Ade Fatai Adeniyi

Diabetes, Sexual Dysfunction and Therapeutic Exercise: A 20 Year Review

Most trials on the effect of exercise on patients with diabetes mellitus focused on their glycaemic control, only a few focused on sexual dysfunction. A comprehensive two-decade literature review (1989-2009) from peer-reviewed journals was undertaken to examine the roles if any, of therapeutic exercise as an intervention for sexual dysfunction in patients with diabetes. Because of the paucity of studies on this subject, meta-analyses, small and non-randomized trials cited on Medline, Pedro, Embase, Scirus, Highwire and the Cochrane Library of systematic reviews were examined. Sexual dysfunction in general, links between diabetes and sexual dysfunction and management options for sexual dysfunction including therapeutic exercises were reviewed. In women, diabetes is reported to slightly increase he risk of decreased sexual arousal, inadequate lubrication and pain on sexual intercourse, while erectile dysfunction is the most common presentation of sexual dysfunction in men. The literature is scanty but shows some effectiveness of therapeutic exercise in managing sexual dysfunction in patients with diabetes. However, this review shows that i) pelvic floor exercises ii) biofeedback techniques iii) electrical stimulation and iv) vaginal dilators are effective in managing sexual dysfunction secondary to other disease factors in the non-diabetic populations. More research is recommended to further establish the efficacy of therapeutic exercise in managing sexual dysfunction in patients with diabetes.

Depression and physical activity in a sample of nigerian adolescents: levels, relationships and predictors

BackgroundPhysical inactivity is related to many morbidities but the evidence of its link with depression in adolescents needs further investigation in view of the existing conflicting reports.MethodsThe data for this cross-sectional study were collected from 1,100 Nigerian adolescents aged 12-17 years. Depressive symptomatology and physical activity were assessed using the Childrens Depression Inventory (CDI) and the Physical Activity Questionnaire-Adolescent version (PAQ-A) respectively. Independent t tests, Pearsons Moment Correlation and Multi-level logistic regression analyses for individual and school area influences were carried out on the data at p < 0.05.ResultsThe mean age of the participants was 15.20 ± 1.435 years. The prevalence of mild to moderate depression was 23.8%, definite depression was 5.7% and low physical activity was 53.8%. More severe depressive symptoms were linked with lower levels of physical activity (r = -0.82, p < 0.001) and moderate physical activity was linked with reduced risk of depressive symptoms (OR = 0.42, 95% CI = 0.29-0.71). The odds of having depressive symptoms were higher in older adolescents (OR = 2.16, 95% CI = 1.81-3.44) and in females (OR = 2.92, 95% CI = 1.82-3.54). Females had a higher risk of low physical activity than male adolescents (OR = 2.91, 95% CI = 1.51-4.26). Being in Senior Secondary class three was a significant predictor of depressive symptoms (OR = 3.4, 95% CI = 2.55-4.37) and low physical activity.ConclusionsA sizable burden of depression and low physical activity existed among the studied adolescents and these were linked to both individual and school factors. Future studies should examine the effects of physical activity among clinical samples of adolescents with depression.

Physical inactivity is associated with low self efficacy and social support among patients with hypertension in Nigeria

Background Physical inactivity is a major factor in the development of many chronic illnesses, including hypertension. Evidence highlighting links among physical activity participation and psychosocial constructs such as self efficacy, social support and perceived barriers among hypertensive patients in the Nigerian population is scarce. This study explored the associations between physical activity and each of self efficacy, social support and perceived barriers. Methods Two hundred and twelve patients receiving treatment in two tertiary health institutions located in Ekiti State, Nigeria were surveyed cross-sectionally. Physical activity level, self efficacy, social support and perceived barriers were measured with the International Physical Activity Questionnaire, Exercise Self-Efficacy Scale, Medical Outcomes Social Support Scale and Exercise Benefits and Barrier Scale respectively. Results Level of physical activity was significantly associated with self efficacy (rs = 0.67, p < 0.01,  = 0.45) and social support (rs = 0.80, p < 0.01,  = 0.64), with most participants (56.1%) being physically inactive. However, no association was found between physical activity level and perceived barriers (rs = 0.07, p > 0.01,  = 0.005). Conclusion Most of the hypertensive patients presented with low levels of physical activity. Physical activity was associated with psychosocial constructs including self efficacy and social support but not with perceived barriers.

