Reducing anxiety and depression in infertility among Nigerian women: an exploratory psycho-educational intervention trial (RADIANT) study protocol.

RATIONALE: high premium is placed on infertility in Nigerian culture. Data is limited on its association with emotional problems in Nigeria. AIMS: to develop content for a culturally relevant and cost-effective psychoeducational intervention package and to evaluate its effectiveness for reducing symptoms of anxiety and depression. Sample size estimate: Methods and design: a multi-method study design including development and validation (which includes focus group discussions) of an audio-visual tool which will serve as the intervention in a randomized controlled trial. Data will be analyzed with interim and survival analyses. POPULATION STUDIED: one hundred and 138 (68 per group) infertile women attending infertility clinic in Ibadan. STUDY OUTCOMES: anxiety and depressions scores assessed with the hospital depression and anxiety scale (HADS) at 0, 3 and 6 weeks. DISCUSSION: it is hoped that the use of the audio-visual tool will improve participants depression and anxiety scores and that the tool will be used for education in routine clinic use and community awareness on psychosocial effects of infertility.

Graded activity with and without daily-monitored-walking in patients with type 2 diabetes with low back pain: secondary analysis of a randomized-clinical trial.

BACKGROUND: Graded activity is gradually emerging as a preferred choice in improving psychosocial outcomes including pain self-efficacy, fear-avoidance beliefs, and back-pain beliefs in the general population with low back pain (LBP). Such evidence is, however, lacking among patients with concomitant LBP and type-2 diabetes mellitus (T2DM). This secondary analysis of a randomized control trial aimed to compare the efficacy between graded activity augmented with additional daily-monitored-walking and graded activity alone on disability, pain self-efficacy (PSE), fear-avoidance beliefs (FAB), back-pain beliefs (BPB) and glycaemic control (HbA1c) in patients with concomitant LBP and T2DM. METHODS: Fifty-eight patients with concomitant LBP and T2DM were randomised into two groups, graded activity with daily-monitored-walking group (GAMWG = 29) or (graded activity group (GAG = 29) in this 12-week single-blind trial. Both groups received graded activity (home/work-place visits, back school and sub-maximal exercises) while the GAMWG received additional daily-monitored-walking. Disability and selected psychosocial outcomes were assessed at weeks 0, 4, 8 and 12 using Roland-Morris disability, fear-avoidance behaviour, pain self-efficacy and back belief questionnaires. Glycaemic control was assessed at weeks 0 and 12 using a point-of-care system (In2it, Biorad Latvia). Data were analysed using mean, median, Friedman's ANOVA, Mann-Whitney test and t-tests. RESULTS: Participants' mean age was 48.3 ± 9.4 years (95%CI: 45.6, 50.9) while 35.3% were males. The GAMWG participants (n = 25) had better outcomes (P < 0.05) than GAG participants (n = 26) on PSE (1.0, 3.0; r = - 0.1) and FAB (0.01, - 2.0; r = - 0.1) at week 4, LBP-related disability (0.01, - 2.0; r = - 0.2) at week 8 and glycaemic control at week 12 (- 0.59 ± 0.51%,-0.46 ± 0.22%). No other between-group comparisons were statistically significant. CONCLUSION: Graded activity with daily-monitored-walking provided earlier improvements on disability, pain self-efficacy, fear-avoidance beliefs, and glycaemic control, but not back pain beliefs, in patients with concomitant LBP and T2DM. TRIAL REGISTRATION: PACTR201702001728564 ; 26 July, 2016 (retrospectively registered).

Factors associated with fatigue in hip and/or knee osteoarthritis: a systematic review and best evidence synthesis.

