physiotherapists are competent enough to handle neuro-rehabilitation needs at the PHC level. The findings highlighted the challenges towards implementing neuro-rehabilitation at the primary health care level.Conclusion: The results revealed positive recommendations from public heath physicians in Nigeria towards the integration of neuro-physiotherapy services in primary health care.

A five-year audit of lower limb amputations below the knee and rehabilitation outcomes: the Durban experience

Introduction: Lower limb amputation (LLA) due to diabetes mellitus (DM) is a growing epidemic worldwide. Objectives: To determine the prevalence of LLAs at Addington Hospital from 2010 to 2014 and to explore the rehabilitation outcomes of amputees. Design and setting: A retrospective chart review of LLAs below the knee was undertaken at Addington Hospital. Subjects: Patients who underwent LLAs were filtered from theatre registers. Methodology:A data collection sheet included demographic profile, diabetic status, level of amputation, limb orientation and rehabilitation outcomes. Outcome measures: Study endpoints were prevalence, compliance and rehabilitation outcomes. Results: From 2010 to 2014, 767 LLAs in 667 patients were identified. Mean age was 59 (13.2) years. M:F ratio was 1:1. Of these, 354 patients (53.1%) had DM. Level of amputation was below-knee 57%, trans-metatarsal 12.4% and toectomy 30.6%. Only 116 patients (17.4%) were referred for physiotherapy, of whom 95 (81.9%) attended. Median frequency of physiotherapy visits was five and four for diabetic and non-diabetic amputees respectively. Mobility after rehabilitation was with a walking frame (49%), crutches (32%), prosthesis and crutches (8%), wheelchair-bound (9%) and independent gait (1%). Conclusion: Over half of amputations were associated with DM. The gender incidence was similar. Referral to physiotherapy and adherence thereto was poor

Research Productivity of Academics in a Physiotherapy Department: a Case Study

Objective: Research productivity is an important activity among academics. This study was done to document the research productivity of the academics of a physiotherapy department in South Africa. Method: An archival research design was used to document the research productivity for the physiotherapy department between 2002 and 2009. Data were analysed by two independent reviewers and consensus was reached on the information to be included in the study. Results: Among the nine academics there were 67 publications; 20 articles in progress; 7 under review and 63 conferences attended. While the overall research productivity of the department seems to be good; the bulk of the productivity rests in the hands of the senior academics. Conclusion: There is a need to facilitate the acquisition of research skills in academic staff; particularly in upgrading staff to PhD level and improving publication output

Research productivity of academics in a physiotherapy department: a case study

Objective: Research productivity is an important activity among academics. This study was done to document the research productivity of the academics of a physiotherapy department in South Africa. Method: An archival research design was used to document the research productivity for the physiotherapy department between 2002 and 2009. Data were analysed by two independent reviewers and consensus was reached on the information to be included in the study. Results: Among the nine academics there were 67 publications; 20 articles in progress; 7 under review and 63 conferences attended. While the overall research productivity of the department seems to be good; the bulk of the productivity rests in the hands of the senior academics. Conclusion: There is a need to facilitate the acquisition of research skills in academic staff; particularly in upgrading staff to PhD level and improving publication output

Treatment of Sports Injuries Referred for Physiotherapy at a National Sports Medicine Centre in Nigeria: a Retrospective Study

Background: Physiotherapists are important members of the sports medicine team and are involved in the prevention and management of injured athletes right from the acute stage of injury to the stage of rehabilitation. However; the type of treatments rendered to injured athletes and level of physiotherapy utilisation in terms of injury referrals for physiotherapy in sports medicine in Nigeria is not fully known. Objective: To find out the extent of referral of sports injuries for physiotherapy and types of treatments rendered to injured athletes referred for physiotherapy at the National Sports Medicine Centre (NSMC); Lagos; South-West; Nigeria. Methods: All case files at the general records unit from January 1995 to December 2002 were investigated. Information on athlete's sport; body part treated and physiotherapy modalities used between January 1997 and December 2002 were also extracted from the treatment register at the physiotherapy department of the sports medicine centre. Results: A total of 171 sports related injuries were reported at the general records unit of the NSMC; with a male to female ratio of 2:1. Of this number; 121 (70.8) were referred for physiotherapy with strain (n= 57; 33.3) constituting the majority of physiotherapy referrals. At the physiotherapy department; the knee (n=43; 30.1) and the thigh (n=33; 25.4) were the most treated body parts. Track and field events (n=48; 36.9) recorded the highest number of injuries treated. Exercise therapy (n=81; 25.5) was the most frequently used modality; followed closely by transcutenous electrical nerve stimulation therapy (n=73; 20.3). Conclusion: The frequency of referral of sports injuries for physiotherapy at the NSMC was high. Exercise therapy was the most frequently used treatment modality and injuries affecting the lower limbs were mostly treated. Emphasis should therefore be laid on prevention of lower limb injuries