Children with paralytic poliomyelitis: a cross-sectional study of knowledge, attitudes and beliefs of parents in Zamfara state, Nigeria

BackgroundNigeria is one of the major African countries in which incidences of polio infection persist in spite of several eradication efforts. The preponderance of paralytic poliomyelitis particularly in the northern part of Nigeria raises the question as to whether parents of children affected with polio know how polio is contracted and spread, whether having a disabled child affects the parents’ attitude towards these children, and what they believe about poliomyelitis in view of their socio-cultural and belief system in the sub-region. Zamfara State, in the north-west of Nigeria is one of the endemic areas where resistance to the global campaign on polio eradication was very high. Therefore this study was conducted to investigate the knowledge, attitudes and beliefs of parents/primary caregivers of children affected with paralytic poliomyelitis in Zamfara State.MethodsThis study is a cross-sectional survey in which the multistage probability sampling technique was used to randomly select two local government areas in Zamfara State where consenting parents/primary caregivers of children with paralytic poliomyelitis were purposively selected. The knowledge, attitudes and beliefs of parents were assessed with the aid of a 4-part 52-item structured researcher administered questionnaire and the data obtained were analyzed.ResultsTwo hundred and seventeen parents/primary caregivers participated in the study. One hundred and forty-two, (65.4%) reported good, 51 (23.8%) reported fair, while 24 (11%) of participants reported poor knowledge of paralytic poliomyelitis. More respondents 120 (55.3%) showed a positive attitude towards children with paralytic poliomyelitis. Younger age (P=0.016) and paid employment (P=0.020) were positively associated with good knowledge of paralytic poliomyelitis. Female gender (P=0.020), higher educational level (P=0.015), being employed (P=0.010) and having from middle to high household income (P=0.016) were positively associated with a positive attitude toward children with paralytic poliomyelitis. Most respondents showed a reasonable belief over the cause of their children’s condition rather than the erroneous traditional belief that paralytic poliomyelitis is caused by spirit forces.ConclusionsIt is of great concern that the good knowledge, positive attitude and reasonable belief by parents/primary caregivers about paralytic poliomyelitis observed in this study did not play a prominent role in preventing susceptibility of children in north-west Nigeria to paralytic poliomyelitis. It is imperative that Nigerian policy makers should device more strategic measures toward the prevention of paralytic poliomyelitis in this sub region.

The SPLASH/ICPC integrity marathon in Ibadan, Nigeria: incidence and management of injuries and marathon-related health problems

BackgroundThe growing interest in marathon runners and marathons in Nigeria has not been reflected in reports of injuries and other health problems associated with these events. This study therefore outlines the incidence of injuries, marathon-related health problems and delivery of physiotherapy at the maiden and second editions of the Splash 105.5 FM/ICPC Integrity Marathon in Ibadan city, south-west Nigeria in 2009 and 2010.MethodsUsing a data entry sheet, demographics and information on running experience, past and present injuries and other health problems reported en route and at the finish line by the runners were documented. The prevalence of injuries and other health problems reported by previous and first-time runners were compared.ResultsIn both events, 16.3% and 17.2% of the runners respectively reported injuries with significant occurrence in first-time runners (p = 0.003 for 2009; p = 0.002 for 2010) mostly at the finish line. The reported injury type and site were muscle cramps and the thigh (39.7% and 76.4% respectively). Heat exhaustion was reported by 42.8% of runners in 2009 and 56.3% in 2010. Cryotherapy was mostly used in combination with other physiotherapy modalities in both years.ConclusionMost of the injuries and other health problems were reported by first-time marathon runners mainly at the finish line. The most reported site of injury was the thigh while muscle cramps and heat exhaustions were the most reported types of injuries and health problems. First-time marathon runners should be adequately informed of the predisposition to injury during marathons and adequate body conditioning should be emphasized. Ample preparation and effective involvement of the physiotherapy team is essential for management of injured runners en route and at the finish line in a marathon.

