Comparative effectiveness of low-level laser therapy versus muscle energy technique among diabetic patients with frozen shoulder: a study protocol for a parallel group randomised controlled trial.

BACKGROUND: Diabetes mellitus is one of the fastest-growing health challenges of the twenty-first century with multifactorial impact including high rates of morbidity and mortality as well as increased healthcare costs. It is associated with musculoskeletal complications, with frozen shoulder being commonly reported. While low-level laser therapy (LLLT) and muscle energy technique (MET) are commonly used to manage  this condition, there remains a lack of agreement on the most effective approach, with limited research available on their comparative efficacy. OBJECTIVES: To evaluate the comparative effectiveness of LLLT versus MET among diabetic patients with frozen shoulder. METHODS: This is a single-centre, prospective, single-blind, randomised controlled trial with three parallel groups to be conducted at Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria. Sixty diabetic patients with frozen shoulder will be randomly assigned into LLLT group, MET group, or control group in a 1:1:1 ratio. All the groups will receive treatment three times weekly for 8 weeks. The primary outcome will be shoulder function and the secondary outcomes will include pain intensity, shoulder ROM, interleukin-6 (IL-6), depression, anxiety, and quality of life (QoL). All outcomes will be assessed at baseline, at post 8-week intervention, and at 3 months follow-up. DISCUSSION: This will be the first randomised controlled trial to evaluate the comparative effectiveness of LLLT versus MET on both clinical and psychological parameters among diabetic patients with frozen shoulder. The findings of the study may provide evidence on the efficacy of these interventions and most likely, the optimal treatment approach for frozen shoulder related to diabetes, which may guide clinical practice. TRIAL REGISTRATION: Pan African Clinical Trials Registry (PACTR202208562111554). Registered on August 10, 2022.

The Hausa Northwick Park Neck Pain Questionnaire: translation, cross-cultural adaptation and psychometric assessment in patients with non-specific neck pain.

PURPOSE: To translate and cross-culturally adapt the Northwick Park Neck Pain Questionnaire (NPQ) into Hausa and assess its psychometric properties. MATERIALS AND METHODS: The NPQ was translated and cross-culturally adapted into Hausa using recommended guidelines. A consecutive sample of 92 Hausa-speaking patients with non-specific neck pain recruited from three tertiary hospitals in north-western Nigeria, completed the questionnaire to assess factorial validity (using confirmatory factor analysis), convergent validity (by correlating the Hausa-NPQ with the Numerical Pain Rating Scale [NPRS]), and internal consistency (using Cronbach's α). A subsample of 50 patients completed the questionnaire again 3 days after the first administration to assess relative reliability using intraclass correlation coefficients (ICC) and absolute reliability using standard error of measurement (SEM), smallest detectable change (SDC), and 95% limits of agreement (LOA). RESULTS: The factor analysis confirmed a single-factor structure with excellent internal consistency (α = 0.94). The questionnaire showed a strong positive correlation with the NPRS (rho = 0.68). The ICC was 0.86, with SEM and SDC of 6.32 and 17.5, respectively. The LOA was - 29.3 to + 37.1 with no evidence of proportional bias. CONCLUSIONS: The Hausa-NPQ is a valid and reliable measure of disability due to neck pain.

This study describes the translation, cross-cultural adaptation, and psychometric assessment of the Hausa-NPQ in Hausa-speaking patients with non-specific neck pain.The questionnaire demonstrated adequate psychometric properties in terms of factorial and convergent validity, internal consistency, and test-retest reliability.The questionnaire will be useful in clinical and research settings to assess disability due to neck pain for screening purposes, evaluation of treatment effectiveness, as well as cross-cultural comparisons involving Hausa-speaking individuals with neck pain.

Prevalence of neck pain and its associated factors in Africa: a systematic review and meta-analysis protocol.

