African Journal of Physiotherapy and Rehabilitation Sciences

Comparative Effects of Interval and Continuous Aerobic Training on Haematological Variables Post-stroke – A randomized clinical trial

E.N.D Ekechukwu, I.O Omotosho, T.K. Hamzat

Stroke induces changes in the haematological variables of post-stroke patients. Pathological changes in haematological variables can be reversed using aerobic exercise. This study assessed and compared the effects of Interval Training (IT), Continuous Training (CT) and a Combination of Interval and Continuous Training (CICT) modes of aerobic exercise on selected haematological variables of stroke survivors (SSv). Sixty-nine consecutively recruited SSv participated in this single blind randomized controlled trial. They were randomly assigned into one of the IT (n=25), CT (n=21) and CICT (n=23) groups. All the participants underwent aerobic training at 40 – 70% of heart rate reserve using a bicycle ergometer for eight consecutive weeks following the American Heart Association/American Stroke Association protocol. White blood cell count (WBC), red blood count (RBC), haemoglobin concentration (Hg), platelet count (PC) and mean platelet volume (MPV) were determined using PROCAN PE-6800. Data was analysed using descriptive statistics, one-way ANOVA, ANCOVA and paired t-test at "0.05. No significant difference was observed in all the baseline variables across the three groups (p>0.05). All the pre- and post-intervention haematological variables were significantly different in all the groups (p<0.05) except WBC in the CT group (t=-0.538, p=0.596). Post-intervention WBC (5.71±1.31*10³/:L; 6.00±1.22*10³/:L; 5.87±1.38*10³/:L), RBC (4.64±0.42*10⁶/:L; 4.64±0.38*10⁶/:L; 4.76±0.42*10⁶/:L), haemoglobin (12.69±1.53g/dL; 11.90±1.47g/dL; 12.30±1.57g/dL), PC (291.40±63.73*10³/:L; 260.48±60.15*10³/:L; 301.57±64.23*10³/:L), and MPV (9.78±0.99fl; 10.47±1.02fl; 10.14±0.97fl) were significantly different across the IT, CT and CICT groups respectively. The IT was the most effective in decreasing WBC and MPV and also the most effective in increasing Hg and PC.
The IT, CT and CICT modes are effective in significantly improving the haematological variables of stroke survivors after eight weeks of aerobic training, the IT mode is, however, the most effective.

KEY WORDS: aerobic training, stroke survivors, haematological variables

Efficacy of Non-thermal Ultrasound in the Management of Breast Engorgement in Post-partum Women: A randomized controlled trial

W. Habibu, S. Hanif

Breast engorgement is one of the main reasons why women throughout the world stop or reduce the duration of breast feeding. The objective of the study, was to determine the efficacy of non-thermal ultrasound in the management of breast engorgement. Fifty-two postpartum women with breast engorgement were included in the study and were randomly assigned to an experimental group and a control group of 26 participants each. Pain and breast engorgement were assessed using the visual analogue scale (VAS) and the six-point engorgement scale (SPES), pre- and post-intervention in both groups. The experimental group received non-thermal therapeutic ultrasound therapy along with conventional treatment interventions for two days while the control group only received conventional treatment for two days. The control group received massage, advice on proper latching technique and the use of bra. Results indicate a significant (P<0.05) difference in symptoms of breast engorgement between pre-intervention and post-intervention in both groups, with greater reduction in symptoms in the experimental group. Also, a maximum of two days was found to be effective in the management of breast engorgement in the experimental group. The use of therapeutic non-thermal ultrasound for 3 treatment sessions in two successive days was effective in the management of breast engorgement and is recommended for use in physiotherapy clinical settings.

