Effect of task-oriented training on balance and motor function of ambulant children with cerebral palsy.

INTRODUCTION AND OBJECTIVES: The study evaluated the effect of task-oriented training (TOT) on the motor function (MF) and balance of ambulant children with cerebral palsy (CP). MATERIALS AND METHODS: A total of 46 children were randomised into TOT group (n=23) and Control Group (CG [n=23]), but 39 children complete the study. Balance and MF were assessed at baseline, 6th and 12th weeks and 6 weeks post-intervention. Data were analysed with repeated measures ANOVA, Friedman's, Mann-Whitney U, Student's-t and post hoc tests at α≤0.05. RESULTS: The two groups were comparable in all baseline scores (P>0.05). At the 6th week, significant between-group difference was observed in MF only [TOT=81.9 (18.5); CG=72.8 (19.4)] (P<0.05). There were significant between-group differences in MF [TOT=88.8 (9.4); CG=75.5 (18.5); P<0.05] and balance (TOT=9.4±4.5; CG=13.6±6.9; P<0.05) at the 12th week (P<0.05) and 6 weeks post-intervention (P<0.05). CONCLUSION: TOT improved the balance and MF of ambulant children with CP.

Dealing with diabetes-specific emotional distress: A cross-sectional survey of physical activity option.

BACKGROUND: Diabetes-specific emotional distress is common among people with type 2 diabetes due to the complexities associated with care and maintenance of wellness among the patients. Unlike the focus on glycaemic control, literature appears unavailable about how physical activity may help in the control of diabetes-specific emotional distress. This study was conducted to investigate the link between diabetes- specific emotional distress and physical activity. METHODOLOGY: Type 2 diabetes patients (n = 206) were enrolled into this study from two major health care facilities in Ibadan, Southwestern Nigeria. Physical activity was assessed using the International Physical Activity Questionnaire while diabetes-specific emotional distress was assessed using the Problem Areas in Diabetes Questionnaire. Data were analysed using descriptive and inferential statistics at ± 0.05. RESULTS: The participants' mean age was 58.6 12.7 years with 109 (52.9%) reporting low physical activity levels and 182 (88.3%) reporting varying degrees of diabetes- specific emotional distress. Compared to participants with low physical activity, those who reported moderate-to- vigorous physical activity reported a reduced risk of diabetes-specific emotional distress (OR = 0.53; 95% CI = 0.26-0.82). Age, sex and level of education were not associated with the distress. CONCLUSIONS: A substantial proportion of patients with type 2 diabetes reported low physical activity levels and much more reported diabetes-specific emotional distress. Those who reported moderate-to-vigorous physical activity reported a significantly lower risk of diabetes-specific emotional distress. Reduction in. the risk of diabetes-specific emotional distress may be yet another strong point in advocacy for physical activity among patients with type 2 diabetes.

Time course of improvement of metabolic parameters after a 12 week physical exercise programme in patients with type 2 diabetes: the influence of gender in a Nigerian population.

Gender is a major determinant of the outcomes of many health interventions. This study documents the order of significant improvements in metabolic parameters of patients with type 2 diabetes mellitus (T2DM) having metabolic syndrome within 12 weeks of physical exercise programmes. Twenty-nine patients, mean age 49.6 ± 3.7 years, presenting with high fasting plasma glucose, high triglycerides, hypertension, and high waist circumference undertook a thrice weekly aerobic and endurance exercise programme in addition to their drugs and diet. Variables were assessed at baseline and end of every two weeks for twelve weeks. Compared with baseline, significant improvement (P < 0.05) in the metabolic parameters occurred in this order for the male participants: fasting glucose (2nd week), triglycerides and waist circumference (4th week), and systolic blood pressure (12th week). For the female participants, it was fasting glucose (4th week), triglycerides (6th week), and waist circumference (10th week). Regardless of the gender, fasting glucose was the first to improve significantly, followed by triglycerides. Hypertension did not improve significantly at all in the female participants as they may require more than twelve weeks of therapeutic exercise for any significant improvement in hypertension.

