Nepali Translation, Validity and Reliability Study of the Cohen-Hoberman Inventory of Physical Symptoms for Utilization With Bhutanese Refugees.

BACKGROUND AND OBJECTIVES: Language-appropriate outcome measurements help to improve health equity. The purpose of this study was to translate and validate the Cohen-Hoberman Inventory of Physical Symptoms (CHIPS) in Nepali for Bhutanese refugee utilization. METHODS: English-Nepali forward and back translations of CHIPS were completed by an official translator and evaluated by three content experts. A scaled rubric measured the following constructs: neurogenic stress response (NSR), somatic stress response (SSR), and visceral stress response (VSR). Data were analyzed using SPSS 26.0. RESULTS: The Nepali version of CHIPS reported good content validity, strong internal consistency (Cronbach's α = .94), and inter-rater reliability (ICC = 0.91). Kappa statistic reported 88% to 96% agreement. Constructs of NSR (0.91), SSR (0.94), and VSR (0.94) reported strong internal consistency. CONCLUSIONS: The Nepali translated version of CHIPS showed strong validity and reliability for utilization in the Bhutanese refugee population and improves health access to outcome measurements for a vulnerable population.

Comparison of Structural Diagnosis and Management (SDM) approach and MyoFascial Release (MFR) for improving plantar heel pain, ankle range of motion and disability: A randomized clinical trial.

[Purpose] The purpose of this study was to compare the effectiveness of the Structural Diagnosis and Management (SDM) approach with Myofascial Release (MFR) in improving plantar heel pain, ankle range of motion, and disability. [Subjects] Sixty-four subjects, aged 30-60 years, with a diagnosis of plantar heel pain, plantar fasciitis, or calcaneal spur by a physician according to ICD-10, were equally allocated to the MFR (n = 32) and SDM (n = 32) groups by hospital randomization and concealed allocation. [Methods] In this assessor-blinded randomized clinical trial, the control group performed MFR to the plantar surface of the foot, triceps surae, and deep posterior compartment calf muscles, while the experimental group performed a multimodal approach utilizing the SDM concept for 12 sessions over 4 weeks. Both groups also received strengthening exercises, ice compression, and ultrasound therapy. Pain, activity limitations and disability were assessed as primary outcomes using the Foot Function Index (FFI) and Range of motion (ROM) assessment of the ankle dorsiflexors and plantar flexors using a universal goniometer. Secondary outcomes were measured using the Foot Ankle Disability Index (FADI) and a 10-point manual muscle testing process for the ankle dorsiflexors and plantar flexors. [Results] Both MFR and SDM groups exhibited significant improvements from baseline in all outcome variables, including pain, activity level, disability, range of motion, and function after the 12-week intervention period (p < .05). The SDM group showed more improvements than MFR for FFI pain (p < .01), FFI activity (p < .01), FFI (p < .01) and FADI (p = <.01). [Conclusion] Both MFR and SDM approaches are effective in reducing pain, improving function, ankle range of motion, and reducing disability in plantar heel pain, however, the SDM approach may be a preferred treatment option.

Health-related quality of life and coping strategies adopted by COVID-19 survivors: A nationwide cross-sectional study in Bangladesh.

INTRODUCTION: This study aims to investigate the health-related quality of life and coping strategies among COVID-19 survivors in Bangladesh. METHODS: This is a cross-sectional study of 2198 adult, COVID-19 survivors living in Bangladesh. Data were collected from previously diagnosed COVID-19 participants (confirmed by an RT-PCR test) via door-to-door interviews in the eight different divisions in Bangladesh. For data collection, Bengali-translated Brief COPE inventory and WHO Brief Quality of Life (WHO-QoLBREF) questionnaires were used. The data collection period was from October 2020 to March 2021. RESULTS: Males 72.38% (1591) were more affected by COVID-19 than females 27.62% (607). Age showed significant correlations (p<0.005) with physical, psychological and social relationships, whereas gender showed only a significant correlation with physical health (p<0.001). Marital status, occupation, living area, and co-morbidities showed significant co-relation with all four domains of QoL (p<0.001). Education and affected family members showed significant correlation with physical and social relationship (p<0.001). However, smoking habit showed a significant correlation with both social relationship and environment (p<0.001). Age and marital status showed a significant correlation with avoidant coping strategies (p<0.001); whereas gender and co-morbidities showed a significant correlation with problem-focused coping strategies (p<0.001). Educational qualification, occupation and living area showed significant correlation with all three coping strategies(p<0.001). CONCLUSION: Survivors of COVID-19 showed mixed types of coping strategies; however, the predominant coping strategy was avoidant coping, followed by problem-focused coping, with emotion-focused coping reported as the least prevalent. Marital status, occupation, living area and co-morbidities showed a greater effect on QoL in all participants. This study represents the real scenario of nationwide health-associated quality of life and coping strategies during and beyond the Delta pandemic.

