Cross-cultural adaptation and psychometric testing of the Yoruba lequesne algofunctional index of knee osteoarthritis among patients with knee osteoarthritis.

BACKGROUND: The Lequesne Algofunctional Index of Knee Osteoarthritis (LAIKOA) is a widely used knee osteoarthritis (KOA) outcome measure and is recommended by many international authorities. It has been cross-culturally adapted to many languages, excluding indigenous Nigerian languages. The aim of this study was to cross-culturally adapt and validate the LAIKOA into Yoruba language. METHODS: This was a validation study. Yoruba LAIKOA was translated and culturally adapted from English version following Beaton's guidelines (including cognitive debriefing). The Yoruba LAIKOA was psychometrically tested for test-retest reliability, standard error of measurements (SEM), smallest detectable change (SDC), internal consistency, and construct validity among 108 Yoruba-speaking patients with KOA recruited from selected hospitals in Ibadan, Nigeria. Participants completed the Yoruba and English versions of LAIKOA, and the Yoruba version of Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM). RESULTS: The mean age of participants was 63.60 ± 11.77 years. Acceptable internal consistency was observed for the global index and function domain (α = 0.63-0.82) and good test-retest for items and domains (ICC = 0.81-0.995). Item-to-scale correlation was significant (r = 0.28-0.69). Its three domains demonstrated structural validity when subjected to confirmatory factor analysis (CFI = 0.99, TLI = 0.99, RMSEA = 0.02). Construct validity was supported by the correlation between Yoruba LAIKOA and IKHOAM (r = -0.39, p = 0.011). The overall scores and domain scores of the Yoruba and English versions of LAIKOA did not differ significantly. The Yoruba LAIKOA has no floor or ceiling effects. CONCLUSION: The Yoruba LAIKOA is reliable and valid, and it is recommended for use in clinical settings in southwestern Nigeria and other Yoruba-speaking populations.

Patterns of objectively assessed physical activity and sedentary time: Are Nigerian health professional students complying with public health guidelines?

BACKGROUND: Understanding patterns of physical activity and sedentary time is important to effective population-wide primary prevention and control of non-communicable diseases. This study examined the patterns of objectively assessed physical activity and sedentary time, and the prevalence of compliance with physical activity guidelines according to different public health recommendations in a sub-population of health professional students in Nigeria. METHODS: A cross-sectional study was conducted among 102 health professional students (age = 19-34 years old, 43.1% women) of the University of Maiduguri, Nigeria. Participants wore Actigraph accelerometers on their waist for minimum of 5 days/week to objectively measure intensity and duration of physical activity and sedentary time. Prevalence and demographic patterns of physical activity and sedentary time were examined using descriptive and inferential statistics. RESULTS: The students spent most time in sedentary activity (458.6 ± minutes/day, about 61% of daily time) and the least in vigorous-intensity activity (2.1 ± 4.4 minutes/day, about 0.3% of daily time). Sedentary time was higher among older than younger students (P<0.038) and among medical laboratory science students than physiotherapy and nursing students (P = 0.046). Total physical activity was higher among nursing and medical students than medical laboratory science students (P = 0.041). Although, 85.3% of the students engaged in 150 minutes/week of moderate-to-vigorous physical activity, only 2.9% met the guideline of 75 minutes/week of vigorous intensity activity. CONCLUSIONS: Prevalence of sedentary time was high while that of vigorous-intensity activity was very low among health professional students in Nigeria. Compliance with physical activity guidelines was mainly through accumulation of moderate intensity activity. The results suggest that age and academic programme may influence physical activity level and sedentary behaviour of health professional students in Nigeria. These findings provide preliminary evidence that could be used to inform the needs to develop interventions to improve and support active lifestyle behaviour among students in Nigerian universities.

Hamstring muscle length and pelvic tilt range among individuals with and without low back pain.

