Review of core stability exercise versus conventional exercise in the management of chronic low back pain.

Exercise has been proven to be effective in the management of chronic low back pain. Over the years, core stability exercise (CSE) has gained popularity however there is lack of consensus on the best exercise treatment. Aims: To review the effectiveness of core stability exercises or conventional exercises in the management of chronic low back pain (CLBP). Methods: This study is a systematic review of randomized clinical trials which examined studies regarding core stability and conventional exercise by using Google scholar, Medline, PEDro and Cochrane from 2010 to 2021. The Methodological quality was evaluated using the PEDro scale. The included studies randomized participants into two different exercise groups. Results: From the 58 potentially relevant trials, a total of 14 trials were included in the current analysis. The data indicated that core stability exercise was better than conventional exercise for short term pain relief. Ten studies included self reported back specific functional status, and compared to conventional exercise, core stability exercise resulted in significant improvement in function. Conclusion: Compared to conventional exercise, core stability exercise is more effective in pain reduction and improved physical function in individuals with CLBP in the short term however, only two trials carried out follow-up assessments post intervention.

Cross-cultural adaptation and validation of the reintegration to normal living index into IGBO language among individuals with mobility disability.

BACKGROUND: Community reintegration is one of the most important elements of disability rehabilitation globally. Hence, there is need for availability of psychometrically-sound and culturally-specific instruments for its measurement. Most of the available community reintegration measures were developed and validated in developed countries and might therefore not be suitable for use in developing countries. This study was aimed at cross-culturally adapting and validating the original English visual analogue scale version of the Reintegration to Normal Living Index (RNLI) into Igbo Language and culture among people with mobility disability in Igbo land, Southeast Nigeria. The English version of the RNLI was cross-culturally adapted to Igbo following the American Association of Orthopaedic Surgeons' guideline. The RNLI was translated into Igbo Language, synthesized, back translated, and subsequently subjected to expert panel review, pretesting and cognitive debriefing interview. The final Igbo version of the RNLI was tested for internal consistency and construct validity in a sample of 102 consenting participants (61.8% males; 46.92 ± 20.91 years) recruited from conveniently sampled clinics and rehabilitation centres in Anambra and Enugu States of South-Eastern Nigeria. The construct (concurrent) validity was evaluated using Spearman rank correlation, scatter plot and Mann-Whitney U test while the internal consistency was evaluated using Cronbach's alpha at alpha level of 0.05. RESULTS: The RNLI was successfully cross-culturally adapted to Igbo with all the 11 items still retained. The mean total score of the participants on the RNLI was 58.62 ± 21.25. The internal consistency coefficient (α = 0.84) of Igbo version of the RNLI was excellent. The Spearman correlation coefficients between the participants' total, subscale and domain scores on the Igbo and the English versions of the RNLI (r = 0.81-0.95) were excellent. There was no significant difference between corresponding scores in the English and Igbo versions of the RNLI. CONCLUSION: The Igbo version of the RNLI is a valid and reliable outcome measure among Igbo people living with mobility disabilities in Southeast Nigeria. It is therefore recommended for use among this group.

UEFA model in identification of types, severity and mechanism of injuries among footballers in the Nigerian Women's Premier League.

OBJECTIVE: To prospectively investigate the injury profile and the incidence rate per 1000 hours exposure during training and actual league matches in the Nigerian Women's Premier League (NWPL) and to develop an adequate information pool, using the UEFA injury study model in order to develop appropriate injury prevention strategies. METHODS: 241 women footballers from the eight football clubs that participated in the 2015/2016 Nigerian Women Premier league (NWPL) season were selected for the study and prospectively followed for a period of 6 months. The UEFA injury report forms and Competitive Aggressiveness and Anger Scale were sent to the various clubs, and the forms administered on them as at when due. The forms were analysed using descriptive statistics. RESULTS: There was a high incidence rate per 1000 hours of exposure during training sessions (10.98 injuries/1000 hours) and matches (55.56 injuries/1000 hours); the predominant injury type was muscle rupture/strain injuries (35.49%), while moderate severity injuries were the most frequent. The predominant injury mechanism was traumatic injuries caused by contact with other players as a result of a tackle by other players (14.5%). No statistical association was established between the level of aggression and the prevalent types of injury (p=0.63). CONCLUSIONS: The organisers of the league and indeed the referees should ensure that the rules of the game are upheld, and foul or overly aggressive play is penalised. Medical staff and coaches should consider evidence-based injury prevention strategies to reduce the risk of the common injuries sustained in the NWPL.