An Analysis of Work-Related Musculoskeletal Disorders Among Butchers in Kano Metropolis, Nigeria

Background Butchering is often associated with high rates of work-related musculoskeletal disorders (WRMSDs). However, published work on the prevalence of WRMSDs among butchers in Nigeria is scarce. This is important because meat processing practices differ across geographical and cultural locations. This study was therefore aimed at analyzing WRMSDs among butchers in Kano metropolis. Methods Sociodemographic and work-settings information was obtained from 102 male cattle butchers (age, 37.49 ± 11.68 years) through survey. Information on the prevalence and pattern of musculoskeletal disorders was obtained from the respondents using the Standardized Nordic Questionnaire. Additional information on health seeking practices was also obtained using a pro forma. Associations between the prevalence of WRMSDs and each of the sociodemographic data and work settings were explored using Chi-square analysis. The level of significance was set at p < 0.05. Results The 12-month and point prevalence rates of WRMSDs among butchers in this study were 88.2% and 74.5%, respectively. Whereas lower back complaints (66.7%) were the overall and lower body quadrants most commonly reported WRMSDs among the butchers surveyed, wrist/hand complaints were the leading upper quadrants (45.1%) most commonly reported WRMSDs among the respondents. There were significant associations between age and majority of WRMSDs in the body regions. Only 23.3% of the 90 individuals who had WRMSD visited the hospital to seek redress for their WRMSD. Conclusion The prevalence of WRMSDs is high among butchers in Kano Metropolis. Few individuals with WRMSD utilize healthcare facilities. Age is a major risk factor in this setting.

Perceived barriers to physical activity among Nigerian stroke survivors.

Introduction Benefits of physical activity in the prevention and management of stroke are well documented in the literature. There is increasing evidence that stroke survivors in South-West Nigeria are physically inactive. Data on barriers to the achievement of the recommended physical activity levels including its differences along socio-demographic characteristics among stroke survivors in South-West Nigeria are needed. Methods The Exercise Benefits and Barrier Scale and the International Physical Activity Questionnaire were administered on 121 stroke survivors to determine their perceived barriers to physical activity and physical activity levels respectively. Information on socio-demographic data and clinical variables were also collected. Results The sample included 70.2% males, with majority of the participants reporting low physical activity levels (80.2%) and high perceived barriers (Mean = 48.13, SD = 7.88). The four most reported common barriers among stroke survivors were access to exercise facilities (95.0%), being embarrassed to exercise (94.2%), economic cost demands of exercise (94.2%) and notion that people in exercise clothes look funny (94.2%) respectively. There were no significant differences found in barriers to physical activity between gender (U= 1471.00, P= 0.74) and across each of: occupational status (H= 4.37, P = 0.22), age group (H= 0.82, P= 0.84) and educational levels (H= 4.56, P= 0.33). Significant difference however existed in perceived barriers across marital status categories (H = 12.87, P= 0.05) Conclusion Stroke survivors indicated high perceived barriers to physical activity and these barriers were associated with marital status.

Psychosocial adversities and depression in mothers of children with cerebral palsy in Nigeria

This study was aimed at examining possible correlation of psychosocial adversities with depression in mothers of children with cerebral palsy (CP) in Nigeria. The cross-sectional survey involved 45 consenting mothers of children with CP attending physiotherapy clinics of the University College Hospital, Ibadan, the Federal Medical Center and King Fahd Ibn Abdul-Aziz Women and Children Hospital Gusau, Nigeria. The psychosocial adversities scale (PAS) was used to assess psychosocial adversity while depression was measured with the patient health questionnaire depression scale. The mean age of the mothers was 32.0 ± 5.0 yr and that of their children was 2.4 ± 1.5 yr. Spearmans rank order correlation showed a significant positive correlation between PAS and patient health questionnaire depression scale scores (r = 0.4; P = 0.006). Significant associations (P < 0.001) were found between depression and each item on the PAS, i.e. separated household, problem with extended family, lack of confidants, feeling of loneliness and isolation of mother. Logistic regression analysis indicated negligible risk of depression for mothers with low educational status (odds ratio = 0.4; 95% confidence interval = 0.08–1.1; P = 0.08). The depression risk was more than fourteen-fold in mothers whose husbands earned low incomes (odds ratio = 14.6; 95% confidence interval = 2.6–82.1 P = 0.002). Psychosocial adversities are significantly associated with depression in mothers of children with CP. Poor marital relationships (separated household and problem with extended family) and inadequate social interaction (feeling of loneliness and lack of confidants) were the most important psychosocial stressors associated with depression among mothers of children with CP in Nigeria.