KEY WORDS: breast engorgement, non-thermal ultrasound, postpartum, pain

Associations Among Depression, Leisure-time and Occupational Physical Activity of Health Care Providers in a Nigerian Tertiary Hospital Setting

E.S. Aliyu, A.F. Adeniyi

Physical activity (PA) has been consistently associated with enhanced quality of life. The tight schedule of duty of health care workers may predispose them to physical inactivity and psychosocial morbidities which most of them tend to ignore while rendering services to others. The prevalence of depression among Nigerian health care workers and its association with PA is not known. This study investigated the levels of leisure-time and occupational PA and their association with depression among health care providers in a Nigerian tertiary hospital setting. The research was a cross-sectional survey of 734 health care providers. The Godin-Shephard Leisure Time Physical Activity Questionnaire, Occupational Physical Activity Questionnaire and the Depression Anxiety and Stress Scale were used to assess leisure-time PA, occupational PA and depression respectively. Data obtained were analysed using descriptive and inferential statistics at α= 0.05. The mean age of participants was 39.6 ± 9.4 years (range 22-57 years). Nearly half of the health care providers (46.2%) reported low participation or insufficient leisure-time PA that could provide substantial health benefits, while 20.2% participated in leisure-time PA that could give some health benefits and 33.7% participated in leisure-time PA that could give substantial health benefits. Sitting/standing were the main occupational PAs of the majority (96.2%) of the health workers. The overall prevalence for depression was 11.4%. There was a significant association between leisure-time PA and depression (χ² =18.9, p= 0.016). There was no significant association between occupational PA and depression. There is low participation in leisure-time PA among health care workers and this is linked with depression. Efforts to improve participation in leisure-time PA among workers may help to relieve their depression symptoms.

KEY WORDS: leisure time, occupation, physical activity, depression

Prevalence and Pattern of Peripheral Nerve Injuries in Kano Metropolis, Nigeria

N.B. Mukhtar, Y.I. Umar, K.I. Mayana, F.G. Sumaila

Peripheral nerve injury (PNI) are a worldwide problem and are among the leading cause of disabilities, thereby posing a major social and economic burden in the society. The prevalence of PNI needs to be known for healthcare actions to be taken and implementation of policies, however, such information is not readily available in this part of the world. Therefore, the objective of the study was to determine the hospital-based prevalence and pattern of PNI in Kano metropolis. The medical records of 28,374 patients who attended five (5) major hospitals in Kano metropolis from 2010- 2014 were reviewed in this retrospective study. The records of patients diagnosed with PNI were screened and 454 met the inclusion criteria. A research pro-forma was used to collect the relevant data, including age, gender, injury aetiology, region, nerve affected and referral for physiotherapy. Data was analysed using descriptive statistics of frequency, tables and percentages. The prevalence of PNI was found to be 1.6%, with males constituting 77.5%. The majority (70%) of the patients were younger than 40 years, and 42% of the PNI were located in the upper limb, with a high prevalence at the ulnar nerve (18%). Motor vehicle accidents (MVA) accounted for the highest number of cases(26.5%). The majority (81.5%) of the patients were not referred for physiotherapy. The hospital-based prevalence of PNI in Kano metropolis is low, so also is referral for physiotherapy and MVA is the leading cause of PNI.

KEY WORDS: peripheral nerves injuries, prevalence, pattern

Quality of Life of Children with Cerebral Palsy: Accumulative Effect of Physiotherapy Intervention in North Central and Southwest Nigeria

M.J Saka, M.A Odunewu, A.O. Saka, S.G. Akinwale, O.U. Anjorin

Quality of life (QoL) has emerged as an important concept in child health. Cerebral palsy (CP) is a life-limiting disorder that is not curable, but the QoL of children with CP can be improved after early neurodevelopmental treatment, such that the affected child can be as independent as possible in carrying out activities of daily living. The purpose of this study was to determine the accumulative effect of physiotherapy treatment on QoL in children with CP. One hundred and twenty male and female children with CP, aged 2 to 8 years, were randomly selected for the study. After their medical history had been taken and diagnosis made, treatment was instituted with the ultimate aims of acquiring advanced postural reactions, strengthening weak back and abdominal muscles, and stimulating cognitive and mental ability. The approaches included passive movement, mobilization to prevent joint stiffness and stretching of stiff joints, and early neurodevelopmental treatment through the use of therapy wedges, rolls and therapy balls to facilitate rolling, sitting and standing. Aids such as standing frames, stimulating toys and diagrams were used to enhance the children's state of mental health. Accumulated physiotherapy treatment had beneficial and statistically significant effect on the QoL (mean score of 54.98%± 13.1%) of children with CP in North Central and South West Nigeria (P < 0.05). It was also found that physiotherapy intervention improves the quality of life of children with cerebral palsy, particularly those who are engaged early enough, and that parental level of education contributes positively to improved quality of life among children with cerebral palsy.