Informal caregiving burden and perceived social support in an acute stroke care facility.

BACKGROUND: Providing informal caregiving in the acute in-patient and post-hospital discharge phases places enormous burden on the caregivers who often require some form of social support. However, it appears there are few published studies about informal caregiving in the acute in-patient phase of individuals with stroke particularly in poor-resource countries. This study was designed to evaluate the prevalence of caregiving burden and its association with patient and caregiver-related variables and also level of perceived social support in a sample of informal caregivers of stroke survivors at an acute stroke-care facility in Nigeria. METHODS: Ethical approval was sought and obtained. Fifty-six (21 males, 35 females) consecutively recruited informal caregivers of stroke survivors at the medical ward of a tertiary health facility in South-Southern Nigeria participated in this cross-sectional survey. Participants' level of care-giving strain/burden and perceived social support were assessed using the Caregiver Strain Index and the Multidimensional Scale of Perceived Social Support respectively. Caregivers' and stroke survivors' socio-demographics were also obtained. Data was analysed using frequency count and percentages, independent t-test, analysis of variance (ANOVA) and partial correlation at α =0.05. RESULTS: The prevalence of care-giving burden among caregivers is 96.7% with a high level of strain while 17.9% perceived social support as low. No significant association was found between caregiver burden and any of the caregiver- or survivor-related socio-demographics aside primary level education. Only the family domain of the Multidimensional Scale of Perceived Social Support was significantly correlated with burden (r = - 0.295). CONCLUSION: Informal care-giving burden was highly prevalent in this acute stroke caregiver sample and about one in every five of these caregivers rated social support low. This is a single center study. Healthcare managers and professionals in acute care facilities should device strategies to minimize caregiver burden and these may include family education and involvement.

Assessment of stigma among people living with Hansen's disease in south-east Nigeria.

Objectives: The purpose of this study was to assess the stigma situation in Hansen's disease from the perspective of both people affected by Hansen's disease and those living in the surrounding community in southeast Nigeria. Design: A cross-sectional survey was conducted among affected people and non-affected people using the xplanatory model interview catalogue stigma scale for the community adjusted for leprosy and for leprosy patients, internalised stigma of mental illness scale adjusted for leprosy, Participation Scale and the Social distance scale. Data obtained were analysed using descriptive statistics of frequency, distribution tables, mean and standard deviation as well as inferential statistics of Mann-Whitney U test, Kruskal-Wallis H test and Spearman rho correlation rank. A total of 434 participants including 63 affected people and 371 community members all within the age range of 12 ­ 89 years participated in this study. Result: The perception of stigmatisation was higher in single participants, female participants, cooks, traders, crafts people and participants with primary and secondary school certificates, while beggars recorded the least perception of stigmatisation. The outcome of this study showed that females living in the community had a higher tendency of keeping a social distance than males. It also showed that on average, severe participation restrictions were found among people with WHO disability Grade II, traders, males, beggars, married people and those without any formal education while crafts people did not have significant participation restrictions. Conclusion: There is an urgent need to intensify the stigma reduction strategies and the necessary rehabilitation support. A standardised instrument should be developed to monitor the efficiency of such programmes.

Establishing the reliability and construct validity of the Igbo version of Screening Activity Limitation and Safety Awareness scale in persons with Hansen disease.