OBJECTIVE: The aim was systematically to identify and evaluate factors related to fatigue in individuals with hip and/or knee OA. METHODS: A systematic literature search was conducted using AMED, CINAHL, MEDLINE, ProQuest and Web of Science Core Collections databases. Inclusion criteria comprised cross-sectional, case-control or longitudinal studies on patients with a diagnosis of hip and/or knee OA that included self-reported fatigue measures. Study quality was assessed using the National Heart, Lung and Blood Institute quality appraisal tool, and factors were synthesized within a bio-behavioural framework. Study designs and quality were combined to determine current evidence levels using best evidence synthesis grading. The full review protocol is available from PROSPERO (PROSPERO 2019: CRD42019138571). RESULTS: Twenty-four studies were included, of which 19 were high, 4 moderate and 1 low quality. There was strong evidence of an association between poor self-reported physical function and high depressive symptoms with higher fatigue. Moderate evidence of an association was found between severe pain, high numbers of co-morbidities and low physical activity levels with higher fatigue. There was moderate or limited evidence of no association between most sociodemographic factors and radiographic OA severity with fatigue. CONCLUSION: Targets for fatigue management might include improving physical function, reducing depressive symptoms, pain and co-morbidities, and increasing physical activity levels. There is a need for more rigorous longitudinal studies to understand the causal effect of fatigue determinants within the hip and knee OA populations.

Translation, cultural adaptation, and psychometric testing of the Yoruba version of Fear-Avoidance Beliefs Questionnaire in patients with low-back pain.

PURPOSE: To translate, culturally adapt, and validate the Fear-Avoidance Beliefs Questionnaire into Yoruba language. MATERIALS AND METHODS: Translation and cultural adaptation of the Yoruba version of the Fear-Avoidance Beliefs Questionnaire was carried out following the Guillemin criteria. One hundred and thirty-one individuals with chronic low-back pain participated in the psychometric evaluation of the Yoruba language translation. Cronbach's alpha (α), principal component analysis, intra-class correlation, Bland-Altman analysis, Spearman rank correlation coefficient, and minimal detectable difference were used for the analysis. Alpha level was set at p < 0.05. RESULTS AND CONCLUSION: The mean age of the respondents was 53.6 ± 11.6 years. The internal consistency of the Yoruba language version of the Fear Avoidance Beliefs Questionnaire yielded a Cronbach's alpha of 0.9. Principal component analysis yielded a three-factor structure including the "work", "beliefs related to work", and "physical activity" which accounted for 61.6% of variance in the Yoruba translation. Test-retest reliability of the Yoruba translation yielded an Intra class correlation coefficient 0.97 (0.95-0.98). The Yoruba Fear Avoidance Beliefs Questionnaire was poorly correlated with the Visual Analog Scale (r = 0.01) and Roland-Morris Disability Questionnaire (r = 0.3). The minimal detectable difference of the Yoruba translation was 7.0. The Yoruba Fear Avoidance Beliefs Questionnaire demonstrated excellent psychometric properties similar to existing versions and is appropriate for clinical use among Yoruba-speaking patients.IMPLICATIONS FOR REHABILITATIONThe Fear-Avoidance Beliefs Questionnaire is a culturally sensitive psychosocial outcome measure, necessitating its existence, and adaptation into different languages.The instrument was translated and culturally adapted into the Yoruba language following the Guillemin criteria.The Yoruba translation demonstrated excellent internal consistency, test-retest reliability and weak correlations with the Visual analog scale and Roland-Morris Disability Scale.The Yoruba version of the Fear-Avoidance Beliefs Questionnaire can be used to assess fear-avoidance beliefs among Yoruba speaking patients with low-back pain.

Development of a community-based, one-stop service centre for children with developmental disorders: changing the narrative of developmental disorders in sub-Saharan Africa.

Sub-Saharan Africa is home to about 15 million children with varying developmental disorders. Services for children with developmental disorders are scarce in Africa. The few available services are limited to the capital cities and are in the private sector, with the cost beyond the reach of most families. In 2016, the Centre for Early Development, Learning and Care was established in Ibadan, South-west, Nigeria. The centre provide services for children with developmental disorders is a one-stop, multidisciplinary team approach. Children are assessed on both structured and unstructured interviews. A total of 584 children were assessed between December 2016 and December 2019. One third (32.4%) of the children assessed within this period met diagnostic criteria for ASD, 29.1% had intellectual disability and 27.6% had cerebral palsy. The remaining clients (10.9%) had other disorders including ADHD, Down's syndrome, hearing impairment and visual impairment. Parents tend to downplay the severity of their children's disability. There are many challenges that are associated with the establishment of a service centre in a low resource setting. These and other experiences are discussed.

