Chidozie E. Mbada

Relationship of anthropometric indicators with blood pressure levels and the risk of hypertension in Nigerian adults

Background and purpose: Studies on cardiovascular risks in relation to anthropometric factors are limited in Sub-Sahara Africa. The aims of this study were to examine the relationship between anthropometric parameters and blood pressure; and to evaluate body mass index (BMI) across the range of underweight and obesity as a primary risk factor of hypertension in adult Nigerians. Material and methods: 2097 adults aged between 20 and 100 years consented and participated in this door-to-door survey. All participants underwent blood pressure and anthropometric measurements using standard procedures. The population study was separated in normotensive and hypertensive males and females and the possible risk for hypertension were categorized into different classes of value based on BMI definition. Results: The relative risks (odds ratio [OR] and 95% confidence interval [CI]) of developing hypertension among the obese compared with the underweight, normal weight, and overweight persons were (OR 5.75; CI 5.67–5.83), (OR 1.73; CI 1.65–1.81), and (OR 1.54; CI 1.46–1.62) for all the participants, respectively. Among obese (BMI ≥ 30.0 Kg/m2) males, the OR for hypertension was three times (OR 2.78; CI 2.76–2.80) that of normal weight (BMI ≥ 18.5–24.9 Kg/m2) males. Females with obesity had a risk of hypertension three times (OR 3.34; CI 3.33–3.35) that of normal weight females. Conclusion: Our results indicated that the there was a significant positive correlation of obesity indicator with blood pressure. In Nigeria, we found a strong gradient between higher BMI and increased risk of hypertension among all ages. Approaches to reduce the risk of hypertension may include prevention of overweight and obesity.

Isometric endurance of the back extensors in school-aged adolescents with and without low back pain

BACKGROUND AND OBJECTIVE Studies on back extensor endurance in adolescents are scarce. This study sought to establish reference data and pattern of back extensor endurance in school-aged adolescents with and without low-back pain (LBP) from Nigeria. SUBJECTS AND METHODS This study recruited 625 adolescents aged 11 to 19 years from eight randomly selected secondary schools. The modified Biering-Sørensen test of Static Muscular Endurance (BSME) was used to assess isometric endurance of the back extensors. Demographic and anthropometric data were collected. A modified LBP questionnaire was used to assess the presence of LBP. Descriptive and inferential analyses were used to analyze data. Significance was set at 0.05 alpha-level. RESULTS The mean isometric holding time (IHT) of all the participants was 132.9

Comparative lung function performance of stroke survivors and age-matched and sex-matched controls.

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Socioeconomic status and obesity among semi-urban Nigerians.

65.6. Males had significantly higher significant (p=0.026) IHT than females. Adolescents without LBP had a higher significant IHT (p=0.042) than those with reported history of previous LBP and those with present LBP (p=0.000) respectively. Using percentile values, poor endurance was defined as IHT that is < 90.0 s and < 67 s for males and females respectively; medium endurance was defined as IHT that ranged between 90 and 193 s and 67 and 170 s for males and females respectively while good endurance was defined as IHT that is > 193 s and > 170 s for males and females respectively. IHT was significantly related to each of body mass index, hip circumference and waist-to-hip ratio (p < 0.05). CONCLUSION Isometric back extensors endurance in Nigerian adolescents was comparable to the original Biering-Sørensen mean value. Majority of the participants had medium endurance performance with the back endurance pattern in the ratio 1:2:1. Male had higher isometric back extensors endurance than females. Decreased isometric back extensors endurance was associated with the presence of LBP in adolescents.

Knowledge and Attitude of Nigerian Pregnant Women towards Antenatal Exercise: A Cross-Sectional Survey