OBJECTIVE: Leprosy or Hansen's disease is an infectious disease affecting skin and peripheral nerves. The World Health Organization (WHO) Recent Report reveals Africa as having 20,599 new cases, America 36, 178, Eastern Asia 166,445, Western pacific 5,400; totally up to 232,875 new cases. Nigeria as at 2012 had 3,805 new cases. Nerve dysfunction can lead to severe impairments, such as wounds, clawing and shortening of digits, and visual impairments that are often indicated as WHO Grade 2 disabilities. The Screening Activity Limitation Safety Awareness (SALSA) scale however, was developed to-measure self-reported activity limitation in people affected by peripheral neuropathy, and has been translated into several languages world-wide, including two of the three major indigenous languages in Nigeria (i.e. Yoruba and Hausa), leaving the Igbo language yet to be translated. This resulted in the present study, in which the scale was translated into Igbo and the psychometric properties also established to help in data collection and to promote research among the Igbo speaking people living with disabilities from Hansen's disease. DESIGN: The research design was a cross-sectional survey, facility based with 70% RFT and 30% on MDT. Data were analysed using Cronbach's alpha and factor analyses. RESULT: A quantitative exploration of participants' characteristics revealed that of the 40 respondents that participated in the study; 87.5% of them were predominantly from a rural population; 42.5% were males and 57.5% females. Their ages ranged between 15 and 64 years; 55% were uneducated; while 45% were educated. The SALSA Scale was interviewer-administered to the participants. Reliability analysis conducted on the data revealed high Cronbach's alpha co-efficient of 0.93 - 0.94 for the entire items on the scale. Firstly, most of the scale items correlated at least 0.3 with at least one other item on the scale, Secondly, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.71, Bartlett's test of sphericity was significant (Χ2 (190) = 482.63, P < 0.001). Finally, the communalities were all above 0.3. The principal factor analysis of the scale revealed a five factor scale, having fulfilled all the necessary conditions. CONCLUSION: It can be concluded that the Igbo version of SALSA is reliable and valid for use among the Igbo speaking group in Nigeria.

Relationships between transtheoretical model stages of change, decisional balance, self-efficacy, and physical activity level among Nigerian market vendors.

PURPOSE: This study explored decisional balance, self-efficacy, and physical activity (PA) level in relation to stages of change (SoC) for PA among Nigerian vendors. The study explored associations among decisional balance, self-efficacy, and PA level, and examined differences, by stage, in decisional balance, self-efficacy, and PA level. DESIGN: Cross-sectional survey. SETTING: Outdoor markets located in Eke Amobi, Nkwo, and Okpuno Egbu in Nnewi, southeastern Nigeria. SUBJECTS: Participants were 499 market vendors (98 males and 401 females). MEASURES: Self-efficacy, perceived barrier and benefit, PA level, and SoC for PA. ANALYSIS: Spearman rank-order and partial correlations; analysis of variance by gender with Bonferroni post hoc adjustment. RESULTS: Self-efficacy (r = 0.69; p = 0.000), perceived benefit (r = .12; p = .007), and perceived barrier (r = -.11; p = .017) for PA were related to the SoC. Adjusting for age, gender, and marital status, only self-efficacy (r = .48; p = .000) remained correlated with the SoC. In males, significant differences in perceived barrier (p = .003) and benefit (p = .003) lay between stages of contemplation and preparation and between stages of precontemplation and contemplation for self-efficacy (p = .006). In females, there were significance differences in self-efficacy across stages of precontemplation and contemplation (p = .000) and preparation and action (p = .007). CONCLUSION: When designing PA interventions, age, gender, and marital status should be considered in explaining the relationships between outcome constructs of transtheoretical model (TTM) and SoC in vendors. It is also important to note that the stages at which outcome constructs of TTM change during PA interventions vary in males and females.