Efficacy of Graded Activity with and without Daily-Monitored-Walking on Pain and Back Endurance among Patients with Concomitant Low-Back Pain and Type-2 Diabetes: A Randomized Trial.

BACKGROUND: There is evidence supporting the efficacy of Graded Activity (GA) in managing clinical attributes of patients with Low-Back Pain (LBP) in the general population. However, it is unknown whether GA alone is efficacious in managing these clinical attributes in patients with concomitant LBP and Type-2 Diabetes (T2D) or additional daily-monitored walking will be required. METHODS: A single-blind controlled trial involving 58 patients (mean age: 48.3±9.4 years, 64.7% females) with concomitant LBP and T2D who received treatment twice weekly for twelve weeks was conducted. Participants were randomized into GA or GA with daily-monitored-walking (GAMW) groups. Pain Intensity (PI), Static Back Extensors Endurance (SBEE), Static Abdominal Muscular Endurance (SAME) and Glycaemic Control (GC) were assessed using Visual Analogue Scale, Biering-Sorensen test, flexor endurance test, and in2itTM device respectively at baseline, 4th, 8th and 12th week. Data were analysed using repeated measures ANOVA and Unpaired t-tests at α = 0.05. RESULTS: There were significant differences in PI, SAME and SBEE among participants in each of GA and GAMW groups respectively (p<0.05). Within-group difference on GC was significant for GAMW (6.3±0.9%, 5.7±0.7%) but not GA (6.3±0.9%, 6.3±0.9%). There was significant difference (p<0.05) between GA and GAMW group participants for SBEE (7.2±0.1 sec, 7.3±0.1 sec) at week 8 of the study and GC (-0.5±0.2%, -0.6±0.5%) at the end of the study. No differences were found between GA and GAMW groups for PI and SAME. CONCLUSION: Graded activity with daily-monitored-walking produced positive effects on GC and yielded a better improvement on SAME and SBEE.

Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries.

BACKGROUND: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5-17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. METHODS: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations' human development index (HDI) classification (low or medium, high, and very high HDI). RESULTS: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of "C-," "D+," and "C-" was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. CONCLUSIONS: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

Indicators of Physical Activity Among Children and Youth in 9 Countries With Low to Medium Human Development Indices: A Global Matrix 3.0 Paper.

BACKGROUND: This study compares results of physical activity report cards from 9 countries with low to medium human development indices, participating in the Global Matrix 3.0 initiative. METHODS: Country-specific report cards were informed by relevant data and government policy documents, reporting on 10 core indicators of physical activity for children and youth. Data were synthesized by report card working groups following a harmonized process. Grade assignments for each indicator utilized a standard grading rubric. Indicators were grouped into one of 2 categories: daily behaviors and settings and sources of influence. Descriptive statistics (average grades) were computed after letter grades were converted into interval variables. Spearman's rank correlation coefficients were calculated for all correlation analyses. RESULTS: Mean grades for daily behaviors were higher (C) than those for settings and sources of influence (D+). Twenty-nine out of the possible 90 grades were assigned an incomplete. There were moderate to strong positive and negative relationships between different global indices and overall physical activity, organized sport and physical activity, active play, family, community and environment, and government. CONCLUSIONS: Findings demonstrate an urgent need for high-quality data at the country level in order to better characterize the physical activity levels of children and youth in countries with low to medium human development indices.

Effectiveness of neck stabilisation and dynamic exercises on pain intensity, depression and anxiety among patients with non-specific neck pain: a randomised controlled trial.