Postpartum Exercise among Nigerian Women: Issues Relating to Exercise Performance and Self-Efficacy.

Physical exercise during postpartum period is beneficial to mothers, and the health gains are abundantly reported. This study characterises the postpartum exercise profile of a group of Nigerian women and reports how their exercise self-efficacies are influenced by sociodemographic characteristics. Participants were women attending the two largest postnatal clinics in Ibadan, south-western Nigeria. A self-developed questionnaire assessed the socio-demographic and exercise profile of participants, while the Exercise Self-Efficacy Scale assessed their exercise self-efficacy. About two-third (61.0%) of the participants were not aware that they could undertake physical exercise to enhance postpartum health, and 109 (47.8%) were not engaged in any exercise. Those who exercised did so for less than three days/week, and 89% of the women did not belong to any exercise support group. Exercise self-efficacy was significantly (P < 0.05) associated with being in an exercise programme, age, employment, work hours/week, monthly income, and number of pregnancies. Most of the women were not aware they could engage in postpartum exercise, and about half were not undertaking it. More women with high compared to moderate exercise self-efficacy undertook the exercise. Efforts at increasing awareness, improving exercise self-efficacy and adoption of postpartum exercise are desirable among the Nigerian women.

Physical inactivity is associated with low self efficacy and social support among patients with hypertension in Nigeria.

BACKGROUND Physical inactivity is a major factor in the development of many chronic illnesses, including hypertension. Evidence highlighting links among physical activity participation and psychosocial constructs such as self efficacy, social support and perceived barriers among hypertensive patients in the Nigerian population is scarce. This study explored the associations between physical activity and each of self efficacy, social support and perceived barriers. METHODS Two hundred and twelve patients receiving treatment in two tertiary health institutions located in Ekiti State, Nigeria were surveyed cross-sectionally. Physical activity level, self efficacy, social support and perceived barriers were measured with the International Physical Activity Questionnaire, Exercise Self-Efficacy Scale, Medical Outcomes Social Support Scale and Exercise Benefits and Barrier Scale respectively. RESULTS Level of physical activity was significantly associated with self efficacy (r(s) = 0.67, p < 0.01, = 0.45) and social support (r(s) = 0.80, p < 0.01, = 0.64), with most participants (56.1%) being physically inactive. However, no association was found between physical activity level and perceived barriers (r(s) = 0.07, p > 0.01, = 0.005). CONCLUSION Most of the hypertensive patients presented with low levels of physical activity. Physical activity was associated with psychosocial constructs including self efficacy and social support but not with perceived barriers.

Local incentive spirometry improves peak expiratory flow rate in teenage sickle cell anaemia patients: a randomized pilot trial.

BACKGROUND: Efforts to promote better health of sickle cell anaemia (SCA) patients in low-income countries through the use of cheap and available alternatives are desirable. OBJECTIVE: We investigated whether a locally designed incentive spirometry will improve peak expiratory flow rate (PEFR) of teenage SCA patients. METHODS: Forty-nine SCA teenagers were randomized into either the SCA spirometry or the SCA control groups, which had 24 and 25 patients respectively. They were initially compared with 25 matched non-SCA teenagers. The SCA spirometry group went through a six-week, thrice-daily local incentive spirometry while the control did not go through the exercise. RESULTS: The PEFR of the SCA spirometry group improved significantly (p = 0.001) between the third and sixth week (211.04 ± 55.67 to 292.08 ± 40.86 litres/min) unlike that of the SCA control group (p = 0.605). At six weeks, PEFR of the SCA spirometry group improved significantly (t=0.624, p=0.003) over that of the SCA control group. However, the improved PEFR of the SCA spirometry group did not match that of their non-SCA counterparts. CONCLUSIONS: Locally designed incentive spirometry improved PEFR of the SCA teenagers significantly in six weeks of spirometry exercise. Routine improvement in PEFR of SCA patients with the aid of incentive spirometry should be encouraged to improve lung function.