Association between demographic characteristics, lower limb range of motion, functional performance, ability to dual task, quality of life and risk of falls in older adults of the United Arab Emirates - A cross-sectional study.

BACKGROUND: With increasing age, decreased range of motion of lower limb joints, impaired functional performance and balance, pain status, altered dual tasking, and poor quality of life may predict the risk for falls in older adults. Therefore, this study aimed to identify which of the aforementioned variables and demographic factors predict falls in older adults in the United Arab Emirates. In addition, the study examined the association between demographic characteristics and the risk of falls in older adults. METHODS: This cross-sectional study included 100 (50 women) community-dwelling older adults (age: 75 ± 3.6 years). Participant demographic characteristics (sex, age, body mass index, limb dominance, exercise status, etc.) were documented. The independent variables included the outcomes of demographic characteristics, active range of motion of the hip, knee, and ankle, single-leg stance, five times sit-to-stand, timed up and go test, dynamic gait index, pain, and World Health Organization Quality of Life Assessment-Bref questionnaire. The dependent variable was the risk of falls (self-reported presence or absence of falls) in the past 12 months. RESULTS: Out of 100 older adults, forty-two reported a fall and among them 26 were women. Many of the independent variables were significantly associated with the risk of falls in univariate analysis. However, multivariable logistic regression revealed that none of them were independently associated with the risk of falls in older adults living in the United Arab Emirates. CONCLUSIONS: Relying specifically on one of the included variables as an independent (risk) factor associated with falls in older adults of the United Arab Emirates warrants further investigation.

Prevalence of Long COVID symptoms in Bangladesh: a prospective Inception Cohort Study of COVID-19 survivors.

BACKGROUND: The objective of this study was to identify the prevalence of long COVID symptoms in a large cohort of people living with and affected by long COVID and identify any potential associated risk factors. METHODS: A prospective survey was undertaken of an inception cohort of confirmed people living with and affected by long COVID (aged 18-87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented were contacted by face-to-face interview, and were interviewed regarding long COVID, and restriction of activities of daily living using post COVID-19 functional status scale. Cardiorespiratory parameters measured at rest (heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation levels, maximal oxygen consumption, inspiratory and expiratory lung volume) were also measured. RESULTS: Among 2198 participants, the prevalence of long COVID symptoms at 12 weeks was 16.1%. Overall, eight long COVID symptoms were identified and in descending order of prominence are: fatigue, pain, dyspnoea, cough, anosmia, appetite loss, headache and chest pain. People living with and affected by long COVID experienced between 1 and 8 long COVID symptoms with an overall duration period of 21.8±5.2 weeks. Structural equation modelling predicted the length of long COVID to be related to younger age, female gender, rural residence, prior functional limitation and smoking. CONCLUSION: In this cohort, at 31 weeks post diagnosis, the prevalence of long COVID symptoms was 16.1%. The risk factors identified for presence and longer length of long COVID symptoms warrant further research and consideration to support public health initiatives.

Physiotherapy Practice for Management of Patients Undergoing Upper Abdominal Surgery in United Arab Emirates - A National Survey.

BACKGROUND: The main goal of physiotherapy post-upper abdominal surgery (UAS) is to expedite recovery from the surgery by avoiding or remediating postoperative pulmonary complications (PPCs) and offering physical rehabilitation to ease the process of returning to premorbid status. The present study aimed to survey physiotherapists in the United Arab Emirates (UAE) about their clinical practice in the assessment and management of patients having upper abdominal surgery. METHODS: The current study adopted a novel anonymous online survey to explore the current practice among physiotherapists in the UAE. The Research Ethics Committee approved the study, and a questionnaire was borrowed from a previous study with similar objectives completed in Australia. The questionnaire had 51 questions cutting across 7 sections that investigated the assessment tools and interventions and explored current practice amongst physiotherapists treating patients following abdominal surgery in UAE hospitals. RESULTS: A survey of 42 post-UAS physiotherapy practitioners across the UAE was conducted with a 42% response rate and 57.5% completion rate. The mean age of physiotherapists who were working in the UAE is 35 years, most of whom have more than five years of general ward experience. Most patients were not seen on day zero (day of surgery). Respondents in the UAE are almost universally preferred prescribing deep breathing exercises, incentive spirometry (IS), mobility from the bedside, and education as their primary intervention either "often" or "always" in the consecutive days post-UAS. Spo2, visual analog scale, respiratory rate and fatigue are used as key outcome measures. CONCLUSION: Research work on physiotherapy postoperatively has shown demonstrated prominence of mobilization but is not yet reflected in current practice among physiotherapists caring for post-UAS cohorts in the UAE. The vast difference in the choice of screening tools preferred by physiotherapists in diagnosing high-risk patients postoperatively reflects a lack of corroborating evidence available to physiotherapists.