INTRODUCTION: Neck pain is one of the most prevalent musculoskeletal pain conditions with multifactorial impact including pain, disability and reduced quality of life. To the best of our knowledge, no systematic review and meta-analysis is available to provide reliable data on the pooled prevalence of neck pain and its associated factors in Africa. Thus, the objective of this study is to describe a protocol for a systematic review and meta-analysis on the prevalence of neck pain and its associated factors in Africa. METHODS: This systematic review protocol has been designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A systematic search will be conducted among six key electronic databases including PubMed/MEDLINE, Scopus, African Journals Online, EMBASE, CINAHL and Web of Science, from inception onwards. Population-based cross-sectional studies reporting prevalence of neck pain in the African continent will be included. The primary outcome will be the prevalence of neck pain, whereas the secondary outcomes will be the factors associated with neck pain prevalence. Two independent reviewers will screen the titles/abstracts and relevant full-text articles of potentially relevant studies. Data from eligible studies will be extracted using a customised data extraction form. The risk of bias and methodological quality of the included studies will be assessed using the Newcastle-Ottawa Scale and critical appraisal tool, respectively. A narrative synthesis will be used to summarise the prevalence estimates of neck pain and associated factors. However, if feasible, random-effects meta-analysis will be conducted with Revman V.5.4 software. Additionally, subgroup, sensitivity and publication bias analyses will be conducted. DISCUSSION: This will be the first systematic review and meta-analysis to systematically identify and synthesise available literature on the prevalence of neck pain and its associated factors in Africa. The results of this review may assist health professionals and policymakers to plan and implement evidence-based strategies that will lessen the burden of neck pain. ETHICS AND DISSEMINATION: Data from previously published studies will be collected and analysed and hence ethical approval will not be sought for this study. The results of this review will be disseminated through publication in a peer-reviewed academic journal and presentation at relevant academic conferences. PROSPERO REGISTRATION NUMBER: CRD42021273585.

Effectiveness of patient education plus motor control exercise versus patient education alone versus motor control exercise alone for rural community-dwelling adults with chronic low back pain: a randomised clinical trial.

BACKGROUND: Chronic low back pain (CLBP) is a common health problem in rural Nigeria but access to rehabilitation is limited. Current clinical guidelines unanimously recommend patient education (PE) including instruction on self-management, and exercises as frontline interventions for CLBP. However, the specific content of these interventions and how they are best delivered remain to be well-described, particularly for low-resource communities. This study determined the effectiveness of PE plus motor control exercise (MCE) compared with either therapy alone among rural community-dwelling adults with CLBP. METHODS: A single-blind, three-arm parallel-group, randomised clinical trial including 120 adult rural dwellers (mean [SD] age, 46.0 [14.7] years) with CLBP assigned to PE plus MCE group (n = 40), PE group (n = 40), and MCE group (n = 40) was conducted. The PE was administered once weekly and the MCE twice weekly. Each group also received stretching and aerobic exercises twice weekly. All interventions were administered for 8 weeks. Blinded assessments for pain intensity and disability level as primary outcomes, and quality of life, global perceived recovery, fear-avoidance beliefs, pain catastrophising, back pain consequences belief and pain medication use as secondary outcomes were conducted at baseline, 8-week (immediately after intervention) and 20-week follow-ups. RESULTS: All the groups showed significant improvements in all the primary and secondary outcomes evaluated over time. Compared with PE alone, the PE plus MCE showed a significantly greater reduction in pain intensity by an additional -1.15 (95% confidence interval [CI], -2.04 to -0.25) points at the 8-week follow-up and -1.25 (95% CI, -2.14 to -0.35) points at the 20-week follow-up. For disability level, both PE plus MCE and MCE alone showed a significantly greater improvement compared with PE alone by an additional -5.04% (95% CI, -9.57 to -0.52) and 5.68% (95% CI, 1.15 to 10.2) points, respectively, at the 8-week follow-up, and -5.96% (95% CI, -9.84 to -2.07) and 6.57% (95% CI, 2.69 to 10.4) points, respectively, at the 20-week follow-up. For the secondary outcomes, at the 8-week follow-up, PE plus MCE showed a significantly greater reduction in fear-avoidance beliefs about physical activity compared with either therapy alone, and a significantly greater reduction in pain medication use compared with PE alone. However, compared with PE plus MCE, PE alone showed a significantly greater reduction in pain catastrophising at all follow-up time points, and a significantly greater improvement in back pain consequences belief at the 20-week follow-up. Additionally, PE alone compared with MCE alone showed a significantly greater improvement in back pain consequences belief at all follow-up time points. No significant between-group difference was found for other secondary outcomes. CONCLUSIONS: Among rural community-dwelling adults with CLBP, PE plus MCE led to greater short-term improvements in pain and disability compared with PE alone, although all intervention strategies were associated with improvements in these outcomes. This trial provides additional support for combining PE with MCE, as recommended in current clinical guidelines, to promote self-management and reduce the burden of CLBP in low-resource rural communities. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03393104), Registered on 08/01/2018.