BACKGROUND AND AIMS: Non-specific neck pain (NsNP) constitutes a burden to the bearers and a management challenge to physiotherapists globally. Effectiveness of neck stabilisation and dynamic exercises in the management of NsNP has been documented, but it is not clear which exercise regimen is more effective in alleviating its associated pain, depression and anxiety. This study was carried out to compare the effectiveness of neck stabilisation and/or dynamic exercises on pain intensity, depression and anxiety among patients with NsNP. METHODS: Eighty-nine consenting individuals with NsNP participated in this single-blind, randomised controlled trial. They were recruited from the outpatient physiotherapy clinics of the National Orthopaedic Hospital in Dala, Kano State, Nigeria. Participants were randomly assigned into one of three intervention groups: neck stabilisation exercise group (NSEG; n=30), neck dynamic exercise group (NDEG; n=28) and neck stabilisation and dynamic exercise group (NSDEG; n=31). Treatment was administered thrice weekly for 8 consecutive weeks. Variables were assessed at baseline, at the end of the fourth and eighth weeks. Pain intensity was assessed through the use of a visual analogue scale, while depression and anxiety were evaluated using both the Beck Depression Inventory and Beck Anxiety Inventory. The data was analysed using descriptive statistics, multivariate analysis of variance (MANOVA) and post hoc tests with Bonferroni adjustment at the p=0.05 significant level. RESULTS: Ages of participants in NSEG (46.8±12.4 years), NDEG (48.6±11.6 years) and NSDEG (45.1±13.4 years) were comparable. The comparison for NSEG, NSDEG and NDEG within groups revealed that there was significant difference in pain intensity, depression and anxiety scores from baseline, in the fourth and eighth weeks of the study - (F=62.40, p=0.001, F=13.91, p=0.001 and F=20.93, p=0.001); (F=11.92, p=0.001, F=8.75, p=0.004 and F=9.70, p=0.001) and (F=36.63, p=0.001, F=11.99, p=0.001 and F=6.59, p=0.001), respectively. A group comparison of the pain intensity, depression and anxiety scores of participants in the NSEG, NSDEG and NDEG at the baseline of the study revealed that there were no significant differences in the pain intensity and depression and anxiety scores among the three groups: p=0.159, 0.58 and 0.179, respectively. At week 4 of the study, however, a significant difference in pain intensity and anxiety scores across the three groups was recorded - p=0.018, p=0.011, respectively, but no significant difference was noted in depression scores (p=0.93). At week 8 of the study, it was determined that there were significant differences in pain intensity and depression scores p=0.001 and p=0.041, but no significant dissimilarities in the anxiety scores. Post hoc revealed that only pain was significant and lay with NSEG. CONCLUSIONS: The study concluded that the stabilisation, dynamic and stabilisation, plus dynamic exercises were effective in relieving pain and reducing depression and anxiety in patients with NsNP. However, stabilisation showed a more marked effect than the combination exercises of stabilisation plus dynamic exercises, and dynamic exercises in reducing pain intensity in patients with NsNP. IMPLICATIONS: It is recommended that stabilisation exercises be chosen over stabilisation plus dynamic exercises, or dynamic exercise, while treating patients with NsNP. However, both are effective.

Physiotherapy management of knee osteoarthritis in Nigeria-A survey of self-reported treatment preferences.

BACKGROUND: knee osteoarthritis (OA) is a prevalent condition. Little is known about whether treatments provided by physiotherapists to patients with knee OA in Nigeria follow recommended clinical practice guidelines. OBJECTIVE: The aims of this study were to investigate Nigerian physiotherapists' treatment preferences for knee osteoarthritis (OA) and to evaluate if their preferences were in line with contemporary clinical practice guidelines and recommendations. METHODS: A cross-sectional survey of 267 physiotherapists from various health institutions in Nigeria were surveyed, using a structured questionnaire incorporating a clinical vignette on knee OA. RESULTS: Based on the clinical vignette, the majority of the respondents (68.2%) recommended review of x-rays as part of the diagnostic process for knee OA. Thermotherapy was the most utilized modality (86.1%), followed by therapeutic exercise (81.3%). Only 11.1% of the physiotherapists used therapeutic exercise alone. Manual therapy in conjunction with other modalities was the choice for 18% of the physiotherapists. Only 49.1% of the physiotherapists reported including advice on weight control and up to 39% reported bed rest as part of the treatment approach. CONCLUSION: There was a poor consensus among the physiotherapists in Nigeria on how knee OA is managed compared with contemporary clinical guidelines and recommendations which emphasized application of core modalities, such as therapeutic exercises, patients' education, and weight control over passive modalities. Some areas of practice are in line with contemporary guidelines, while some were in conflict with evidence-based practice.

Results From Nigeria's 2016 Report Card on Physical Activity for Children and Youth.

