Validation of the Yoruba Version of the Pain Self-Efficacy Questionnaire in Patients with Chronic Low Back Pain.

STUDY DESIGN: Cultural adaptation and psychometric analysis. OBJECTIVE: This study determined the test-retest reliability, acceptability, internal consistency, divergent validity of the Yoruba pain self-efficacy questionnaire (PSEQ-Y). It also examined the ceiling and floor effects and the small detectable change (SDC) of the PSEQ-Y among patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA: There are various indigenous language translations of the PSEQ and none adapted to African language. However, translations of the PSEQ into Nigerian languages are not readily available. METHODS: The validity testing phase of the study involved 131 patients with LBP, while 83 patients with LBP took part in the reliability phase. Following the Beaton recommendation for cultural adaptation of instruments, the PSEQ was adapted into the Yoruba language. The psychometric properties of the PSEQ-Y determined comprised: internal consistency, divergent validity, test-retest reliability, and SDC. RESULTS: The mean age of the participants was 52.96 ±â€Š17.3 years. The PSEQ-Y did not correlate with the Yoruba version of Visual Analogue Scale (VAS-Y) scores (r = -0.05; P = 0.59). The values for the internal consistency and the test-retest reliability of the PSEQ-Y were 0.79 and 0.86, with the 95% confidence interval of the test-retest reliability ranging between 0.82 and 0.90. The standard error of measurement (SEM) and the SDC of the PSEQ-Y were 1.2 and 3.3, respectively. The PSEQ-Y had no floor or ceiling effect, as none of the respondents scored either the minimal or maximal scores. CONCLUSION: This is the first study in Nigeria to culturally adapt PSEQ. The PSEQ-Y showed adequate psychometric properties similar to existing versions. Therefore, the tool can be used to assess pain self-efficacy in clinical and research settings and help to improve the health outcomes of patients chronic LBP.Level of Evidence: 3.

An evaluation of the nature and level of musculoskeletal imaging training in physiotherapy educational programmes in Nigeria.

BACKGROUND: Deficiency in musculoskeletal imaging (MI) education will pose a great challenge to physiotherapists in clinical decision making in this era of first-contact physiotherapy practices in many developed and developing countries. This study evaluated the nature and the level of MI training received by physiotherapists who graduate from Nigerian universities. METHODS: An online version of the previously validated Physiotherapist Musculoskeletal Imaging Profiling Questionnaire (PMIPQ) was administered to all eligible physiotherapists identified through the database of the Medical Rehabilitation Therapist Board of Nigeria. Data were obtained on demographics, nature, and level of training on MI procedures using the PMIPQ. Logistic regression, Friedman's analysis of variance (ANOVA) and Kruskal-Wallis tests were used for the statistical analysis of collected data. RESULTS: The results (n = 400) showed that only 10.0% of the respondents had a stand-alone entry-level course in MI, 92.8% did not have any MI placement during their clinical internship, and 67.3% had never attended a MI workshop. There was a significant difference in the level of training received across MI procedures [χ2 (15) = 1285.899; p = 0.001]. However, there was no significant difference in the level of MI training across institutions of entry-level programme (p = 0.36). The study participants with transitional Doctor of Physiotherapy education were better trained in MI than their counterparts with a bachelor's degree only (p = 0.047). CONCLUSIONS: Most physiotherapy programmes in Nigeria did not include a specific MI module; imaging instructions were mainly provided through clinical science courses. The overall self-reported level of MI training among the respondents was deficient. It is recommended that stand-alone MI education should be introduced in the early part of the entry-level physiotherapy curriculum.