Effectiveness of an 8-week overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors: a protocol for randomised controlled trial.

BACKGROUND: Post-stroke gait deviations contribute to significant functional disability, impaired walking ability and poor quality of life. Prior studies suggest that gait training with paretic lower limb loading may improve gait parameters and walking ability in post-stroke. However, most gait training methods used in these studies are not readily available, and studies using cheaper methods are limited. OBJECTIVE: The purpose of this study is to describe a protocol for a randomised controlled trial on the effectiveness of an 8-week overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors. METHODS: This is a two-center, single-blind, two-arm parallel randomised controlled trial. Forty-eight stroke survivors with mild to moderate disability will be recruited from two tertiary facilities and randomly assigned into two intervention arms; overground walking with paretic lower limb loading or overground walking without paretic lower limb loading in a 1:1 ratio. All interventions will be administered thrice weekly for 8 weeks. Primary outcomes will be step length and gait speed whereas the secondary outcomes will include step length symmetry ratio, stride length, stride length symmetry ratio, stride width, cadence and motor function. All outcomes will be assessed at baseline, 4, 8 and 20 weeks after the start of intervention. DISCUSSION: This will be the first randomised controlled trial to report the effects of overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors from low-resource setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT05097391. Registered on 27 October 2021.

Water quality modelling using principal component analysis and artificial neural network.

The study investigates the latent pollution sources and most significant parameters that cause spatial variation and develops the best input for water quality modelling using principal component analysis (PCA) and artificial neural network (ANN). The dataset, 22 water quality parameters were obtained from Department of Environment Malaysia (DOE). The PCA generated six significant principal component scores (PCs) which explained 65.40 % of the total variance. Parameters for water quality variation are mainlyrelated to mineral components, anthropogenic activities, and natural processes. However, in ANN three input combination models (ANN A, B, and C) were developed to identify the best model that can predict water quality index (WQI) with very high precision. ANN A model appears to have the best prediction capacity with a coefficient of determination (R2) = 0.9999 and root mean square error (RMSE) = 0.0537. These results proved that the PCA and ANN methods can be applied as tools for decision-making and problem-solving for better managing of river quality.

Musculoskeletal disorders and their associated factors among individuals with diabetes mellitus in northwest Nigeria.

Introduction: Diabetes mellitus (DM) is a growing public health problem causing a significant amount of disability and mortality in Nigeria. Musculoskeletal disorders (MSDs) are common complications associated with DM. However, studies on the prevalence of MSDs and their associated factors are limited in Nigeria, particularly in the northwest region. The purpose of this study was to determine the prevalence of MSDs and their associated factors among individuals with DM in northwest, Nigeria. Material and methods: A retrospective cross-sectional survey of medical case records of all consecutive patients with DM attending a diabetic clinic in Ahmadu Bello University Teaching Hospital, Zaria was conducted between February 2015 and September 2021. Data on sociodemographic and clinical variables was collected using a researcher-designed questionnaire and analysed using descriptive statistics and logistic regression models. Results: Four hundred eighty-nine cases (170 men [34.8%], 319 females [65.2%]; mean age: 51.4 ±12.3 years) were analysed. The majority of the participants had type 2 DM (96.7%), with a mean DM duration of 7.02 ±5.05 years. The overall prevalence of MSDs was 32.7%, with the highest prevalence found for lumbosacral spondylosis (11%) followed by knee osteoarthritis (8.4%). Among the different potential predictors examined, only duration of DM was significantly associated with overall MSDs (AOR: 1.76, 95% CI: 1.04-2.98; p = 0.035) whereas both duration of DM (AOR: 2.64, 95% CI: 1.19-5.89; p = 0.018) and body mass index (AOR: 7.461, 95% CI: 1.33-43.8; p = 0.023) were significantly associated with lumbosacral spondylosis. Conclusions: Approximately one-third of the study participants had MSDs, with lumbosacral spondylosis being the most frequently occurring disorder. Being obese and having a longer duration of DM were associated with MSDs. Clinicians in Nigeria need to pay attention to MSDs and related factors in DM patients by conducting routine assessments and implementing early treatment.

