Comparison of the knowledge and perception of physiotherapy by medical students of the institutions with and without physiotherapy training programme.

AIMS AND OBJECTIVES: To compare the knowledge and perception of physiotherapy by medical students of two institutions, one (i.e. University of Lagos - UL) with and the other (i.e. Lagos State University - LSU) without physiotherapy training programme. SUBJECTS AND METHODS: A total of 193 undergraduate medical students (UL = 96, LSU = 97) participated in this survey by completing a 26-item closed-ended questionnaire with a response rate of 96%. The questionnaire included information on personal characteristics, general knowledge and perception of physiotherapy. Chi-square statistics, t-test and Mann-Whitney U test were used to determine significant differences between variables at 95% confident interval. RESULTS: Respondents from UL (medical school with physiotherapy training facility) were significantly knowledgeable (p<0.05) and at all Levels of the clinical years (p<0.05) than those from LSU (medical school with no physiotherapy training facility). Also their perception of physiotherapy was significantly (p<0.05) better than those from LSU, particularly in the 600Level (i.e. final year). While there was no gender difference in knowledge, the males from UL had significantly better perception of Physiotherapy (p<0.05). CONCLUSION: Medical students from UL had better knowledge and perception of physiotherapy than those from LSU. The low level of knowledge and perception of medical students of LSU about physiotherapy may be due to the absence of physiotherapy training in LSU.

Risk factors of post-stroke depression among stroke survivors in Lagos, Nigeria.

OBJECTIVE: Stroke is an important neurological problem and a leading cause of death in clinical practice. Among survivors, over half have significant disabilities; and/ or psychiatric complications most especially Post-stroke depression (PSD). The study aimed to establish prevalence and risk factors for post stroke depression. METHOD: A prospective study carried out among selected stroke survivors in Lagos University Teaching Hospital (LUTH). Subjects included those who satisfied the WHO definition of stroke. The necessary socio-demographic data was obtained from each subject; the Depression Anxiety Stress Scale-21 (DASS-21) and Modified Motor Assessment Scale (MMAS) were administered. Risk factors of PSD studied were gender, laterality of stroke, post stroke functional impairment and post stroke duration before clinical presentation. RESULTS: A total of 51 stroke survivors were studied, made up of 31 (60.8%) males and 20 (39.2% ) females. The mean age was 52.5+/-5.9 years; and age range of 40-64 years. From assessment with the depression subscale of DASS-21, 38 (74.5% ) of the subjects were normal and the rest 13 (25.5% ) had depression. Risk factors found to be statistically significant for PSD in the study included: gender (X(2)=10.3 at p=0.001) and stroke laterality ( X (2)=6.1 at p = 0.013). However, there were no statistically significant differences for mean post-stroke duration before clinical presentation and PSD ( "t" =3.5 and p= 0.073) ; and post-stroke disability as shown by mean MMAS scores and PSD ( "t" =7.6 and p= 0.084). CONCLUSION: Depression was found to be an important complication among stroke survivors in our study. Important risk factors found for PSD included gender and laterality. The findings emphasized a need for appropriate health facilities and for stroke survivors to present early for treatment to attenuate stroke complications.

Knowledge and perception of physiotherapy by final year medical students of a Nigerian university.

BACKGROUND: It has been shown that multidisciplinary interactions have become a feature of the changing medical education system. It is not clear to what extent medical students have been integrated into this newer model, more especially at the College of Medicine of the University of Lagos (CMUL), AIM: To assess the level of knowledge and perception of physiotherapy by the final year medical students of CMUL about physiotherapy. MATERIAL AND METHODS: Ninety eight final year medical students of CMUL participated in the study. They were required to complete a standard 22 item closed-ended questionnaire which was self administered. Data were presented as mean +/- standard deviation; Inferential statistics of chi-square and t-tests were used to compare differences between variables. RESULTS: The respondents displayed above average knowledge of physiotherapy as the mean scores obtained for knowledge of physiotherapy were 20.25 +/- 4.50 and 18.77 +/- 4.60 for males and females respectively. They also showed a fair perception towards physiotherapy as the mean scores obtained were 32.70 +/- 7.20 and 34.33 +/- 7.30 for males and females respectively. However there was a significant gender difference in the medical students' knowledge of physiotherapy (p < 0.05). CONCLUSION: The sampled final year medical students of CMUL had a good knowledge and fair perception of physiotherapy. Their main source of knowledge was classroom lectures. The need for further education of medical students with particular emphasis on clinical interaction was identified. It is hereby suggested that interprofessional courses and communication should be given greater attention during medical training.

Comparison of the therapeutic efficacy of phonophoresis and iontophoresis using dexamethasone sodium phosphate in the management of patients with knee osteoarthritis.

BACKGROUND AND OBJECTIVE: Many treatment options, including non-pharmacological and pharmacological measures, have been recommended in the management of osteoarthritis (OA). Among the non-pharmacological approach is physiotherapy, which involves the use of physical modalities like, heat therapy, exercise therapy, electrical stimulation, therapeutic ultrasound, iontophoresis, and phonophoresis. This study was therefore designed to compare the effectiveness of 0.4% Dexamethasone sodium phosphate (DEX-P) phonophoresis (PH) with 0.4% DEX-P iontophoresis (ION) therapy in the management of patients with knee joint OA. METHODS: Fifty patients (19 males and 31 females) with a mean age of 53.6 +/- 8.9 years were randomly assigned to PH or ION groups with 25 patients in each group. Ultrasound waves of 1 MHz frequency was applied for 5 minutes to the target knee, so also was the direct current for 10 minutes for 10 sessions treatment period. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores, 20 meters ambulatory time, and knee range of motion (ROM) were evaluated before and after therapy as the outcome measures. RESULTS: At the end of two weeks, significant improvement in total WOMAC scores was observed in 15 (60%) and 16 (64%) patients in the PH and ION groups respectively, indicating no significant difference in the improvement rate. Twenty (20) metres ambulatory time and knee range of motion also improved significantly in both groups, yet these variables showed no significant difference between the two groups. CONCLUSION: Both therapeutic modalities were found to be effective and generally well tolerated after 10 treatment sessions. DEX-P phonophoresis was not superior to DEX-P iontophoresis in the treatment of patients with OA of the knee.

Comparison of the effects of tens and sodium salicylate iontophoresis in the management of osteoarthritis of the knee.

The aim of this study was to compare the effects of transcutaneous electrical nerve stimulation (TENS) and sodium salicylate Iontophoresis on pain and functional disability in patients with osteoarthritis of the knee. Twenty (20) subjects participated in this study. Their ages ranged from 40-65 years. They were assigned to either the TENS or Iontophoresis group. The application of TENS was done using an EV 904 unit made by. Electro-medical supplies, while Iontophoresis treatment was delivered using a Galvanic current machine by F.W. Read and Sons London. The subjects levels of pain and functional disability prior to commencement of treatment and after the 6 weeks of treatment was taken using the Visual Analogue Scale (VAS) and Disability Index Questionnaire for patients with osteoarthritis of the knee joint(s). Analysis of data obtained was done using the Mann-Whitney U test and level of significance was set at (P < 0.05). The statistical analysis of the result showed a statistically significant reduction in pain and functional disability in both groups (P < 0.05). Patients treated with Sodium salicylate iontophoresis had a more statistically significant reduction of pain and functional disability in comparison with TENS group (P < 0.05). It is hereby suggested that the use of sodium salicylate iontophoresis and TENS be included in treatment of osteoarthritis to enhance pain relief and functional activity.