BACKGROUND AND PURPOSE Reduced endurance and excessive fatigue in stroke survivors (SS) during exercise may be linked to impairment of lung function and breathing mechanics, but little is known about lung function of SS. The purpose of this study is to determine lung function (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], FEV1 /FVC ratio and peak expiratory flow [PEF]) and influence of anthropometrics on lung function in SS compared with healthy controls (CG). METHODS In this case-control, cross-sectional study, we recruited 70 participants (42 males, 28 females), comprising 35 SS and 35 CG (range 34-73 years). Anthropometrics were measured using standard instruments and procedure. Chest excursion was measured at the axilla, xiphoid and lower costal levels. Lung function indices were measured using a micro-computerized spirometer. Ethical approval was obtained from the Ethics and Research Committee of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. RESULTS/FINDINGS Compared with the CG, the SS had significantly lower values for FEV1 (1.99 ± 0.66 vs. 2.36 ± 0.45 L, p = 0.004), FVC (2.55 ± 0.70 vs. 2.90 ± 0.54 L, p = 0.014), PEF (3.88 ± 1.38 vs. 5.24 ± 1.30 L second(-1) , p = 0.001) and chest excursion (3.0 ± 0.71 vs. 3.5 ± 0.91 cm, p = 0.018). Correlations between chest excursion, FEV1 , FVC and PEF were not significant (p > 0.05). DISCUSSION The weakness of respiratory muscles associated with stroke may have contributed to decreases in lung function observed. There was a significant reduction in chest excursion of SS compared with CG. Chest excursion has been used as an indicator of respiratory muscle function because the range of motion of the thorax serves the respiration. Movements of the thorax influence the content of the thorax cavity, leading to alterations in lung volumes. IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE Stroke survivors have lower lung function when compared with CG; this has implications for clinicians in stroke rehabilitation, underscoring the importance for inclusion of interventions to improve lung function.

Reference Values of Static Back Extensor Muscle Endurance in Healthy Nigerian Adults

Objective: The relation between socioeconomic status (SES) and obesity in Sub-Saharan Africa (SSA) has been inconsistent. Methods: This study examined the prevalence of obesity and SES/obesity relations in 1,067 adults aged 30–60 years from a semi-urban Nigerian population. A structured questionnaire validated by a pictorial selfrating ladder was used to determine the participants’ SES. Results: SES was found to be inversely related (p < 0.010) to weight and BMI, respectively. The odds ratio (OR) and 95% confidence interval (CI) for obesity among lower SES individuals were OR 2.4 and CI 1.91–2.88 compared with OR 2.9 and CI 2.42–3.39 in those of the middle and higher socioeconomic strata. Among males, the OR and 95% CI for obesity among lower SES individuals were OR 1.9 and CI 1.21–2.59 compared with OR 1.7 and CI 1.00–2.39 in those of the middle and higher socioeconomic strata. Among females, the OR and 95% CI for obesity among lower SES individuals were OR 3.0 and CI 2.32–3.68 compared with OR 4.7 and CI 4.02–5.38 in those of the middle and higher socioeconomic strata. Conclusion: SES was inversely associated with the risk of obesity, with a higher prevalence of obesity in the lower socioeconomic stratum of the semi-urban Nigerian population.

Influence of Mckenzie protocol and two modes of endurance exercises on health-related quality of life of patients with long-term mechanical low-back pain

Background. Engagement in physical exercise in pregnancy is hamstrung by safety concerns, skepticism about usefulness, and limited individualized prescription guidelines. This study assessed knowledge and attitude of pregnant women towards antenatal exercises (ANEx). Methods. The cross-sectional study recruited 189 pregnant women from six selected antenatal clinics in Ile-Ife, South-West, Nigeria. Data were obtained on maternal characteristics, knowledge, and attitude towards ANEx. Results. Relaxation and breathing (59.8%), back care (51.3%), and muscle strengthening (51.3%) exercises were the most commonly known ANEx. Prevention of back pain risk (75.9%) and excess weight gain (69.1%) were perceived as benefits, while lower extremities swelling (31.8%) and extreme weight gain or loss (30.7%) were considered as contraindications to ANEx. 15.8% of the respondents had negative attitude towards ANEx resulting from insufficient information on exercise (83.3%) and tiredness (70.0%). Age significantly influences knowledge about contraindications to ANEx (P = 0.001), while attitude was influenced by age and occupation, respectively (P < 0.05). There was significant association between attitude and knowledge about benefits and contraindications to ANEx (P < 0.05). Conclusion. A majority of Nigerian pregnant women demonstrated inadequate knowledge but had positive attitude towards ANEx. Knowledge about benefits and contraindications to ANEx significantly influenced the attitude towards exercise in pregnancy.

Comparative functional exercise capacity of patients with type 2-diabetes and healthy controls: a case control study.