Kinetics and computational study of butyrylcholinesterase inhibition by methylrosmarinate: relevance to Alzheimer's disease treatment.

Butyrylcholinesterase (BChE) performs a significant function in Alzheimer's disease progression. Experimental studies have shown that the function of BChE in the attenuation of cholinergic neurotransmission is essentially altered in brains of advanced AD patients. Here, using the complimentary methods of enzyme kinetic studies, molecular modeling and protein-ligand interaction profiling, we sought to reveal the mechanistic and structural features of BChE-methyrosmarinate interactions. Molecular docking simulations revealed that methylrosmarinate dwelled well in the active centre of BChE, where it got involved in stabilizing non-covalent associations with myriad subsites. Enzyme kinetic experiments showed that the V m and K s values were 156.20 ± 3.11 U mg-1 protein and 0.13 ± 0.01 µM, respectively. The inhibition studies showed that methylrosmarinate apparently inhibited BChE in a linear mixed manner, with an IC 50 value of 10.31 µM and a K i value of 3.73 ± 1.52 µM. Taken together, the extremely reduced K i value and the increased number of BChE-methylrosmarinate interactions presuppose that methylrosmarinate is a good inhibitor of BChE, despite the fact that the mechanism for the effect of BChE inhibition on several pathological conditions in vivo remains unexplored.

Effectiveness of lumbar stabilization exercise with real-time ultrasound imaging biofeedback on lumbar multifidus muscle cross-sectional area in individuals with non-specific chronic low back pain: a study protocol for a randomized controlled trial.

BACKGROUND: Structural impairment of the lumbar multifidus muscle, such as reduced cross-sectional area, is evident among individuals with chronic low back pain. Real-time ultrasound imaging (RUSI) biofeedback has been reported to improve preferential activation of as well as retention in the ability to activate the lumbar multifidus muscle during lumbar stabilization exercises (LSE). However, evidence of the effectiveness of this treatment approach in individuals with non-specific chronic low back pain (NCLBP) is still limited. The purpose of this study is, therefore, to determine the effectiveness of LSE with RUSI biofeedback on lumbar multifidus muscle cross-sectional area in individuals with NCLBP. METHODS/DESIGN: This study is a prospective, single-center, assessor-blind, three-arm, parallel randomized controlled trial to be conducted at National Orthopedic Hospital, Kano State, Nigeria. Ninety individuals with NCLBP will be randomized in a 1:1:1: ratio to receive LSE, LSE with RUSI biofeedback, or minimal intervention. All participants will receive treatment twice weekly for 8 weeks. The primary outcome will be the lumbar multifidus muscle cross-sectional area. The secondary outcomes will include pain (Numerical Pain Rating Scale), functional disability (Roland-Morris Disability Questionnaire), and quality of life (12-Item Short-Form Health Survey). All outcomes will be assessed at baseline, 8 weeks post-intervention,  and 3 months follow-up. DISCUSSION: To our knowledge, this study will be the first powered randomized controlled trial to compare the effectiveness of LSE training with and without RUSI biofeedback in individuals with NCLBP. The outcome of the study may provide evidence for the effectiveness of LSE with RUSI biofeedback on enhancing the recovery of the lumbar multifidus muscle in individuals with NCLBP. TRIAL REGISTRATION: Pan African Clinical Trials Registry ( PACTR201801002980602) . Registered on January 16, 2018.

Knowledge, attitude, and perception of low back pain and activities that may prevent it among adolescents in Nigeria.

Background: Awareness of activities that may result in low back pain (LBP) among adolescents is fundamental in preventing adulthood LBP. Objective: The aim of this study was to investigate adolescents' knowledge, attitude, and perception of LBP and activities that may prevent LBP in Kano, North-western, Nigeria. Methods: This was a cross-sectional survey involving 400 school-going adolescents recruited using a multistage random sampling technique. Data was analysed using descriptive statistics and Chi-square test with 0.05 set as level of significance. Results: The mean age of the respondents was 16.0±1.50 years. LBP annual prevalence was 34.2%, with more girls (31.1%) reporting having LBP compared to boys (28.4%). More than half (59.3%) of the respondents had poor knowledge of LBP and activities that may prevent it. However, they had a good attitude (63%) and perception (74%) of LBP and activities that may prevent it. There was no significant association of levels of knowledge, attitude, and perception of LBP and activities that may prevent LBP with gender, age, and class of study (p > 0.05). Conclusion: Adolescents in Kano, North-western Nigeria had poor knowledge of LBP and activities that may prevent it. Therefore, there is a need to embark on an LBP prevention program among adolescents in Kano, North-western Nigeria.