Dor musculoesquelética relacionada com o trabalho e características dos trabalhadores de cervejaria no sudoeste da Nigéria - Um estudo-piloto / Work-related musculoskeletal pain and characteristics of brewery workers in southwest Nigeria- a pilot study

A dor osteoarticular relacionada ao trabalho (DORT) é um sintoma comum associado a perturbações musculoesqueléticas relacionadas com o trabalho. É agravada por más técnicas de elevação, ergonomia inadequada, movimentos repetitivos e postura incômoda durante o exercício das suas funções. Variáveis como a idade, o estado civil, a experiência profissional, o álcool, o tabagismo e os hábitos de exercício têm desempenhado um papel importante na prevalência das DORT entre as diferentes categorias de trabalhadores. OBJETIVOS: este estudo centrou-se na prevalência ao longo da vida, de 12 meses e pontos das WMSP em associação com as características sociodemográficas, de estilo de vida e de trabalho dos trabalhadores da indústria cervejeira no Estado de Osun, sudoeste, Nigéria. MÉTODO: um design de pesquisa descritiva foi utilizado, e um total de oitenta e nove (89) participantes foram recrutados com estrita adesão aos critérios de inclusão. Foi desenvolvido um questionário de 28 itens para obter informações específicas sobre a prevalência e o padrão de DORT, enquanto medições antropométricas (peso e altura) de cada participante foram medidas. Os dados coletados foram organizados e analisados usando estatísticas descritivas e teste de Qui quadrado. RESULTADOS: A prevalência de DORT ao longo da vida, 12 meses e pontos entre os participantes foi de 96,6%, 93,3% e 57,3%, respectivamente. As costas baixas eram a região corporal mais afetada. Existem associações significativas entre cada uma das idades, a prevalência de 12 meses e pontos das DORT e o estado civil dos participantes. Além disso, existe uma associação significativa entre a prevalência pontual de DORT e a idade dos participantes. CONCLUSÃO: concluiu-se que havia uma elevada prevalência de DORT entre os trabalhadores da cervejaria no Estado de Osun, sudoeste, Nigéria.

Work-related musculoskeletal pain (WMSP) is a common symptom associated with workrelated musculoskeletal disorders. It is aggravated by poor lifting techniques, inappropriate ergonomics, repetitive movements and awkward posture during the course of performing one's duties. Variables such as age, marital status, work experience, alcohol, smoking and exercise habits have been found to play major roles in WMSP prevalence among different categories of workers. OBJECTIVES: This study focused on the lifetime, 12-month and point prevalence of WMSP in association with the socio-demographics, lifestyle and work-related characteristics of brewery workers in Osun state, Southwest, Nigeria. METHOD: A descriptive research design was utilized, and a total of eightynine (89) participants were recruited with strict adherence to the inclusion criteria. A 28-item questionnaire was developed to obtain specific information on the prevalence and pattern of WMSP, while anthropometric measurements (weight and height) of each participant were measured. Collected data were organized and analyzed using descriptive statistics and Chi square test. RESULTS: The lifetime, 12-month and point prevalence of WMSP among the participants were 96.6%, 93.3%, and 57.3% respectively. The low back was the mostly affected body region. Significant associations exist between each of the lifetime, 12-month and point prevalence of WMSP and participants' marital status. Furthermore, a significant association exists between the point prevalence of WMSP and participants' age. CONCLUSION: It was concluded that there was a high prevalence of WMSP among brewery workers in Osun state, Southwest, Nigeria.

Evaluation of Predictive Factors Influencing Community Reintegration in Adult Patients with Stroke.

OBJECTIVES: Patients with stroke are faced with gait, balance, and fall difficulties which could impact on their community reintegration. In Nigeria, community reintegration after stroke has been understudied. The objective of this study was to evaluate the predictors of community reintegration in adult patients with stroke. MATERIALS AND METHODS: Participants were 91 adult patients with stroke. Gait variables, balance self-efficacy, community balance/mobility, and fall self-efficacy were assessed using Rivermead Mobility Index, Activities-specific Balance Confidence Scale, Community Balance and Mobility Scale, and Falls Efficacy Scale-International respectively. Reintegration to Normal Living Index was used to assess satisfaction with community reintegration. Pearson Product-Moment Correlation Coefficient was used to determine the relationship between community reintegration and gait spatiotemporal variables, balance performance, and risk of fall. Multiple regression analysis was used to determine predictors of community reintegration (P ≤ 0.05). RESULTS: There was significant positive relationship between community reintegration and cadence (r = 0.250, P = 0.017), functional mobility (r = 0.503, P = 0.001), balance self-efficacy (r = 0.608, P = 0.001), community balance/mobility (r = 0.586, P = 0.001), and duration of stroke (r = 0.220, P = 0.036). Stride time (r = -0.282, P = 0.073) and fall self-efficacy (r = 0.566, P = 0.001) were negatively correlated with community reintegration. Duration of stroke, balance self-efficacy, community balance/mobility, and fall self-efficacy (52.7% of the variance) were the significant predictors of community reintegration. CONCLUSION: Community reintegration is influenced by cadence, functional mobility, balance self-efficacy, community balance/mobility, and duration of stroke. Hence, improving balance and mobility during rehabilitation is important in enhancing community reintegration in patients with stroke.