Voltaren emulgel: a non-steroidal anti-inflammatory drug in the management of acute painful conditions

Encountered during the daily activities of the individuals are injuries resulting in acute painful conditions. Among such injuries are sprains; strains; bruises; contusions; superficial thrombophlebitis; and localised rheumatic conditions. The management of painful conditions that was investigated in this study is topical therapy using Voltaren emulgel; a non-steroidal anti-inflammatory drug; a product of CIBA-GEIGY. This drug otherwise described as diclofenac; consists of an active substance of diethylamine salt of an 0-aminophenylacetic acid; namely diethylamonium -(0-(2;6-dichlorophenyl) - amino-phenyl) acetate. The procedure of physiotherapeutic application of this drug is by massage manipulation

The effect of abnormal foot wear on postural stability

A brief review of the result of studies on the wearing of high heel shoes was presented. The primary objective of determining in a quantifiable manner; the effect of such shoes on the stability of the body during standing and walking was defined. With the use of a gravity reference goniometer values; in degrees; of the stability range of movement (SROM) were obtained from 23 undergraduate female students; in standing positions; under 2 conditions of experiment viz:- (i) wearing of low heel shoes and (ii) wearing of high heel shoes. Inferential statistics were invoked to compare the scores of the SROM under these two conditions. Regression analysis was also used to determine the effect of anthropometric variables - of weight and height - on these scores. The results were discussed and the limitation of the study was spelt out. Proposals for public englightenment were suggested

SAMADHI TANK : A floatcell for enhancement of learning and management of stress and some painful conditions

The main objective of the present investigation was to study the Samadhi tank; a technologically and controlled relaxation environment and its effects on the African blacks within the tropics. Other objectives were to investigate the effects of flotation in the Samadhi tank on the human of cardiovascular and cardiorespiratory systems; the body temperature; intellectual learning; relief of tension and the therapeutic response of some patients having hypertension and other painful conditions

The use of ultrasound in the management of bells's palsy: case studies

Four cases of bell's palsy were managed using low intensity continous ultrasonic energy. Two cases reported for treament within two weeks of the onset; one case within one week of onset while the last case was about six months old. Average of five treatments were given over a two week period; using 0.5 -0.8 watts/cm2 for five minutes over the mestoid process region. Feldene gel was used as couplant. All cases recovered spontaneously

Occupational health hazards in physiotherapy practice in Nigeria : a survey research

This survey was carried out with the aim of ascertaining the occupational hazards that are speculated to be inherent in the practice of modern physiotherapy. The methodology consisted of preparing a list of injuries or conditions that are sustainable; and circulating a questionnaire to physiotherapists practising in different hospitals across the country. The responses; confirmed the presence of occupational hazards in physiotherapy practice. The limitations of the survey were addressed and the prospect of further studies on this subject was highlighted

Physiotherapy in dentistry : the experience in U.C.H. Ibadan

Physiotherapy has been involved in the management of various clinical conditions in the University College Hospital; Ibadan. However a low frequency of referrals from the department of Dentistry was observed. A two-year review of case notes in the Department of Dentistry showed 226 cases who could have benefited from physiotherapy; but only seven of the cases were referred. Case report of three patients were presented to highlight the value of early physiotherapy intervention in some temporomandibular disorders

Respiratory function in insulin-dependent diabetic patients

The study was designed to evaluate the difference in some respiratory functions between insulin-dependent diabetic patients(n=19) and non-diabetic individuals (n = 19). The measured values of FVC; FEV1 and PEFR of the diabetic patients were compared with those of the non-diabetics; as well as the predicted volumes for Nigerians. The diabetic patients showed significantly lower values when compared with the non-diabetics and the predicted volumes. The reduced volumes observed were related to the widespread abnormality of connective tissue known to occur in diabetes. The need for studies on larger population of insulin-dependent patients was highlighted

A case report on socio-economic and behavioural results of late physiotherapy in Nigeria