Optimization of slurry ratio and sonication time on biogas production from chicken droppings.

Background: A research was conducted on the ultrasonic pretreatment of chicken droppings for biogas production. The hydrolysis step in anaerobic digestion is rate-limiting and time-consuming due to the presence of complex molecules in the organic wastes. Pretreatment encourages faster digestion and yields improvement by making the organic waste ready for microbial attack. Material and methods: To achieve the optimum sonication time and slurry ratio for maximum biogas production, Response Surface Methodology (RSM) was used in this study. 13 experimental runs were developed according to Central Composite Design with different setup conditions and five replicates at center points to observe the Response, i.e., volumes of biogas produced. This was achieved with the aid of a software package (Design Expert 12.0.1.0). A quadratic model was developed for the responses and a 3D response surface plot was obtained to analyze the effect of the variables and their interactions to determine their optimum levels. Results: The numerical optimization and point prediction result gave a sonication time of 18.6 minutes and a slurry ratio of 2.0 (i.e., 2.0 : 1.0). Under this condition, the predicted maximum volume of biogas production is 24.514 ml in 12 days. This prediction was tested and validated, and the volume of biogas produced under the same conditions was 22.282 ml. This confirmed the adequacy of the predicted model as only a 10.02% error was recorded. Conclusions: Henceforth, the optimum sonication time and slurry ratio were achieved for maximum biogas production from chicken droppings.

Effects of variable frequencies of kinesthesia, balance and agility exercise program in adults with knee osteoarthritis: study protocol for a randomized controlled trial.

BACKGROUND: Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive training programs in the form of kinesthesia, balance and agility (KBA) exercises have been reported to be beneficial for individuals with knee OA. However, the most optimal training dosage of KBA exercises is still unclear. The aim of this study is to determine the effects of different frequencies of KBA training (i.e., twice-weekly or thrice-weekly) in adults with knee OA. METHODS: A single (assessor) blind, three-arm parallel, multi-center randomized controlled trial will be conducted. One hundred twenty adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; twice-weekly KBA (n = 40), thrice-weekly KBA (n = 40), and conventional physiotherapy (n = 40) in the ratio of 1:1:1. Participants in the conventional physiotherapy group will receive two sessions of brief patient education, and sixteen sessions of ultrasound therapy, and stretching and strengthening exercises for 8 weeks. Participants in the two different KBA groups will receive KBA training according to the designed sessions for 8 weeks in addition to the conventional physiotherapy program. All groups will be assessed pre-intervention, immediately post-intervention and at 3 months, 4 months, and 6 months post-randomization. The primary outcome will be physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure) whereas the secondary outcomes will be pain intensity (Visual Analogue Scale for pain), knee stability (Knee Outcome Survey-Activities of Daily Living Scale), proprioception (electronic goniometer), and quality of life (Osteoarthritis Knee and Hip Quality of Life Questionnaire). DISCUSSION: The findings of this study may provide evidence on the effectiveness of KBA exercise training and the ideal number of sessions needed to achieve the highest effectiveness in adults with knee OA. TRIAL REGISTRATION: Pan African Clinical Trials Registry ( PACTR201810713260138 ). Registered on 28 November 2017.

Reference genomes of the two cultivated jute species.

Cultivated jute, which comprises the two species Corchorus capsularis and C. olitorius, is the second most important natural fibre source after cotton. Here we describe chromosome-level assemblies of the genomes of both cultivated species. The C. capsularis and C. olitorius assemblies are each comprised of seven pseudo-chromosomes, with the C. capsularis assembly consisting of 336 Mb with 25,874 genes and the C. olitorius assembly containing 361 Mb with 28 479 genes. Although the two Corchorus genomes exhibit collinearity, the genome of C. olitorius contains 25 Mb of additional sequences than that of C. capsularis with 13 putative inversions, which might give a hint to the difference of phenotypic variants between the two cultivated jute species. Analysis of gene expression in isolated fibre tissues reveals candidate genes involved in fibre development. Our analysis of the population structures of 242 cultivars from C. capsularis and 57 cultivars from C. olitorius by whole-genome resequencing resulted in post-domestication bottlenecks occurred ~2000 years ago in these species. We identified hundreds of putative significant marker-trait associations (MTAs) controlling fibre fineness, cellulose content and lignin content of fibre by integrating data from genome-wide association studies (GWAS) with data from analyses of selective sweeps due to natural and artificial selection in these two jute species. Among them, we further validated that CcCOBRA1 and CcC4H1 regulate fibre quality in transgenic plants via improving the biosynthesis of the secondary cell wall. Our results yielded important new resources for functional genomics research and genetic improvement in jute and allied fibre crops.