Differences in prevalence of self-reported musculoskeletal symptoms among computer and non-computer users in a Nigerian population: a cross-sectional study.

BACKGROUND: Literature abounds on the prevalent nature of Self Reported Musculoskeletal Symptoms (SRMS) among computer users, but studies that actually compared this with non computer users are meagre thereby reducing the strength of the evidence. This study compared the prevalence of SRMS between computer and non computer users and assessed the risk factors associated with SRMS. METHODS: A total of 472 participants comprising equal numbers of age and sex matched computer and non computer users were assessed for the presence of SRMS. Information concerning musculoskeletal symptoms and discomforts from the neck, shoulders, upper back, elbows, wrists/hands, low back, hips/thighs, knees and ankles/feet were obtained using the Standardized Nordic questionnaire. RESULTS: The prevalence of SRMS was significantly higher in the computer users than the non computer users both over the past 7 days (chi2 = 39.11, p = 0.001) and during the past 12 month durations (chi2 = 53.56, p = 0.001). The odds of reporting musculoskeletal symptoms was least for participants above the age of 40 years (OR = 0.42, 95% CI = 0.31-0.64 over the past 7 days and OR = 0.61; 95% CI = 0.47-0.77 during the past 12 months) and also reduced in female participants. Increasing daily hours and accumulated years of computer use and tasks of data processing and designs/graphics significantly (p < 0.05) increased the risk of reporting musculoskeletal symptoms. Over the past 7 day duration, the neck (33.9%) and low back (11.4%) had highest prevalence of SRMS for the computer and non computer users respectively. CONCLUSION: The prevalence of SRMS was significantly higher in the computer users than the non computer users and younger age, being male, working longer hours daily, increasing years of computer use, data entry tasks and computer designs/graphics were the significant risk factors for reporting musculoskeletal symptoms among the computer users. Computer use may explain the increase in prevalence of SRMS among the computer users.

Neuromusculoskeletal disorders in patients with type 2 diabetes mellitus: outcome of a twelve-week therapeutic exercise programme.

BACKGROUND AND OBJECTIVES: Usual line of management of diabetes patients is drug and diet with their physical needs usually receiving minimal attention. Among the physical needs, requiring attention is their neuromusculoskeletal disorders. This study was designed to investigate the effect of a twelve-week therapeutic exercise on neuromusculoskeletal disorders of Type 2 Diabetes (T2D) patients. METHODS: Forty-three participants from the Diabetes Specialty Clinic of Aminu Kano Teaching Hospital, Kano completed the study. Selected neuromusculoskeletal disorders including pain, dermatological foot grades, disorders of ranges of motion and strength of selected joints and muscles were assessed before and after a period of twelve weeks of therapeutic exercises. Participants were followed up for another twelve weeks without therapeutic exercises. RESULTS: Baseline assessment revealed poor neuromusculoskeletal status. Significant improvements (P < 0.05) were obtained for pain, Severity of Dermatological Foot Grading, Muscle strength (One Repetition Maximum) and Range of Motions at the end of the exercises except that of right wrist extension (P > 0.05). CONCLUSIONS: T2D patients presented with neuromusculoskeletal disorders at baseline. Therapeutic exercises however assisted in the improvement of these disorders but relapsed when exercises were suspended. Engagement in therapeutic exercises enhanced neuromusculoskeletal health, while withdrawal from the exercise contributed to a decline. T2D patients should be encouraged to participate in therapeutic exercises in order to promote their health and function.

Levels and predictors of physical activity in a sample of pre-retirement and retired civil servants in Nigeria.

