Olufemi O. Oyewole

Physical activity among type‑2 diabetic adult Nigerians

BACKGROUND Regular participation in physical activity (PA) programs is a key concept included in current public health guidelines. Therefore, this study was aimed to determine PA level among adult with type 2 diabetes. METHODS A cross-section of 122 participants selected consecutively were categorized as physically inactive or active using International Physical Activity Questionnaire. Data was assessed using descriptive and inferential statistics. RESULTS About 31% of the respondents were physically inactive. Residential areas were significantly associated with PA. A high proportion of those who lived in the metropolitan area were physically inactive. Less likely to be physically inactive were married (odds ratios [OR] =0.29, confidence interval [CI] =0.09-0.93) and living in an urban area (OR = 0.19, CI = 0.40-0.87). The degree holders are least physically inactive while the primary school leavers are highest. The median energy expenditure for walking, moderate and vigorous PA was 280.5, 80 and 0 MET-min/week respectively. The sedentary behavior of the respondents was 288 min/day, behavior which increases with age. CONCLUSION This study suggests that the prevalence of physical inactivity was high among type 2 diabetics and their sedentary behavior is over 4 h/day. This group of people should be encouraged to participate regularly in PA.

Prevalence and impact of disability and sexual dysfunction on Health-Related Quality of Life of Nigerian stroke survivors

Abstract Purpose: To investigate the impact of disability and sexual dysfunction on Health-Related Quality of Life (HRQoL) among Nigerian stroke survivors (SSv) and to determine their association using sexual functioning (SF), Global Disability Measure and Function (GDMF), and demographic profiles. Methods: This study involved 121 consecutive SSv attending healthcare services in two tertiary health facilities in Nigeria. Demographic details were obtained through interview while HRQoL, SF, and Global Disability (GD) were assessed using Stroke-Specific Quality of Life (SS-QoL-12), Changes in Sexual Functioning Questionnaire (CSFQ-14), and World Health Organization Disability Assessment Schedule (WHODAS-2.0), respectively. Determinants of HRQoL were explored using the Poisson regression analysis. Results: Most of the SSv had moderate/severe GD (95%) and low SF (86.8%). Their HRQoL decreased with increase in their age (p = 0.005) and with increase in GD (p = 0.001). This association remained unchanged even when adjusted for SF (p = 0.001). Those with low SF but with mild GD had relatively better HRQoL than those with moderate/severe GD even when they had higher SF. Their HRQoL was negatively impacted by their GD but not by their SF despite direct correlation between SF and HRQoL. With a unit increase in level of GD, there was 8% decrease in HRQoL scores in psychosocial and 17% decrease in physical domains. Conclusion: Although sexual dysfunction and global disability are prevalent among Nigerian SSv, their low HRQoL is determined by their disability and not by SF. Hence, effort at reducing global disability should be the focus of rehabilitation after stroke. Implication for Rehabilitation Global functional and sexual deficiencies abound in stroke survivors and they impact negatively on their overall quality of life. Sexual dysfunction correlates negatively on physical and psychosocial wellbeing of stroke survivors. Rehabilitation goal(s) should focus disability reduction and improvement of sexual functioning to enhance quality of life. Rehabilitation professionals should equip themselves with tools to counsel stroke survivors on sex issue since sexual dysfunction is common post stroke.

A comparative survey of Nigerian physiotherapists’ familiarity with, knowledge of and utilisation of standard outcome measures: 10 years after initial survey

Background The need for physiotherapists to use standardised outcome measures (SOMs) is recognised and recommended in clinical practice guidelines in many countries. Aim To evaluate changes in physiotherapy practice in Nigeria on the utilisation of SOMs and physiotherapists’ familiarity with and knowledge of SOMs over the past decade. Methods A comparative cross-sectional survey of present data with 2006 data was undertaken. The existing validated questionnaire of 2006 was used to assess physiotherapists’ familiarity with, knowledge of and utilisation of 16 SOMs. Results There was a noticeable change in familiarity with and utilisation of 16 SOMs in the current data and in knowledge. Between 52% and 90% of physiotherapists were not familiar with 14 SOMs in 2006, whereas 51.4% – 85.8% of physiotherapists were not familiar with 8 SOMs in 2016; 77% – 97% and 63.4% – 97.3% of physiotherapists were not utilising SOMs in the 2006 and 2016 data, respectively. The least utilised SOMs in 2006 were Western Ontario McMaster Osteoarthritis Index, Chedoke McMaster Stroke Assessment and SF-36 Health Survey; in 2016, it was only the Chedoke McMaster Stroke Assessment. The Visual Analogue Scale and Gross Motor Function Measure remained the most utilised in both data. Duration of practice, age and sex were significant factors for the utilisation of and familiarity with SOMs. Conclusion There was an improvement in the familiarity with, knowledge of and utilisation of SOMs over the past decade among Nigerian physiotherapists but the level of utilisation is unsatisfactory. Action is required if routine outcome measurement is to be achieved. Clinical Implications Utilisation of SOMs is part of core standards of physiotherapy practice for effective management of patients. Although the utilisation of SOMs improved over the past 10 years, it is very low. Therefore, studies directed at finding factors responsible for low utilisation of SOMs among Nigerian physiotherapists are warranted.

Physiotherapy clinical students’ perception of their learning environment: A Nigerian perspective

Background. A favourable environment has a positive and significant impact on students’ learning, academic progress and well-being. The present study was undertaken to identify the perceptions of physiotherapy students in their clinical years of their learning environment at the College of Medicine, University of Ibadan, Nigeria. Methods. A focus group discussion involving 12 undergraduate physiotherapy students was used to obtain information about their perception of their learning environment. Six students from two clinical levels of study were recruited through a simple random sampling technique. The focus interview guide was developed based on information obtained from the DREEM questionnaire and literature review. The interviews were analysed using the identified themes from DREEM and grounded theory for emerging subcategories. Results. Five descriptive themes and several subcategories were identified: ( i ) context of learning (course objectives, student focused/teacher centred, active learning); ( ii ) context of teachers (knowledgeable teachers, provision of formative assessment, approachable lecturers, cordial teacher-student relationship); ( iii ) context of students’ perception of their academic skills (understanding the subject); ( iv ) context of atmosphere (adequacy of facilities, e.g. chairs, classrooms, library, books); and ( v ) context of social life (religious activities, social functions, school-related social activities). Conclusion. Most students perceived their learning environment as good, especially with regard to student-teacher relationships. Some of the teachers were described as knowledgeable, and as providing formative assessment. However, students perceived their learning as being teacher centred. To facilitate an excellent learning environment, particular attention needs to be paid to availability of physiotherapy textbooks in the college library, sufficient appropriate furniture in classrooms, and provision of a functioning departmental library. The findings from this study may provide insights for teachers who wish to enhance the effectiveness of their teaching and of their students’ learning.