Correction: The Hausa Back Beliefs Questionnaire: Translation, cross-cultural adaptation and psychometric assessment in mixed urban and rural Nigerian populations with chronic low back pain.

[This corrects the article DOI: 10.1371/journal.pone.0249370.].

Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome.

CONTEXT: Studies have indicated that the muscle energy technique (MET) and the positional release technique (PRT) are effective in the management of piriformis syndrome (PS); however, evidence is scarce regarding the combination of these techniques in the form of an integrated neuromuscular inhibition technique (INIT) in the management of individuals with PS. Although a previous trial investigated the effect of INIT for PS, that study did not integrate Ruddy's reciprocal antagonist facilitation (RRAF) method into the INIT protocol, nor did the authors diagnose PS according to established criteria. OBJECTIVES: To examine the effects of INIT with integrated RRAF compared with PRT in the management of patients diagnosed with PS. METHODS: This study was designed as a single blind randomized clinical trial in which participants diagnosed with PS were randomly allocated into INIT and PRT groups. Each group attended two treatment sessions per week for 8 weeks. Patients in the INIT group received a protocol in which the patient's tender point or trigger point was palpated in the belly of the piriformis approximately halfway between the inferior lateral angle of the sacrum and the greater trochanter, at which point the therapist applied an intermittent or sustained pressure and maintained the pressure for 20-60 seconds (depending on the participant's response to pain reduction). For INIT patients, that protocol was also followed by RRAF, a method in which a patient introduces a series of tiny/miniature contractions or efforts (20 times per 10 seconds) against a therapist's resistance. Patients in the PRT group were treated by palpating the same trigger point described in the INIT group, followed by application of light pressure at the location of the trigger point, which was maintained the pressure for 2 minutes or until the pain subsided (determined by asking the participant to report a pain score using a visual analog scale at 30 second intervals). For both groups, three repetitions of the INIT or PRT treatment were performed over 10 minutes at each clinical visit. Additionally, each group also received stretching exercises immediately after the INIT or PRT treatment session. Each participant was assessed at baseline, immediately posttreatment, and at 4 months posttreatment for pain, sciatica, functional mobility, quality of life, hip abduction, and internal rotation. A repeated measures analysis of variance (ANOVA) of within-between group interactions was used to analyze the treatment effect. RESULTS: Forty eight participants (age range, 25-47 years; mean age ± standard deviation, 32.81 ± 3.27 years) were randomized into the INIT and PRT groups, with 24 participants in each group. No significant between-group differences (p>0.05) were observed in the baseline demographic and clinical variables of the participants. A repeated-measures ANOVA indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (p<0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the INIT group improved significantly compared with the PRT group in all outcomes (p<0.05) immediately posttreatment and at the 4 months follow up period. CONCLUSIONS: INIT was more effective than PRT in the management of individuals with PS. It should be noted the significant improvement achieved in both the groups may have also been contributed to by the stretching exercises that were used as adjunct therapies by both groups.

The Hausa Back Beliefs Questionnaire: Translation, cross-cultural adaptation and psychometric assessment in mixed urban and rural Nigerian populations with chronic low back pain.