Hamstring tightness has been documented not to be related to the pelvic tilt position during static standing posture, but there is limited data on the relationship between hamstring muscle length (HML) and pelvic tilt range (PTR) during the dynamic movement of forward bending. This ex-post facto study was designed to compare each of HML and PTR in individuals with low back pain (LBP) and counterparts without LBP, and the relationship between HML and PTR in individuals with and without LBP. The study involved 30 purposively recruited individuals with LBP and 30 height and weight-matched individuals without LBP. Participants' PTR and HML were assessed using digital inclinometer and active knee extension test respectively. Data were analyzed using t-test and Pearson Correlation (r) at α = 0.05. Participants without LBP had significantly longer (p = 0.01) HML than those with LBP but the PTR of both groups were not significantly different. HML and PTR had indirect but not significant correlations in participants with and without LBP. Hamstring muscle length is significantly reduced in individuals with LBP but it has no significant correlation with pelvic tilt range. Pelvic tilt range reduces as hamstring muscle length increases.

Effects of a Twelve-Week Weight Reduction Exercise Programme on Selected Spatiotemporal Gait Parameters of Obese Individuals.

Objectives. This study was carried out to investigate the effects of twelve-week weight reduction exercises on selected spatiotemporal gait parameters of obese individuals and compare with their normal weight counterparts. Methods. Sixty participants (30 obese and 30 of normal weight) started but only 58 participants (obese = 30, normal weight = 28) completed the quasi-experimental study. Only obese group had 12 weeks of weight reduction exercise training but both groups had their walking speed (WS), cadence (CD), step length (SL), step width (SW), and stride length (SDL) measured at baseline and at the end of weeks 4, 8, and 12 of the study. Data were analysed using appropriate descriptive and inferential statistics. Results. There was significantly lower WS, SL, and SDL but higher CD and SW in obese group than the normal weight group at baseline and week 12. However, the obese group had significantly higher percentage changes in all selected spatiotemporal parameters than the normal weight group. Conclusion. The 12-week weight reduction exercise programme produced significantly higher percentage changes in all selected spatiotemporal gait parameters in the obese than normal weight individuals and is recommended for improvement of these parameters among the obese individuals with gait related problems.

Adolescent low back pain among secondary school students in Ibadan, Nigeria.

BACKGROUND: Adolescent low back pain (ALBP) can be considered a signal or precursor of a serious organic disease or telltale sign of future incidence of low back pain in adulthood. Published articles on ALBP in Nigeria are not readily available. OBJECTIVES: The study's objectives were to investigate the prevalence of Adolescent Low Back Pain (ALBP) among secondary school students in Ibadan, Nigeria and the prevalence's association with some socio-demographic variables. METHODS: Participants were adolescent students from 15 secondary schools in Ibadan. Data was collected using a respondent-administered, validated questionnaire on low back pain in adolescents. Participants (Female: 298; Male: 273) aged 14.23 ±2.27 years (range 10-19) were recruited through multi-stage random sampling. Five hundred and seventy-one (83.97%) of the 680 copies of the questionnaire administered were returned. Data was analysed using mean, standard deviation, frequency, percentages, and Chi-square test with alpha level at 0.05. RESULT: Lifetime, twelve-month, one-month and point prevalence rates of ALBP were 58.0%, 43.8%, 25.6% and 14.7% respectively. Age at first experience of ALBP was 11.86 ± 2.36 years. Gender was not significantly associated with any rate (p ≥0.317). Age (p ≤ 0.043) and engagement in commercial activities (p ≤ 0.025) were significantly associated with all period prevalence rates while injury to the back was significantly associated with all period prevalence rates except point prevalence (p = 0.087). CONCLUSION: Adolescent low back pain is common among secondary school students in Ibadan and its prevalence is significantly associated with age and engagement in commercial activities, but not with gender.

Variation in percentage weight bearing with changes in standing posture during water immersion: implication for clinical practice.