Musculoskeletal pain among postmenopausal women in Nigeria: Association with overall and central obesity

Background: Menopausal women experience musculoskeletal changes such as muscle atrophy, muscle weakness and osteoporosis—symptoms associated with advancing age coupled with depletion of the female sex hormone, estrogen. Estrogen is important in the maintenance of the integrity of the musculoskeletal system and its reduction in the circulation due to menopausal transition results in reduced resting metabolic rate, lowered energy expenditure, increase in fat mass, and central adipose tissue accumulation. Objective: This study investigated the prevalence of musculoskeletal pain (MSP) in postmenopausal women (PMW) in Nigeria. We examined the association of overall and central obesity with complaints of MSP and the screening potential of obesity measures for risk of musculoskeletal problems among PMW in Nigeria. Methods: This was a cross-sectional survey of MSP in 310 PMW in Ibadan, Nigeria. MSP was assessed using the Standardized Nordic Musculoskeletal Questionnaire, and overall and central obesity were assessed using body mass index (BMI), waist/height ratio (WHtR), waist circumference, and waist/hip ratio. Data were analysed using descriptive statistics, chi-square test, and logistic regression models with the probability level at p = 0.05. Results: Participants were of the modal age group (51–60 years). The highest prevalence rates of MSP were in the lower extremity (189; 61.0%) and the back (164; 52.9%). A direct association was observed between the categories of BMI and lower extremity symptoms (p < 0.05), and the categories of WHtR and waist circumference were associated with back and lower extremity symptoms (p < 0.05). Postmenopausal women had greater odds of reporting MSP across various classes of BMI. WHtR revealed the greatest odds for back (odds ratio = 1.70, 95% confidence interval 1.07–2.75) and lower extremity symptoms (odds ratio = 2.33, 95% confidence interval 1.44–3.78). Conclusion: Lower extremity and back pain symptoms were the most prevalent. For overall and central obesity directly associated with MSP, WHtR seemed the best obesity screening tool for MSP in postmenopausal women.

Global Account of Barriers and Facilitators of Physical Activity Among Patients with Diabetes Mellitus: A Narrative Review of the Literature

BACKGROUND With diabetes rates escalating globally, there is the need for a better integration of all aspects of diabetes care for improved population outcomes. An understanding, not only of regional but global literature on physical activity barriers and its facilitators is important if healthcare providers and policy makers are to create programs tailored to their populations. OBJECTIVES Herein, we report the results of a narrative review of the global barriers and facilitators of physical activity for patients with diabetes mellitus. METHODOLOGY An in-depth literature search was conducted to identify English-language studies that examined physical activity barriers and associated facilitators among patients with diabetes mellitus. Major electronic literature databases that were searched included Google Scholar, PubMed, Hub-Med, and Highwire. RESULTS Studies were available from Africa, Asia, Australia, Europe, and, predominantly North America. A total of 34 predominantly internal barriers emerged globally. The most commonly reported were time constrains, fear of provoking additional disorders, exercise venue and weather related barriers. Facilitators of physical activity were reported for most of the internal barriers (e.g. time constraints, lack of knowledge etc) while the external barriers (e.g. weather, environmental pollution etc) received only a minimal attention. CONCLUSIONS Globally, patients with diabetes are confronted with an enormous number of physical activity barriers. Unlike the robust solutions proffered for the internal barriers, the literature is largely silent about solutions to the external barriers, which though fewer, may be highly influential. Additional data is needed to better understand physical activity behaviors in populations outside of North America.