BACKGROUND: The Nigerian Report card on Physical Activity (PA) in Children and Youth was first developed in 2013 to inform practice and policy on healthy living and prevention of noncommunicable diseases among Nigerian children and youth. This article summarizes the results of the 2016 report card and provides updated evidence on the current situation in Nigeria. METHODS: A comprehensive review of literature was undertaken by the Report Card Working Group. Grades were assigned to 10 PA indicators based on the criteria used for the 2013 edition. RESULTS: Grades assigned to the indicators were Overall PA, D; Active Play and Leisure, C; Active Transportation, B; Sedentary Behaviors (screen-based, F and nonscreen-based, D); Overweight and Obesity, A; PA in Schools, C-; Government/Nongovernment Organizations/Private Sector/Policy, B. The following indicators were graded as Incomplete: Organized Sport and PA, Community and Built Environment, and Family and Peers. CONCLUSIONS: The overall PA levels of Nigerian children and youth seemed to be declining compared with the 2013 Report card but with slight improvement in active play and leisure, and PA in school settings. A substantial number of Nigerian children and youth still have high sedentary behaviors, overweight and obesity. Efforts are needed to promote PA among them.

An Analysis of Work-Related Musculoskeletal Disorders Among Butchers in Kano Metropolis, Nigeria.

BACKGROUND: Butchering is often associated with high rates of work-related musculoskeletal disorders (WRMSDs). However, published work on the prevalence of WRMSDs among butchers in Nigeria is scarce. This is important because meat processing practices differ across geographical and cultural locations. This study was therefore aimed at analyzing WRMSDs among butchers in Kano metropolis. METHODS: Sociodemographic and work-settings information was obtained from 102 male cattle butchers (age, 37.49 ± 11.68 years) through survey. Information on the prevalence and pattern of musculoskeletal disorders was obtained from the respondents using the Standardized Nordic Questionnaire. Additional information on health seeking practices was also obtained using a pro forma. Associations between the prevalence of WRMSDs and each of the sociodemographic data and work settings were explored using Chi-square analysis. The level of significance was set at p < 0.05. RESULTS: The 12-month and point prevalence rates of WRMSDs among butchers in this study were 88.2% and 74.5%, respectively. Whereas lower back complaints (66.7%) were the overall and lower body quadrant's most commonly reported WRMSDs among the butchers surveyed, wrist/hand complaints were the leading upper quadrant's (45.1%) most commonly reported WRMSDs among the respondents. There were significant associations between age and majority of WRMSDs in the body regions. Only 23.3% of the 90 individuals who had WRMSD visited the hospital to seek redress for their WRMSD. CONCLUSION: The prevalence of WRMSDs is high among butchers in Kano Metropolis. Few individuals with WRMSD utilize healthcare facilities. Age is a major risk factor in this setting.

Effects of acute exercise on salivary free insulin-like growth factor 1 and interleukin 10 in sportsmen.

BACKGROUND: Saliva analysis is rapidly developing as a tool for the assessment of biomarkers of sports training. It remains poorly understood whether a short bout of sport training can alter some salivary immune biomarkers. AIM: To investigate the effect of acute exercise using football training session on salivary flow rate, salivary free Insulin-like Growth Factor-1 (IGF-1) and Interleukin 10 (IL-10). METHODS: Saliva samples were collected before and immediately after a football session. Salivary flow rates, salivary levels of free IGF-1 and IL-10 (using ELISA) were determined. Data was analyzed and compared using Related Samples Wilcoxon Signed Rank test (non-parametric test). Relationships between salivary flow rate and levels of free IGF-1 and IL-10 were determined using Spearman correlation test. RESULTS: There were 22 male footballers with a mean age of 20.46 years. Salivary flow rate reduced significantly (p = 0.01) after the training session while salivary levels of free IGF-1 and IL-10 did not show any significant change. Also, there were no correlations between salivary flow rates and salivary levels of free IGF-1 and IL-10 before and after exercise. CONCLUSION: These findings suggest that acute exercise caused significant reduction in salivary flow rate but no change in the levels of salivary free IGF-1 and IL-10.