BACKGROUND: The degree of weightlessness during water immersion is usually estimated through percentage weight bearing (PWB). However, variations in PWB in different standing postures have not been documented. The study was designed to investigate the PWB of apparently healthy individuals in four standing postures at the anterior superior iliac spine level of immersion. METHODS: One hundred and ninety-three consenting undergraduates were purposively enlisted in this study. Participants' body weight (BW) was measured on land as well as in Erect Standing (ES), Grasp-Inclined-Prone-Standing (GIPS), Half-Grasp-Inclined-Towards-Side Standing (HGITSS) and Inclined-Standing with Head Support (ISHS) postures in hydro pool, using a specially designed water-proof weighing scale. PWB was calculated by dividing BW in water by BW on land and multiplying by 100. Data were analyzed using mean, standard deviation and ANOVA at α = 0.05. RESULTS: The mean age and BW (on land) of the participants were 22.4 years and 60.7 kg respectively. Participants' PWB were significantly different (p < 0.05) across the four standing postures. PWB was highest in ES and lowest in ISHS; PWB in ES (52.3 ± 5.8) being significantly higher (p < 0.001) than that observed in the derived standing postures. Further, PWB in GIPS (43.3 ± 5.6) and ISHS (43.2 ± 7.3) were significantly lower than in HGITSS (47.4 ± 5.2) posture while PWB in GIPS and ISHS postures were not significantly different (p > 0.05). CONCLUSION: Changes in standing posture have significant effect on PWB in hydro pool. The finding has implication for partial weight bearing exercises in hydro pool.

Perceived crime and traffic safety is related to physical activity among adults in Nigeria.

BACKGROUND: Neighborhood safety is inconsistently related to physical activity, but is seldom studied in developing countries. This study examined associations between perceived neighborhood safety and physical activity among Nigerian adults. METHODS: In a cross-sectional study, accelerometer-based physical activity (MVPA), reported walking, perceived crime and traffic safety were measured in 219 Nigerian adults. Logistic regression analysis was conducted, and the odds ratio for meeting health guidelines for MVPA and walking was calculated in relation to four safety variables, after adjustment for potential confounders. RESULTS: Sufficient MVPA was related to more perception of safety from traffic to walk (OR=2.28, CI=1.13- 6.25) and more safety from crime at night (OR=1.68, CI=1.07-3.64), but with less perception of safety from crime during the day to walk (OR=0.34, CI=0.06- 0.91). More crime safety during the day and night were associated with more walking. CONCLUSIONS: Perceived safety from crime and traffic were associated with physical activity among Nigerian adults. These findings provide preliminary evidence on the need to provide safe traffic and crime environments that will make it easier and more likely for African adults to be physically active.

Environmental factors associated with overweight among adults in Nigeria.

BACKGROUND: Understanding environmental factors related to obesity can inform interventions for the world wide obesity epidemic, yet no study has been conducted in this context in Africa. This study examined associations between neighbourhood environment variables and overweight in Nigerian adults. METHODS: A total of 1818 randomly selected residents (age: 20-65 years, 40% female, 31% overweight and 61.2% response) living in high and low socioeconomic (SES) neighbourhoods in Metropolitan Maiduguri, Nigeria, participated in a cross-sectional study. Anthropometric measurements of height and weight and an interview-assisted self-reported measure of 16 items of perceived neighborhood environments were conducted. The primary outcome was overweight (body mass index [BMI] > or = 25 kg/m(2)) vs. normal weight (BMI = 18.5-24.9 kg/m(2)). RESULTS: After adjustment for sociodemographic variables, overweight was associated with distant access to commercial facilities (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.02- 2.18), poor neighbourhood aesthetics (OR, 1.58; 95% CI, 1.16-2.09), perceiving garbage and offensive odours in the neighbourhood (OR, 1.41; 95% CI, 1.05-1.89) and feeling unsafe from crime at night (OR, 1.47; 95% CI, 1.13- 1.91) and unsafe from traffic (OR, 1.56; 95% CI, 1.17-2.07) in the total sample. Significant interactions regarding overweight were found between gender and four environmental variables, with low residential density (OR, 1.39; 95% CI, 1.02-1.93) and poorly maintained pedestrian pathways (OR, 1.89; 95% CI, 1.13-3.17) associated with overweight in men only, and absence of beautiful things (OR, 2.23; 95% CI, 1.42-3.50) and high traffic making it unsafe to walk (OR, 2.39; 95% CI, 1.49-3.83) associated with overweight in women only. There were few significant interactions between environmental factors and neighborhood SES regarding overweight. CONCLUSION: Neighbourhood environment factors were associated with being overweight among Nigerian adults. These findings support previous reports in international literature, but should be replicated in other African studies before any firm conclusions can be drawn.