KEY WORDS: Quality of life, cerebral palsy, physiotherapy intervention

Correlates of Satisfaction with Community Reintegration Among Stroke Survivors in Kano Metropolis

U.M. Badaru, A. Nasir, J. Mohammed, M.A. Abba, O.O. Ogwumike, A.F. Adeniyi

The aim of stroke rehabilitation is to ensure successful reintegration of stroke survivors (SSV) into their communities to enable them effectively discharge their physical, economic and social roles. This study assessed factors related to satisfaction with community reintegration (CR) of SSV in Kano metropolis. It was a cross sectional survey that recruited 68 consenting SSV using the purposive sampling technique. Assessments of CR, physical function, social support and depression were done with Reintegration to Normal Living Index (RNLI), Functional Independence Measure (FIM), Multidimensional Scale of Perceived Social Support (MPSS) and Patient Health Questionnaire (PHQ-9) respectively. Spearman Rank Order Correlation and Wilcoxon Sign Rank tests were used to analyze the data at a level of statistical significance of 0.05 using SPSS version 16.0. A total of 36(52.9%) males and 32(47.1%) females with mean age of 59.69±13.568 years took part in the study. About 50 (73.6%) are modified dependent and 46 (67.6%) enjoyed moderate social support. The majority 87% (N=59) experienced severe restrictions to CR. There were significant correlations between RNLI and each of MSPSS (rho=0.249, p=0.041) and FIM (rho =0.406, p=0.001) scores. Occupational status (Z=-6.693, p=0.000), income (Z=-3.910, p=0.000) and driving status (Z=-5.292, p=0.000) changed significantly. It was concluded that the level of CR of most SSV in Kano metropolis was not satisfactory with significant loss of employment and earnings and ability to drive post stroke. Increased levels of social support and adequate recovery of physical functions are likely to improve satisfaction with CR.

KEY WORDS: stroke, satisfaction, community reintegration, social support, driving, return to work

Clinical Profile of Patients with Hip Hemi-arthroplasty Managed at the Physiotherapy Department of a Nigerian Tertiary Health Institution between 2008 and 2013

OF Odusanya, AC Odole

This study was a review of individuals who had hip hemi-arthroplasty and were managed at the physiotherapy department of a Nigerian tertiary health institution. Information on age, sex, causes of fracture, types of referral, outcomes assessed, treatment provided and discharge pattern were obtained from physiotherapy patients’ register, case files and nursing registers. Data was summarized using descriptive statistics of range, mean, standard deviation, and percentages. A total of 57 cases (26 males; 31 females) aged 76.77±11.59 years (32-92 years) was reviewed. The majority (98.2%) had hip hemi-arthroplasty secondary to femoral neck fracture. Only one case was due to femoral head damage secondary to sickle cell disease. The cause of fracture was documented in 21 cases with 76% of the fractures resulting after falls. Forty-one patients (71%) were referred for ambulation only post-surgery while sixteen (29%) were referred for full physiotherapy. Pain and muscle strength were the only impairment variables assessed in those referred for physiotherapy. Fifty-five (91%) were discharged home with walking aids while three (6%) were deceased. Fourteen (25%) continued physiotherapy on out-patient basis and 12 completed physiotherapy. It was observed that more women had hemi-arthroplasty compared to men. The majority of the patients who had hemi-arthroplasty were aged seventy years and above and were not referred for full physiotherapy. There was poor documentation of the cause of fracture in the files of most of the cases reviewed, though a fall was the cause of fracture in the few that were documented. Outcome measures were underutilized with no record of reported patient-centred outcome measures for all the reviewed cases.

KEY WORDS: hemi-arthroplasty, full physiotherapy, ambulation