INTRODUCTION: Negative attitudes and beliefs about low back pain (LBP) can lead to reduced function and activity and consequently disability. One self-report measure that can be used to assess these negative attitudes and beliefs and to determine their predictive nature is the Back Beliefs Questionnaire (BBQ). This study aimed to translate and cross-culturally adapt the BBQ into Hausa and assess its psychometric properties in mixed urban and rural Nigerian populations with chronic LBP. METHODS: The BBQ was translated and cross-culturally adapted into Hausa (Hausa-BBQ) according to established guidelines. To assess psychometric properties, a consecutive sample of 200 patients with chronic LBP recruited from urban and rural clinics of Nigeria completed the questionnaire along with measures of fear-avoidance beliefs, pain catastrophizing, functional disability, physical and mental health, and pain. One hundred of the 200 patients completed the questionnaire twice at an interval of 7-14 days to assess test-retest reliability. Internal construct validity was assessed using exploratory factor analysis, and external construct validity was assessed by examining convergent, divergent, and known-groups validity. Reliability was assessed by calculating internal consistency (Cronbach's α), intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change at 95% confidence interval (MDC95), and limits of agreement using Bland-Altman plots. Reliability (ICC, SEM and MDC95) was also assessed separately for rural and urban subgroups. RESULTS: The factor analysis revealed a four-factor solution explaining 58.9% of the total variance with the first factor explaining 27.1%. The nine scoring items loaded on the first factor hence supporting a unidimensional scale. The convergent and divergent validity were supported as 85% (6:7) of the predefined hypotheses were confirmed. Known-groups comparison showed that the questionnaire discriminated well for those who differed in education (p < 0.05), but not in age (p > 0.05). The internal consistency and ICC (α = 0.79; ICC = 0.91) were adequate, with minimal SEM and MDC95 (1.9 and 5.2, respectively). The limits of agreements were -5.11 to 5.71. The ICC, SEM and MDC95 for the urban and rural subgroups were comparable to those obtained for the overall population. CONCLUSIONS: The Hausa-BBQ was successfully adapted and psychometrically sound in terms of internal and external construct validity, internal consistency, and test-retest reliability in mixed urban and rural Hausa-speaking populations with chronic LBP. The questionnaire can be used to detect and categorize specific attitudes and beliefs about back pain in Hausa culture to prevent or reduce potential disability due to LBP.

Development of the Hausa version of the Pain Catastrophizing Scale: translation, cross-cultural adaptation and psychometric evaluation in mixed urban and rural patients with chronic low back pain.

BACKGROUND: Catastrophizing has been recognized as an important contributor to chronicity in individuals with chronic pain syndromes including low back pain (LBP). The Pain Catastrophizing Scale (PCS) is perhaps the most widely used tool to evaluate the degree of pain catastrophizing. However, its use is limited in Hausa-speaking countries due to the lack of a validated translated version. OBJECTIVE: To translate and cross-culturally adapt the PCS into Hausa (Hausa-PCS), and evaluate its psychometric properties in mixed urban and rural patients with chronic LBP. METHODS: The PCS was translated and cross-culturally adapted into Hausa in accordance with established guidelines. To evaluate its psychometric properties, a consecutive sample of 200 patients with chronic LBP was recruited from urban and rural Nigerian hospitals. Validity was evaluated by exploring content validity, factorial structure (confirmatory factor analysis [CFA]), construct validity (Spearman's rho for a priori hypotheses) and known-groups validity. Reliability was evaluated by calculating internal consistency (Cronbach's α), intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC) and limits of agreement with 95% confidence interval (LOA95%). RESULTS: The Hausa-PCS was comprehensible with good content validity. The CFA confirmed a 3-factor structure similar to the original English version. The concurrent validity was supported as 83% (5/6) of the a priori hypotheses were confirmed. Known-groups comparison showed that the questionnaire was unable to differentiate between male and female or urban and rural patients (p > 0.05). Internal consistency and ICC were adequate for the Hausa-PCS total score (α = 0.84; ICC = 0.90) and the subscale helplessness (α = 0.78; ICC = 0.89) but for the subscales rumination (α = 0.69; ICC = 0.68) and magnification (α = 0.41; ICC = 0.43). The LOA95% for the Hausa-PCS total score was between - 8.10 and + 9.75, with SEM and MDC of 3.47 and 9.62 respectively. CONCLUSION: The Hausa-PCS was successfully developed and psychometrically adequate in terms of factorial structure, construct validity, internal consistency and test-retest reliability when applied in mixed urban and rural patients with chronic LBP. However, the internal consistency and reliability coefficients (ICC) for the individual subscales are inadequate. Thus, we support the use of the total score when evaluating pain catastrophizing for clinical or research purposes.

Translation, Cross-cultural Adaptation and Psychometric Evaluation of the Hausa Roland-Morris Disability Questionnaire in Mixed Rural and Urban Nigerian Populations with Low Back Pain.