Pain, balance, self-reported function and physical function in individuals with knee osteoarthritis.

Disability resulting from knee osteoarthritis (OA) is determined by physiological and functional variables though the interactions between the variables remain unclear and deserve further study. This study's major objective was to explore the relationship between pain, body mass index (BMI), balance, self-report function, and physical function in a cohort who had both unilateral and bilateral knee OA. Fifty-two patients (46 female, 6 male) ranging from 31 to 80 years of age (mean ± SD: 59.0 ± 9.8 years) with radiograph-confirmed OA of the knees participated in this study. Participants' pain intensity, self-reported function, dynamic balance, and physical function performance were measured by using box numerical scale, OA Index of Lequesne, functional reach test, and both stair climbing and timed up-and-go (TUG) tests, respectively. Associations between age, BMI, pain, balance, self-reported function, and physical function performance were explored by univariate and multivariate analyses at α = 0.05. Significant direct correlations were found between physical function performance and self-reported function (r = 0.56, r = 0.01) and age (r = 0.55, p = 0.01) and between self-reported function and age (r = 0.40, p = 0.01) in the cohort with bilateral knee OA. Significant inverse correlation was observed between age and balance (r = -0.58, p = 0.01) in participants with unilateral knee OA. In the regression model for all participants, self-reported function and age accounted for 27.0% of the variance in stair climbing test and 29.0% of the variance in the TUG test. Self-reported function and age are significant predictors of physical function in individuals with knee OA.

Physical inactivity in Nigerian young adults: prevalence and socio-demographic correlates.

BACKGROUND: This study assessed the prevalence of physical inactivity and the influence of sociodemographic variables on physical activity categories, highlighting the correlates of physical inactivity in Nigerian young adults. METHODS: A representative sample of young adults age 16 to 39 years (n = 1006) from a Nigerian University were categorized using the International Physical Activity Questionnaire as physically inactive, moderately active, and highly active. Prevalence rates were computed for the activity categories and the independent associations of sociodemographic correlates on each category were determined using the multinomial logistic regression. RESULTS: Physical inactivity prevalence was 41%. More likely to be inactive were females (OR = 1.93; CI: 1.49-2.49), those of Hausa ethnicity (OR = 2.29; CI: 1.08-5.84), having BMI > 30 kg/m2 (OR = 2.88; CI: 1.16-7.17), and those whose parents' annual income was < 180,000 NAIRA (OR = 1.69; CI: 1.04-2.95). Less likely to be moderately active were females (OR = 0.71; CI: 0.61-0.95), those with BMI between 25.0 to 29.9 kg/m2 (OR = 0.46; CI: 0.23-0.92), and those of Hausa ethnicity (OR = 0.17; CI: 0.04-0.74). CONCLUSION: Important sociodemographic variables that can contribute to the preliminary analysis of correlates of physical inactivity among Nigerian young adults were identified.

The Short International Physical Activity Questionnaire: cross-cultural adaptation, validation and reliability of the Hausa language version in Nigeria.