BACKGROUND: Lack or inadequate physical activity may have dire health implications on both pre-retirement and retired individuals. Previous studies on the socioeconomic and demographic predictors of physical activity in this population may not fully apply in African because most were conducted outside the continent, hence this study. METHODS: A cross sectional survey of pre-retirement and retired civil servants in Kano State, North-Western Nigeria. A total of 532 participants comprising equal halves of sex-matched pre-retired and retirees met the inclusion criteria. We investigated their socioeconomic and demographic background as well as participation in vigorous and moderate physical activities, walking and sitting using the International Physical Activity Questionnaire. Regression analyses were conducted to identify predictors of moderate physical activities. RESULTS: Only 38.3% of pre-retired and 22.1% of the retirees engaged in moderate physical activities level. Being male, lower age, living in a rural settlement (OR = 1.56; 95% CI = 1.27-1.82), lower income and lower job/retirement years increased the odds of moderate activities in the pre-retired and retirees (except age and gender). Additionally, unavailability of recreational facilities (OR = 0.42; 95% CI = 0.33-0.61) was linked to lesser engagement in moderate physical activities in the retirees. CONCLUSION: Pre-retirement civil servants and retirees were physically active in both work and leisure mainly at the sub-moderate level, with lesser engaging in moderate level but below the recommended frequency. Settlement type, income and years of job/retirement were the common predictors of moderate physical activity in both groups.

Physical activity levels of type 2 diabetes patients seen at the outpatient diabetes clinics of two tertiary health institutions in Nigeria.

BACKGROUND: It is uncertain whether physical activity is sufficiently utilized as a complementary therapy in diabetes management by the patients visiting Nigerian hospitals. OBJECTIVES: This study assessed the level of physical activity of Type 2 Diabetes (T2D) patients attending tertiary hospital clinics, and investigates the factors that may expose them to sedentariness. METHODS: Physical activity survey was carried out on 248 T2D patients randomly selected from the University College Hospital, Ibadan, and Aminu Kano Teaching Hospital, Kano, Nigeria; and 248 matched non-diabetic participants. Physical activity level was assessed using the International Physical Activity Questionnaire. Socio-demographic information in addition to any previous expert advice on physical activity was recorded. Chi-Squared tests and regression analysis were conducted at p < 0.05. RESULTS: Significant difference existed between the physical activity levels of the T2D patients and the nondiabetic participants (c2 = 57.1, p = 0.0001). Most of the T2D patients were moderately active (62.1%) and less sedentary (27.4%) compared to the non-diabetic participants who were less moderately active (30.6%) and more sedentary (37.5%). Being female doubles the odds of being sedentary (OR = 2.02; 95% CI = 1.52-3.18) likewise increasing age, paid employment and fewer sessions of expert advice on physical activities encourage sedentariness. CONCLUSION: The T2D patients were more physically active at moderate levels than the non-diabetic participants, although, a substantial proportion of the T2D patients were sedentary. Lack of, or infrequent expert advice on physical activity, older age, being female and in paid employment may contribute to sedentariness among the participants.

Relationship between duration of diagnosis and neuromusculoskeletal complications of middle-aged type 2 diabetes patients.

BACKGROUND: Patients with Type 2 Diabetes (T2D) often present with complications involving the neuromusculoskeletal system which creep in as the condition advances in years. Hence there is a need to further understand how the duration of diagnosis of diabetes (DD) relates to the neuromusculoskeletal complications in order to design timely preventive programmes. OBJECTIVE: To investigate the relationship between the duration of diabetes and neuromusculoskeletal complications in type 2 diabetes. METHODS: This was a cross-sectional survey involving 139 consenting T2D patients and 139 age and sex-matched nondiabetic individuals. The participants were assessed for the DD and selected neuromusculoskeletal complications including muscle weakness, ranges of motion (ROM), pain and foot ulceration. RESULTS: The mean DD was 7.82 ± 2.41 years. There were significant differences (p < 0.01) between the clinical variables of both groups. In the diabetic participants, significant inverse relationships (P<0.05) were obtained between the DDD and each of muscle strength {{lbow flexors (r =-0.57), knee extensors (r=-0.63), handgrip (r=-0.82)}; ROM {wrist extension (r=-0.64) and ankle planterflexion (r=-0.63)}. Significant and direct relationships were obtained between the DDD and each of pain (r=0.62) and ulcerative grading (r= 0.81). CONCLUSIONS: Type 2 Diabetes patients have poorer neuromusculoskeletal variables and longer duration of diabetes is associated with reduced muscle strength, diminished ROM, gradual ulceration of skin of the feet and higher level of foot pain. Immediate therapeutic exercises against these complications soon after diagnosis of diabetes may help to decelerate their progression.