Objective: This study aimed to establish gender and age reference values of static back extensor muscle endurance in healthy Nigerian adults. Subjects and Methods: This study involved 373 consecutive participants aged between 21 and 60 years who were grouped into four age strata. A modification of the Sørensen test of Static Muscular Endurance (BSME) was used to quantify static endurance. The mean, standard deviation, range and 25th, 50th, and 75th percentile scores were determined for four gender/age categories. Results: Endurance time differed significantly across the age groups (F = 47.286; p = 0.000). Males exhibited higher mean endurance than females (t = 2.583; p = 0.010). Using percentiles, 25th (poor endurance), 25th–75th (medium endurance) and >75th (good endurance) percentile were 72, 72–161, and >161–240 s, respectively, for males; and 64, 64–142, and >142–236 s, respectively, for females. There was an age and gender variation in the median values. The results suggest that the significant age and anthropometric differences between the categories of participants could contribute to endurance differences. Conclusion: This study established a set of reference values for static back endurance in healthy Nigerians. These values can be used to compare a patient’s score at intake or as an outcome measure in clinical practice.

Rehabilitation of Back Extensor Muscles' Inhibition in Patients with Long-Term Mechanical Low-Back Pain

Introduction Long-term Mechanical Low-Back Pain (LMLBP) negatively impacts on patients’ physical capacity and quality of life. This study investigated the relationship between Health-Related Quality of Life (HRQoL) and pain intensity, and the influence of static and dynamic back extensors’ endurance exercises on HRQoL in Nigerian patients with LMLBP treated with the McKenzie Protocol (MP). Methods A single-blind controlled trial involving 84 patients who received treatment thrice weekly for eight weeks was conducted. Participants were assigned to the MP Group (MPG), MP plus Static Back Endurance Exercise Group (MPSBEEG) or MP plus Dynamic Endurance Exercise Group (MPDBEEG) using permuted randomization. HRQoL and pain was assessed using the Short-Form (SF-36) questionnaire and Quadruple Visual Analogue Scale respectively. Results Sixty seven participants aged 51.8 ± 7.35 years completed the study. A total drop-out rate of 20.2% was observed in the study. Within-group comparison across weeks 0-4, 4-8 and 0-8 of the study revealed significant differences in HRQoL scores (p < 0.05). Treatment Effect Scores (TES) across the groups were significantly different (p = 0.001). MPSBEEG and MPDBEEG were comparable in TES on General Health Perception (GHP) at week 4; and GHP and Physical Functioning at week 8 respectively (p > 0.05). However, MPDEEG had significantly higher TES in the other domains of the SF-36 (p = 0.001). Conclusion HRQoL in patients with LMLBP decreases with pain severity. Each of MP, static and dynamic back extensors endurance exercises significantly improved HRQoL in LMLBP. However, the addition of dynamic back extensors endurance exercise to MP led to greater improvement in HRQoL.

Influence of Relative Adiposity on Static Back Extensor Muscle Endurance in Apparently Healthy Adults

Introduction Functional Exercise Capacity (FEC) is a valid measure of physical fitness in health and disease. However, there is paucity of studies on FEC in African patients with Type-2 Diabetes (T2D). This study compared FEC between patients with T2D and healthy controls. Methods Thirty five patients with T2D (18 men, 17 women) and 35 (16 men, 19 women) age-sex matched healthy controls participated in this case-control study. Anthropometric and demographic characteristics and cardiovascular parameters were measured following standard procedures. A glucometer was used to determine the Fasting Blood Glucose (FBG) level following at least 8 hours of overnight fasting. FEC was assessed using the Six-Minute Walk Test (6MWT) while Hand Grip Strength (HGS) test was measured with an electronic dynamometer. Data were analyzed using descriptive and inferential statistics. Alpha level was set at p< 0.05. Results Patients with T2D and controls were similar in age (p > 0.05). There were significant differences in the distance covered during 6MWT between patients and controls (t= 0.329; p =0.03), exercise capacity (t = 0.329; p = 0.03), FBG (t = 7.403; p = 0.001), systolic and diastolic blood pressure (t = 12.56; p = 0.001 and t = 27.23; p = 0.001) respectively. There were significant inverse relationships between 6MWD and Body mass index (r = -0.39; p = 0.02) and FBS(r = -0.51; p = 0.02) in patients with type-2 respectively. No significant association was found between exercise capacity and HGS (p > 0.05). Conclusion Patients with type-2 diabetes demonstrated lower functional exercise capacity than healthy controls. High body mass index and fasting blood glucose were significantly associated with lower functional exercise capacity.