BACKGROUND: Accurate assessment of physical activity is important in determining the risk for chronic diseases such as cardiovascular disease, stroke, type 2 diabetes, cancer and obesity. The absence of culturally relevant measures in indigenous languages could pose challenges to epidemiological studies on physical activity in developing countries. The purpose of this study was to translate and cross-culturally adapt the Short International Physical Activity Questionnaire (IPAQ-SF) to the Hausa language, and to evaluate the validity and reliability of the Hausa version of IPAQ-SF in Nigeria. METHODS: The English IPAQ-SF was translated into the Hausa language, synthesized, back translated, and subsequently subjected to expert committee review and pre-testing. The final product (Hausa IPAQ-SF) was tested in a cross-sectional study for concurrent (correlation with the English version) and construct validity, and test-retest reliability in a sample of 102 apparently healthy adults. RESULTS: The Hausa IPAQ-SF has good concurrent validity with Spearman correlation coefficients (ρ) ranging from 0.78 for vigorous activity (Min Week-1) to 0.92 for total physical activity (Metabolic Equivalent of Task [MET]-Min Week-1), but poor construct validity, with cardiorespiratory fitness (ρ = 0.21, p = 0.01) and body mass index (ρ = 0.22, p = 0.04) significantly correlated with only moderate activity and sitting time (Min Week-1), respectively. Reliability was good for vigorous (ICC = 0.73, 95% C.I = 0.55-0.84) and total physical activity (ICC = 0.61, 95% C.I = 0.47-0.72), but fair for moderate activity (ICC = 0.33, 95% C.I = 0.12-0.51), and few meaningful differences were found in the gender and socioeconomic status specific analyses. CONCLUSIONS: The Hausa IPAQ-SF has acceptable concurrent validity and test-retest reliability for vigorous-intensity activity, walking, sitting and total physical activity, but demonstrated only fair construct validity for moderate and sitting activities. The Hausa IPAQ-SF can be used for physical activity measurements in Nigeria, but further construct validity testing with objective measures such as an accelerometer is needed.

Nosocomial infections: knowledge and source of information among clinical health care students in Ghana.

BACKGROUND: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana. METHODS: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ) was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal-Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05) RESULTS: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05) between course of study and knowledge of students about preventive measures for nosocomial infections. CONCLUSION: The students sampled demonstrated moderate knowledge of nosocomial infections and this was acquired largely through formal classroom training. These findings underscore the need for more emphasis on education about this important source of infection in the clinical training curriculum.

Perceived environmental correlates of physical activity and walking in African young adults.

PURPOSE: Evidence on environmental correlates of physical activity (PA) conducted in Western developed countries may not be generalizable to Africa. This study examined the associations between perception of the neighborhood environment and PA and walking in African young adults. DESIGN: Cross-sectional analysis of self-reported survey. SETTING: University of Ibadan, in the capital city of Oyo State, Nigeria. SUBJECTS: A representative sample of undergraduates of a Nigerian university, age 16 to 39 years and 50.7% female. MEASURES: Total walking activity and PA were measured with the short version of the International Physical Activity Questionnaire. Sixteen perceived neighborhood environmental variables were measured using the Physical Activity Neighborhood Environment Scale (PANES), which was used to assess environmental correlates of PA that are internationally relevant. Outcomes were meeting health-related guidelines for sufficient PA and walking activity. RESULTS: After adjustments for demographics and dormitory site, the proximity of bus/transit stop (odds ratio [OR]=1.41), traffic as not a problem (OR=.45; unexpected direction), and not many four-way intersections (OR=.72; unexpected direction) were significantly associated with sufficient PA. Low crime rate at night (OR=1.53), many interesting things to look at (OR=1.90), and seeing many people active (OR=.59; unexpected direction) were significantly associated with sufficient walking. Inconsistent patterns were also observed in gender-specific analyses. CONCLUSION: Few neighborhood environment correlates of PA or walking reported in the international literature were replicated with African young adults. Environmental measures need to be developed that are tailored to low- and middle-income countries, such as those in Africa, so that research in understudied regions can advance.

Physical Inactivity in Nigerian Young Adults: Prevalence and Socio-Demographic Correlates.