Cost burden of post stroke condition in Nigeria: a pilot study.

AIM: Estimation of cost burden of a disease condition is a very important part of health care policy making worldwide. Till now, such documents are lacking especially on non-communicable diseases in the health policy making process in Nigeria. This article therefore attempts to report the results of a prospective cross-sectional study on the cost burden of a cerebrovascular accident condition (stroke) in Nigeria. It estimates the direct health care cost for a minimum period of 12 weeks and maximum of 36 weeks for post stroke hemiplegia. STUDY DESIGN/SETTING: It was a collaborative cross-sectional study amongst centers situated in urban and sub-urban environments in Southern Nigeria. It involved a hospital of an Oil and Gas Company in Port Harcourt, Nigeria, two Government tertiary hospitals in Port Harcourt and Benin-City, all in South-South Nigeria, the industrial hub of the country. A Private Specialist hospital in Lagos, South-West Nigeria, the corporate hub of the country was also included. METHOD: Patients diagnosed and admitted for management for cerebrovascular accident (stroke) in the above named health facilities formed the subjects of this study. Medical records (case files) of two hundred and forty (240) stroke patients managed within the last six years (2005- 2011) were randomly selected from the medical record departments of the study centers. Files of the patients who were admitted during acute care period (without discharge against medical advice) and were followed on out-patient basis without default within the study period were purposively utilized. The files were then assessed for the various investigations and treatment interventions of acute and long term care and the costs thereof. Ethical approval to access patients' case files was sought and granted by the Research Ethics Committee of the different study centers. RESULTS: The results revealed that it requires an average of N95,100: 00 ($600 ) and N767,900: 00 ($4860)in a government and a private hospital, respectively to access care within the first 36 weeks of post stroke affectation in Nigeria. CONCLUSION: The outcome of this study suggests that managing stroke constitutes a huge direct cost burden unaffordable by an average Nigerian stroke sufferer. The implication is that lack of means for rehabilitative care may result in disability adjusted life years which further compounds burdens in terms of indirect cost on the sufferers' and care givers' productivity. It is therefore recommended that awareness of this disorder is created by policy makers and implementers where it does not exist and increased where it does with health promotion and preventive measures.

Assessing tetraplegic patients' neuro-muscular adaptations to a six-week physiotherapeutic programme.

Spinal cord injury is a life-transforming condition of sudden onset that can have devastating consequences. A multidisciplinary, functional goal-oriented programme is required to enable the tetraplegic patient live as fully and independently life as possible. Physiotherapy is a very important part of the multidisciplinary team required to prevent many of the immobilization complications that may result in serious functional limitations, reduce overall morbidity and achieve well patterned recovery. This study therefore highlights the neuromuscular adaptations of tetraplegic patients to physiotherapy over a period of six weeks. Fifteen patients participated in this study and the results showed that even though changes in the musculoskeletal parameters are inevitable in tetraplegics, the extent/degree of reduction of these parameters was grossly minimized in the studied subjects through the administration of physiotherapeutic measures. However, further research using a large sample size will be required to evaluate the physiologic adaptations of the neuromuscular system to the physiotherapy interventions among patients with spinal cord injury.