Global Account of Barriers and Facilitators of Physical Activity Among Patients with Diabetes Mellitus: A Narrative Review of the Literature.

BACKGROUND: With diabetes rates escalating globally, there is the need for a better integration of all aspects of diabetes care for improved population outcomes. An understanding, not only of regional but global literature on physical activity barriers and its facilitators is important if healthcare providers and policy makers are to create programs tailored to their populations. OBJECTIVES: Herein, we report the results of a narrative review of the global barriers and facilitators of physical activity for patients with diabetes mellitus. METHODOLOGY: An in-depth literature search was conducted to identify English-language studies that examined physical activity barriers and associated facilitators among patients with diabetes mellitus. Major electronic literature databases that were searched included Google Scholar, PubMed, Hub-Med, and Highwire. RESULTS: Studies were available from Africa, Asia, Australia, Europe, and, predominantly North America. A total of 34 predominantly internal barriers emerged globally. The most commonly reported were time constrains, fear of provoking additional disorders, exercise venue and weather related barriers. Facilitators of physical activity were reported for most of the internal barriers (e.g. time constraints, lack of knowledge etc) while the external barriers (e.g. weather, environmental pollution etc) received only a minimal attention. CONCLUSIONS: Globally, patients with diabetes are confronted with an enormous number of physical activity barriers. Unlike the robust solutions proffered for the internal barriers, the literature is largely silent about solutions to the external barriers, which though fewer, may be highly influential. Additional data is needed to better understand physical activity behaviors in populations outside of North America.

Physical activity level of postmenopausal women in Nigeria: Association with self-rated health status, overall obesity, and abdominal obesity.

Regular physical activity (PA) has been shown to have many health benefits in various populations, including postmenopausal women (n = 310). Self-rated health has been positively associated with PA. This cross-sectional survey of postmenopausal women in Nigeria was conducted from April to September 2012 to investigate associations among PA level, self-rated health, overall obesity (body mass index [BMI]), and abdominal obesity (waist-height ratio, waist-hip ratio, and waist circumference). The International Physical Activity Questionnaire was used to classify PA. Chi-square and logistic regression were used for analyses with level of significance set at .05. Participants were aged 53.0 ± 4.2 years; moderate to vigorous PA was reported by 188 (60.0%), while 26 (8.4%) self-rated their health as poor/fair, and 242 (78.1%) were either predominantly overweight or obese when classified according to BMI. Participants with fair/poor self-rated health had less odds of involvement in moderate to vigorous PA. Obese postmenopausal women had greater odds of reporting lower PA. PA was positively related to self-rated health, which was negatively associated with overall obesity but not abdominal obesity. Measures to control obesity among postmenopausal women are essential in view of its direct association with poor self-rated health and low PA in this group of women.

Musculoskeletal pain among postmenopausal women in Nigeria: Association with overall and central obesity.

BACKGROUND: Menopausal women experience musculoskeletal changes such as muscle atrophy, muscle weakness and osteoporosis-symptoms associated with advancing age coupled with depletion of the female sex hormone, estrogen. Estrogen is important in the maintenance of the integrity of the musculoskeletal system and its reduction in the circulation due to menopausal transition results in reduced resting metabolic rate, lowered energy expenditure, increase in fat mass, and central adipose tissue accumulation. OBJECTIVE: This study investigated the prevalence of musculoskeletal pain (MSP) in postmenopausal women (PMW) in Nigeria. We examined the association of overall and central obesity with complaints of MSP and the screening potential of obesity measures for risk of musculoskeletal problems among PMW in Nigeria. METHODS: This was a cross-sectional survey of MSP in 310 PMW in Ibadan, Nigeria. MSP was assessed using the Standardized Nordic Musculoskeletal Questionnaire, and overall and central obesity were assessed using body mass index (BMI), waist/height ratio (WHtR), waist circumference, and waist/hip ratio. Data were analysed using descriptive statistics, chi-square test, and logistic regression models with the probability level at p = 0.05. RESULTS: Participants were of the modal age group (51-60 years). The highest prevalence rates of MSP were in the lower extremity (189; 61.0%) and the back (164; 52.9%). A direct association was observed between the categories of BMI and lower extremity symptoms (p < 0.05), and the categories of WHtR and waist circumference were associated with back and lower extremity symptoms (p < 0.05). Postmenopausal women had greater odds of reporting MSP across various classes of BMI. WHtR revealed the greatest odds for back (odds ratio = 1.70, 95% confidence interval 1.07-2.75) and lower extremity symptoms (odds ratio = 2.33, 95% confidence interval 1.44-3.78). CONCLUSION: Lower extremity and back pain symptoms were the most prevalent. For overall and central obesity directly associated with MSP, WHtR seemed the best obesity screening tool for MSP in postmenopausal women.