BACKGROUND: This study assessed the prevalence of physical inactivity and the influence of sociodemographic variables on physical activity categories, highlighting the correlates of physical inactivity in Nigerian young adults. METHODS: A representative sample of young adults age 16 to 39 years (n = 1006) from a Nigerian University were categorized using the International Physical Activity Questionnaire as physically inactive, moderately active, and highly active. Prevalence rates were computed for the activity categories and the independent associations of sociodemographic correlates on each category were determined using the multinomial logistic regression. RESULTS: Physical inactivity prevalence was 41%. More likely to be inactive were females (OR = 1.93; CI: 1.49-2.49), those of Hausa ethnicity (OR = 2.29; CI: 1.08-5.84), having BMI > 30 kg/m2 (OR = 2.88; CI: 1.16-7.17), and those whose parents' annual income was < 180,000 NAIRA (OR = 1.69; CI: 1.04-2.95). Less likely to be moderately active were females (OR = 0.71; CI: 0.61-0.95), those with BMI between 25.0 to 29.9 kg/m2 (OR = 0.46; CI: 0.23-0.92), and those of Hausa ethnicity (OR = 0.17; CI: 0.04-0.74). CONCLUSION: Important sociodemographic variables that can contribute to the preliminary analysis of correlates of physical inactivity among Nigerian young adults were identified.

Comparison of four physiotherapy regimens in the treatment of long-term mechanical low back pain.

OBJECTIVE: This study compared efficacy of combinations of Back Muscles Endurance Exercise (BMEE) and McKenzie Exercise (ME) and McKenzie Back Care Education (MBE) in the management of long term mechanical Low Back Pain (LBP). SUBJECTS AND METHODS: A single-blind randomized controlled comparative trial was employed. Seventy three participants mean age 45.3 ± 8.1 years were recruited for the study but only 53 completed the study. Participants in group A were treated with a combination of BMEE, ME and MBE. Group B: A combination BMEE and MBE. Group C: A combination of ME and MBE. Group D: MBE only. Participants were seen thrice weekly for 8 weeks. They were measured for pain intensity, lumbar flexibility, activities limitation and self esteem. Data were analysed using descriptive and inferential statistics of F-test. Significance was set at 0.05 alpha-level. RESULTS: At the end of the study, the four treatment groups had significant reduction in pain intensity p<0.05. Post hoc analysis showed groups A, B, and C had significantly greater reduction than D, and groups A and C had significantly greater reduction than B. Groups A, B and C also had significant improvement in activities limitation p<0.05. Post hoc analysis showed groups A, B and C had significantly greater improvement than D, and group B significantly greater improvement than C. CONCLUSION: Combination physiotherapy regimens proved effective in the management of long- term mechanical LBP. Regimen A is recommended in managing long-term mechanical LBP.

Work-related musculoskeletal disorders among Nigerian physiotherapists.

BACKGROUND: Physiotherapists are known to be prone to Work- related musculoskeletal disorders (WRMDs) but its prevalence among physiotherapists in Nigeria has not been reported. This study investigated the prevalence and work factors of WRMDs among physiotherapists in Nigeria. METHODS: A cross- sectional survey was administered to physiotherapists in different parts of Nigeria using a 2- part questionnaire with items adopted from questionnaires used for similar studies around the world. Two hundred and seventeen copies of the questionnaire were distributed for self administration but 126 physiotherapists returned completed surveys for a 58.1% response. The data were analyzed using SPPS version 10 at alpha level of 0.05. Descriptive statistics of frequency and percentages and inferential statistics of chi2 were used as appropriate for data analysis. RESULTS: Reported 12- month prevalence of WRMDs among Nigerian physiotherapists was 91.3%. Prevalence of WRMDs was significantly higher in female physiotherapists (p = 0.007) and those with lower body mass index (p = 0.045). The low back (69.8%) was the most commonly affected body part, followed by the neck (34.1%). Fifty percent of the physiotherapists first experienced their WRMDs within five years of graduation and the highest prevalence (61.7%) was found among physiotherapists younger than 30 years. Treating large number of patients in a day was cited by most (83.5%) of the respondents as the most important work factor for their WRMDs. The most commonly adopted coping strategy identified was for the therapists to modify their position and/or the patient's position (64.3%). Majority of the respondents (87.0%) did not leave the profession but 62.6% changed and/or modified their treatment because of their WRMDs. CONCLUSION: The prevalence of WRMDs among physiotherapists in Nigeria is higher than most values reported for their counterparts around the world. The coping strategies and work factors of WRMDs among Nigerian physiotherapists are mostly similar to those of their counterparts elsewhere.