The scope of physiotherapy in establishing the patient's physical problem; identifying his physical needs and attempting to prevent avoidable secondary conditions has been defined. It was also reviewed that late referrals or reports for physiotherapy (PT) often precipitate handicapping situations which on the long run are un-economical and uncosmetic for the patients concerned. A case report which shows the consequence of lateness in the commencement of PT has been presented. It is concluded that in musculo-skeletal disorders; where PT if often indicated; timely consultation or referral is ideal and very beneficial

Ultraviolet radiation therapy: determination of the first degree erythema dose in blacks and its implications

The Kromayer lamp is one of the most effective instruments in the production of therapeutic ultraviolet rays (Linct; 1967; Scott; 1973). Experts who recommend its technique and use say that at a distance of 4 inches it produces a First-degree erythema dose (E1) on the human skin in 10 seconds (Scott; 1973). A total of 30 blacks (Nigerians) patients were recruited at the dressing section of the out-patient department of Obafemi Awolowo University Teaching Hospital Complex; Ile-Ife; for this study; the purpose being to test whether the above parameters are applicable in our environment

The management of shoulder pain of musculo-sekeletal origin using Feldene gel (PIROXICAM)

From the results of this research study; it can be concluded that topical application of Feldene gel (i.e. Piroxicam) in conjunction with other physiotherapeutic modalities such as short-wave diathermy; ultrasonic therapy and physical exercise is very effective in the relief of shoulder pain of musculo-skeletal origin

Modern concept of movement control and its implications for health

This paper has examined the subject of neural control of movement. It has discussed that reflexes are not the means by which complex movements are controlled. Such movements are controlled by centrally located networks called generators. The specificities of these generators are related to the function in which movement is required. It has been explained that an understanding of the action of the generators is fundamental in the management of pathologies related to movement

Muscle strengthening and rheumatoid arthritis

Rheumatoid arthritis often cripples its victims. Signs and symptoms of the disease are inflammation of joints; pain; tenderness weakness and atrophy of muscles. The cause is not fully understood. The two forms that exist are the acute and chronic. Literature reveals that while the acute form would respond more to drugs and heat therapy; the chronic form responds more to a programme of muscle strengthening through resistive exercises isotonic and isometric. The physical therapist is advised to pay closer attention to ways and means of designing resistive strengthening programmes for those patients suffering from the chronic form of rheumatoid arthritis

The gross body weight; following the treatment of traumatically ruptured tendon by electrical stimulation

The purpose of this study was to investigate the effect which pulsed galvanic current stimulation of traumatically ruptured Achilles tendons has on their calf muscles; and on the gross body weight of each subject. The effect of current polarity (i.e. anodal and cathodal currents) on these variables were also studied. To achieve these the total body weights and the calf circumferences of the subjects prior to the traumatic rupture of their Achilles tendons and following treatment with the two currents (i.e. after the traumatic rupture of their tendons) were therefore compared to each other and to those measures in a group where healing took place without electrical stimulation

Principles of exercise prescription for asymtomatic asthmatic - patients with other ailments on referral

The asthmatic patient may be required to participate in an exercise programme as part of the rehabilitation for some other ailments. The bronchial response of asthmatics to exercise puts them at a physiological disadvantage for exercise therapy. The bronchoconstrictor response of asthmatics to exercise can be made less severe by manipulating the type; duration; intensity and frequency of exercise. The time of the routine bronchodilator drug administration can also be manipulated such that the bronchodilator effect of the drug can effectively accommodate the bronchoconstrictor response to exercise. The asthmatic patient needs to be given special consideration while drawing up a plan of exercise for his rehabilitation either as part of the physical treatment of asthma or when he presents with other ailments on referral. This will enable him to exercise safely and effectively

A study of paraplegic eye contact behaviour in response to positive and negative feedback conditions

Eye contact behaviour of 62 paraplegics was examined during the reception of positive and negative feedback messages. There were 31 subjects in the positive feedback group and 30 in the negative feedback group. The purpose of this investigation was to examine the relative efficacy of positive and negative feedback in improving the self-esteem of paraplegic subjects. Eye contact was used as a measurable index of self-esteem. Eye contact scores were obtained by subtracting each subject's eye contact duration score for the feedback interview and the eye contact duration score for the neutral interview from each other. This yielded the difference in eye contact - D.E.C. - Score. The result from this study indicated that paraplegic subjects with low esteem made significantly more eye contacts for positive feedback. It was concluded that self esteem of paraplegics could be improved by communicating positive rather than negative feedback to them