Perceived barriers to physical activity among Nigerian stroke survivors.

INTRODUCTION: Benefits of physical activity in the prevention and management of stroke are well documented in the literature. There is increasing evidence that stroke survivors in South-West Nigeria are physically inactive. Data on barriers to the achievement of the recommended physical activity levels including its differences along socio-demographic characteristics among stroke survivors in South-West Nigeria are needed. METHODS: The Exercise Benefits and Barrier Scale and the International Physical Activity Questionnaire were administered on 121 stroke survivors to determine their perceived barriers to physical activity and physical activity levels respectively. Information on socio-demographic data and clinical variables were also collected. RESULTS: The sample included 70.2% males, with majority of the participants reporting low physical activity levels (80.2%) and high perceived barriers (Mean = 48.13, SD = 7.88). The four most reported common barriers among stroke survivors were access to exercise facilities (95.0%), being embarrassed to exercise (94.2%), economic cost demands of exercise (94.2%) and notion that people in exercise clothes look funny (94.2%) respectively. There were no significant differences found in barriers to physical activity between gender (U = 1471.00, P = 0.74) and across each of: occupational status (H = 4.37, P = 0.22), age group (H = 0.82, P = 0.84) and educational levels (H = 4.56, P = 0.33). Significant difference however existed in perceived barriers across marital status categories (H = 12.87, P = 0.05). CONCLUSION: Stroke survivors indicated high perceived barriers to physical activity and these barriers were associated with marital status.

Results from Nigeria's 2013 Report Card on Physical Activity for Children and Youth.

BACKGROUND: Physical activity (PA) promotion in children and youth is an impetus for prevention and control of NCD morbidity and mortality, but evidence is needed for effective interventions. The aim of the present paper is to summarize the results of the 2013 Nigerian Report Card on Physical Activity for children and youth. METHODS: The Technical Report Committee conducted a comprehensive review of available literature in Nigeria. Grades were assigned to 10 PA indicators modeled after the Active Healthy Kids Canada (AHKC) grading system. RESULTS: Specific grades were assigned for several indicators: Overall Physical Activity Levels, C; Organized Sport and Physical Activity Participation, Incomplete; Active Play and Leisure, C-; Active Transportation, B; Sedentary Behaviors, F; Overweight and Obesity, B+. The following indicators were graded as INCOMPLETE: Physical Activity in School setting, Family and Peers, Community and Built Environment, and Government Strategies and Investments. CONCLUSIONS: PA levels of Nigerian children and youth are moderate while sedentary behaviors are high. The development of national guidelines for PA and sedentary behaviors can better inform policy and practice on healthy living among Nigerian children and youth.

Physical activity and energy expenditure: findings from the Ibadan Pregnant Women's Survey.

Physical activity, if there are no medical caveats, is beneficial to all people including pregnant women. This study examined the level of physical activity in a group of pregnant Nigerian women. Pregnancy Physical Activity Questionnaire was used to assess the physical activity of 453 pregnant women. The mean age of participants was 30.89 +/- 4.44 years, 222 (49.0%) were sedentary, and only 46 (10.2%) presented with moderate activity level. The highest amount of energy (75.9 MET-h x wk(-1)) was expended on household activities. Women in the third trimester of pregnancy had more than three times the risk of being sedentary (OR = 3.26, 95% CI = 2.11-4.56) but the risk reduced by 58% in gravid > or = 5 women. Most of the pregnant women recorded physical activity that was lower than the recommended level, which could lead to unfavourable health outcomes for mother and child. Efforts to promote physical activity in pregnant women in this environment are desirable.