Knowledge, Attitudes, Behavioural Practises, and Psychological Impact Relating to COVID-19 Among People Living With Spinal Cord Injury During In-Patient Rehabilitation in Bangladesh.

AIM: The aim of this research is to focus on gaining an insight into the knowledge, attitudes, behavioural practises (KAP), and psychological impact relating to COVID-19 among the people living with spinal cord injury receiving in-patient rehabilitation. METHODS: A prospective, cross-sectional survey of people with SCI (N = 207), who were in active in-patient rehabilitation from two tertiary SCI Rehabilitation Centres in Bangladesh. Data were collected via face-to-face interviews, after voluntary consent, using a pretested, language validated questionnaire on Knowledge, Attitude and Behavioural practises (KAP) and the Depression, Anxiety, Stress Scale (DASS-21). Ethical approval and trial registration were obtained prospectively. RESULTS: A total of 207 people with SCI responded, among which 87% were men and 13% were women, with a mean age of 34.18 ± 12.9 years. Within the sample group, people living with tetraplegia comprised 33.8%, and people living with paraplegia comprised 66.2%. Overall, 63.8% of the participants were diagnosed with an SCI categorised as ASIA-A. Overall, the "knowledge score" was 8.59 ± 2.3 out of 12, "depression" was 11.18 ± 8, "anxiety" was 7.72 ± 5.1, and "stress" was 9.32 ± 6.7 from a total of 21 scores each category. The strong correlation was between knowledge, DASS scores, and age (p < 0.05). In addition, there was a strong correlation between knowledge, gender (p < 0.05) and education (p < 0.01). Binary logistic regression found a stronger association of knowledge and DASS scores with gender, young age, illiteracy (p < 0.01), and rural residence (p < 0.05). A positive relationship was found between depression and anxiety scores (p < 0.01) and a moderate positive relationship was found between depression and stress scores (p < 0.01). A positive attitude was reported by the majority of participants (p < 0.05). In terms of behavioural practises, participants reported both self and caregiver had followed health advice with regard to consulting health professionals (65.7%), implementing isolation (63.8%), taking droplet precaution care (87.4%), and hygiene care (90.3%). CONCLUSION: Participants in this study reported high levels of knowledge, adoption of positive attitudes, and the practise of positive health advisory behaviours related to COVID-19 prevention procedures. However, high levels of depression, anxiety, and stress were also reported. Overall, women and younger participants were more likely to have high KAP, whereas those living in rural areas and with literacy challenges were less likely to report high knowledge scores.

Differences in dual task paradigms and executive function ability for recreational athletes in United Arab Emirates.

[Purpose] The purpose of this study to measure four components of executive function: (1) cognitive flexibility, (2) inhibition, (3) working memory and (4) processing speed, along with the ability to dual task in recreational athletes. [Participants and Methods] This was a cross-sectional study of (n=102) male and female participants, between the ages of 18-40 years of age across different levels and types of sport related physical activity. The International Physical Activity Questionnaire (IPAQ), short version, Dual Task Abilities (DTA) were measured utilizing a quantitative, dual task, gait test and Executive Function (EF) was measured through Stroop Color Word Test and Trail Making Test. [Results] Differences in EF and Dual Task-Interference (DTI) in recreational athletes did not show a significant difference between varying types of sport and level of sport related activity, with reported values high across all groups. Males reported better dual task interference abilities than females, though there were no significant differences in executive function between males and females. Executive function performance was the highest among the age group (18-24 years) population, but there were no significant differences between those in the higher age groups (25-34 years) and (35-40 years). [Conclusion] Overall, those participating in the study exhibited high prevalence of strong EF ability, regardless of sport activity type or level. This may suggest that type and level of sport activity may not be important when considering executive function performance maintenance for recreational athletes.

Knowledge, attitudes, and fear of COVID-19 during the Rapid Rise Period in Bangladesh.