Relationship between duration of diagnosis and neuromusculoskeletal complications of middle-aged type 2 diabetes patients

Abstract. BACKGROUND: Patients with Type 2 Diabetes (T2D) often present with complications involving the neuromusculoskeletal system which creep in as the condition advances in years. Hence there is a need to further understand how the duration of diagnosis of diabetes (DD) relates to the neuromusculoskeletal complications in order to design timely preventive programmes. OBJECTIVE: To investigate the relationship between the duration of diabetes and neuromusculoskeletal complications in type 2 diabetes. METHODS: This was a cross-sectional survey involving 139 consenting T2D patients and 139 age and sex-matched nondiabetic individuals. The participants were assessed for the DD and selected neuromusculoskeletal complications including muscle weakness, ranges of motion (ROM), pain and foot ulceration. RESULTS: The mean DD was 7.82 ± 2.41 years. There were significant differences (p < 0.01) between the clinical variables of both groups. In the diabetic participants, significant inverse relationships (P<0.05) were obtained between the DDD and each of muscle strength {elbow flexors (r = -0.57), knee extensors (r = -0.63), handgrip (r = ­0.82)}; ROM {wrist extension (r = -0.64) and ankle planterflexion (r = -0.63)}. Significant and direct relationships were obtained between the DDD and each of pain (r = 0.62) and ulcerative grading (r = 0.81). CONCLUSIONS: Type 2 Diabetes patients have poorer neuromusculoskeletal variables and longer duration of diabetes is associated with reduced muscle strength, diminished ROM, gradual ulceration of skin of the feet and higher level of foot pain. Immediate therapeutic exercises against these complications soon after diagnosis of diabetes may help to decelerate their progression

Prevalence of Non-Invasive Risk Factors of Type 2 Diabetes among Higher Education Teachers in North-Western Nigeria

Background: Teaching is associated with a number of stressful circumstances that promote unhealthy lifestyles capable of fuelling risk factors for metabolic and cardiovascular disorders. This study investigated the prevalence of selected non-invasive risk factors of Type 2 Diabetes (T2D) among higher education teachers. Methods: Higher education teachers numbering 876 from three tertiary institutions in Kano; North- Western Nigeria were assessed on selected non-invasive risk factors of T2D including Body Mass Index (BMI); Waist Circumference (WC); Waist-Hip-ratio (WHR); Percent Body Fat (PBF) and family history of diabetes. Lifestyle including smoking; alcoholism and physical inactivity were also assessed. Results: Female-male ratio of participants was 1:5 while the age range was 24-58 years. Female teachers had higher prevalence of poor adiposity markers represented by overweight (33.8); obesity (12.7); high PBF (21.7) and WC in the high risk domain (53.5). They also had higher prevalence of hypertension (22.5) while men had higher prevalence of WHR (31.2) in the high risk domain. Positive family history of diabetes was 6.5(males); 7.5(females); physical activity at walking level 46.0(males); sedentary activity 85.9(females); current smoking habit 42.8(males); 4.3(females) and current alcohol consumption was 11.9for males and 0for female teachers. Conclusion: There may be considerable chances of developing T2D among the higher education teachers based on prevalence of the selected risk factors and the risk may be higher among the female teachers. Measures to change the modifiable risk factors for the better in this population are urgently needed

Neuromusculoskeletal disorders in patients with Type 2 Diabetes Mellitus: outcome of a twelve-week therapeutic exercise programme

ABSTRACT. Background and Objectives:Usual line of management of diabetes patients is drug and diet with their physical needs usually receiving minimal attention. Among the physical needs, requiring attention is their neuromusculoskeletal disorders. This study was designed to investigate the effect of a twelve-week therapeutic exercise on neuromusculoskeletal disorders of Type 2 Diabetes (T2D) patients. Methods: Forty-three participants from the Diabetes Specialty Clinic ofAminu KanoTeaching Hospital, Kano completed the study. Selected neuromusculoskeletal disorders including pain, dermatological foot grades, disorders of ranges of motion and strength of selected joints and muscles were assessed before and after a period of twelve weeks of therapeutic exercises. Participants were followed up for another twelve weeks without therapeutic exercises. Results: Baseline assessment revealed poor neuromusculoskeletal status. Significant improvements (P<0.05) were obtained for pain, Severity of Dermatological Foot Grading, Muscle strength (One Repetition Maximum)and Range of Motions at the end of the exercises except that of right wrist extension (P>0.05). Conclusions: T2D patients presented with neuromusculoskeletal disorders at baseline. Therapeutic exercises however assisted in the improvement of these disorders but relapsed when exercises were suspended. Engagement in therapeutic exercises enhanced neuromusculoskeletal health, while withdrawal from the exercise contributed to a decline. T2D patients should be encouraged to participate in therapeutic exercises in order to promote their health and function

Balance scores of hospitalized middle-aged medical patients on the day of discharge: indication for balance re-training.

Falls due to inadequate balance may occur among newly discharged hospitalized patients of any age but most studies focused on recuperating older adults with neurological or orthopaedic disorders. This study assessed on-the-spot discharge day balance of middle-aged medical patients and investigated whether this related to duration of hospitalization. Eighty-seven newly discharged middle-aged patients managed for hypertension, diabetes mellitus, lung and heart diseases and cancer patients receiving only chemotherapy and 87 age and sex matched apparently healthy controls were assessed for static and dynamic balance using the One Leg Stance (OLS) and 5-meter Timed Up and Go (5mTUG) tests respectively. Mean duration of hospitalization was 15.72 +/- 9.51 days. The OLS was shorter (4.79 +/- 2.34 secs) in the patients than controls (11.64 +/- 2.59 secs); while the 5 mTUG was longer (22.26 +/- 11.67 secs) in the patients. Significant differences (P < 0.05) were obtained when both tests were compared for both groups. Using Pearson's correlation, duration of hospitalization significantly (P < 0.05) related with both tests. Middle-aged medical patients had low balance at discharge. The balance reduced as the hospitalization period advanced. Hospitalized medical patients should be assessed for balance and treated accordingly before final discharge in order to minimize dangerous outcomes from falls.

Sociodemographic determinants of attrition in hospital based therapeutic exercise programme for type 2 diabetes patients.

BACKGROUND: Abandoning research programmes by participants may impose disadvantages on the participant, the research and the researcher. This study investigated the contributions of sociodemographic characteristics to the attrition of Type 2 Diabetes (T2D) patients who enrolled into a 12-week therapeutic exercise programme. METHODS: In the 12-week, thrice weekly hospital-based therapeutic exercise programme, the contributions of age, gender, duration of diagnosis, marital status, cohabitation, urbanization, educational and employment status to two sources of attrition (inability to locate and decline to commence or complete) were studied. RESULTS: Participants were aged 48 +/- 9.62 years. Out of the 152 participants who agreed to participate, only 93 (61.18%) actually commenced the exercise programme, while 69 (74.19%) of those who commenced the programme completed it. Risk of attrition due to inability to locate participants was higher in females (OR = 3.25, 95% CI = 2.96-3.91), single or divorced and living in the rural area (OR = 1.37, 95% CI = 1.12-1.52). Risk of decline to commence or complete was higher with increasing age, living alone, longer duration of diagnosis and being in paid employment while this was less likely in individuals who were married and more educated. CONCLUSION: We recorded 25.81% attrition for those who actually commenced the programme. Sociodemographic characteristics contributed to attrition in the 12-week, thrice weekly hospital-based exercise programme and we suggest closer monitoring (based on these sociodemographic characteristics) of T2D patients scheduled for therapeutic exercises in order to minimize attrition, maximise attendance and ensure higher retention.