STUDY DESIGN: Cross-cultural adaptation and cross-sectional study. OBJECTIVE: The aim of this study was to translate and cross-culturally adapt the Roland-Morris Disability Questionnaire (RMDQ) into Hausa language, and evaluate its psychometric properties in mixed rural and urban populations with low back pain (LBP). SUMMARY OF BACKGROUND DATA: The RMDQ is one of the most commonly used and recommended condition-specific measures of disability related to LBP. However, no formal adapted and validated Hausa version exists at the time our study was initiated. METHODS: The Hausa version of the RMDQ (Hausa-RMDQ) was developed according to established guidelines. Psychometric properties were evaluated in 125 patients with LBP recruited from rural and urban Nigerian clinics. Internal consistency (Cronbach's α), test-retest reliability using Intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and limits of agreement using Bland-Altman plots were calculated to evaluate reliability. Using Spearman's correlation for a priori hypotheses, the Hausa-RMDQ was correlated with Oswestry Disability Index (ODI) to evaluate concurrent validity, Numerical Pain Rating Scale (NPRS) to evaluate convergent validity, and age, educational level, and occupational status to evaluate divergent validity. Reliability and validity analyses were also conducted separately for rural and urban subgroups. RESULTS: The Hausa-RMDQ had no major translation problems. The questionnaire had adequate internal consistency (α = 0.70), test-retest reliability (ICC = 0.79), minimal SEM (1.30) and MDC (3.60), and good agreement between test-retest values. The Hausa-RMDQ had a strong correlation with ODI (rho = 0.59), a moderate correlation with NPRS (rho = 0.46), and a null correlation with age, educational level, and occupational status (P > 0.05), thus confirming all the (5:5) a priori hypotheses constructed. These reliability and validity results were also replicated in the rural and urban subgroups. CONCLUSION: The Hausa-RMDQ was successfully developed and proved to be a reliable and valid measure of functional disability in Hausa culture. This questionnaire is recommended for future clinical and scientific research purposes.Level of Evidence: 3.

Molecular docking and prediction of ADME/drug-likeness properties of potentially active antidiabetic compounds isolated from aqueous-methanol extracts of Gymnema sylvestre and Combretum micranthum.

Gymnema sylvestre and Combretum micranthum are well known for their ethno-medicinal uses in the northwest of Nigeria. In our recent study, we demonstrated the antidiabetic and antioxidant activities of the aqueous-methanol extracts of the two plants and identified some potentially active compounds. The present study aimed to conduct molecular docking and ADME/drug-likeness screening of the identified potentially active candidate compounds from aqueous-methanol extracts of G. sylvestre and C. micranthum leaves by using in silico techniques. Molecular docking of compounds on target proteins (α-amylase, α-glucosidase, and phosphorylated insulin receptor tyrosine kinase) was performed using Molsoft ICM-pro 3.8-3. The physicochemical, ADME, and drug-likeness parameters were computed using the SwissADME online program. The result corroborated the antidiabetic activities of the plants with significant binding interactions between compounds A (2,2-dimethyl-3-[4-(acetyloxy)phenyl]-4-ethy-l2H-1-benzopyran-7-ol acetate), D (9,13-di-cis-retinoic acid), E (4-hydroxycinnamic acid), F ((-)-11-hydroxy-9,10-dihydrojasmonic acid), G (colnelenic acid), H (glyinflanin A), I (6,8a-seco-6,8a-deoxy-5-oxoavermectin "2a" aglycone), and J (3-deshydroxysappanol trimethyl ether) and at least one of the three target proteins. Four compounds, namely A (2,2-dimethyl-3-[4-(acetyloxy)phenyl]-4-ethyl-2H-1-benzopyran-7-ol acetate), E (4-hydroxycinnamic acid), H (glyinflanin A), and J (3-deshydroxysappanol trimethyl ether), yielded the best docking scores with respect to the target proteins, of which three (E (4-hydroxycinnamic acid), H (glyinflanin A), and J (3-deshydroxysappanol trimethyl ether)) were identified to have relatively optimal drug-likeness and medicinal chemistry characteristics. Thus, the present study concluded that these compounds may have contributed to the observed antidiabetic properties of these plants and can be investigated further as drugs or drug-like compound candidates.