The study aims to determine the level of Knowledge, Attitude, and Practice (KAP) related to COVID-19 preventive health habits and perception of fear towards COVID-19 in subjects living in Bangladesh. DESIGN: Prospective, cross-sectional survey of (n = 2157) male and female subjects, 13-88 years of age, living in Bangladesh. METHODS: Ethical approval and trial registration were obtained before the commencement of the study. Subjects who volunteered to participate and signed the informed consent were enrolled in the study and completed the structured questionnaire on KAP and Fear of COVID-19 scale (FCV-19S). RESULTS: Twenty-eight percent (28.69%) of subjects reported one or more COVID-19 symptoms, and 21.4% of subjects reported one or more co-morbidities. Knowledge scores were slightly higher in males (8.75± 1.58) than females (8.66± 1.70). Knowledge was significantly correlated with age (p < .005), an education level (p < .001), attitude (p < .001), and urban location (p < .001). Knowledge scores showed an inverse correlation with fear scores (p < .001). Eighty-three percent (83.7%) of subjects with COVID-19 symptoms reported wearing a mask in public, and 75.4% of subjects reported staying away from crowded places. Subjects with one or more symptoms reported higher fear compared to subjects without (18.73± 4.6; 18.45± 5.1). CONCLUSION: Bangladeshis reported a high prevalence of self-isolation, positive preventive health behaviors related to COVID-19, and moderate to high fear levels. Higher knowledge and Practice were found in males, higher education levels, older age, and urban location. Fear of COVID-19 was more prevalent in female and elderly subjects. A positive attitude was reported for the majority of subjects, reflecting the belief that COVID-19 was controllable and containable.

The Influence of Parents and Schools on Adolescents' Perceived Diet and Exercise Self-Efficacy: A School-Based Sample From the United Arab Emirates.

Introduction: In the United Arab Emirates, an alarming rate of 19% obesity among adolescents, associated with poor lifestyle, is apparent. Diet and exercise self-efficacy could influence adolescents' engagement in healthy behaviors. This study evaluates adolescents' perceptions of diet and exercise self-efficacy and explores the impact of parents and schools on self-efficacy. Method: A cluster sampling approach in cross-sectional design was used to recruit 610 school adolescents (Grades 7-12) over a 6-month period. Information on sociodemographics, lifestyle, parents, and schools was explored. Self-efficacy was assessed using The Eating Habits and Exercise Confidence Survey. Results: Participants reported moderate diet and exercise self-efficacy. Diet self-efficacy was predicted by parental support, eating breakfast and meals regularly at home, and prohibiting soft drinks. School support and frequency of weekly exercise classes predicted exercise self-efficacy; p values ≤.05. Discussion: Cultural knowledge and collaboration are essential to promote self-efficacy in multiethnic adolescents in the United Arab Emirates.

Effects of an 8-week pelvic core stability and nutrition community programme on maternal health outcomes.

INTRODUCTION: Women, during the antenatal and post-partum period, report pelvic, low back pain, stress and urge urinary incontinence, colorectal dysfunction, and other co-morbidities that negatively affect health-related quality of life. Exercise and nutrition are important considerations for improving maternal health in this period. PURPOSE: The purpose of this study was to examine the effects of a community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling over an 8-week period on pelvic floor and urinary distress (UDI), prolapse and colorectal distress for antenatal and post-partum women with limited access to health care, and low socio-economic resources from a Midwestern Region of the United States. MATERIALS AND METHODS: Purposive sample of 35 females, ages 18-44, were recruited for this prospective, preintervention to postintervention study, following ethical approval from Institutional Review Board and voluntary written consent from participants. The Health History Questionnaire, SF-36, Food Frequency Questionnaire, report of pelvic organ prolapse dysfunction (POPDI), colorectal-anal dysfunction (CRADI), and UDI as measured by the Pelvic Floor Distress Inventory (PFDI) were completed before and after intervention. RESULTS: Thirty-five women (n = 35) 18 to 44 years old (mean age of 22.72 ± 3.45 years) completed the study. A significant difference was found from preintervention to postintervention scores means for PFDI total scores, CRADI individual scores, and UDI individual scores (p < .05). POPDI scores decreased preintervention to postintervention but were not significant. A significant improvement in healthy nutrition and breastfeeding postintervention was also found (z = 3.21, p = .001). Further analysis showed significant, but weak, correlation between parity and POPDI (r = .366, p = .033); between parity and UDI (r = .384, p = .03); and between parity and PFDI (r = .419, p = .014). DISCUSSION: Our study found a significant reduction in pelvic floor dysfunction, urinary, and colorectal-anal distress symptoms and improvement in breastfeeding and healthy nutrition following an 8-week community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling.