Olusola Ayanniyi

Prevalence and Profile of Back Pain in Nigerian Adolescents

Objective: This study aimed to investigate prevalence, characteristics, perceived predisposing factors and mode of treatment sought for back pain among school-aged adolescents in Nigeria. Subjects and Methods: A self-administered questionnaire employed in this cross-sectional study was distributed to 4,400 students [mean age 15.0 ± 1.7 years (range 10–19)] from 44 randomly selected schools. Results: Of the 4,400 questionnaires, 3,185 were completed (1,455 boys and 1,730 girls), thereby yielding a response rate of 72.4%. The lifetime and point prevalence of back pain were 59 and 17%, respectively. Low back pain was the most prevalent type, reported by 25%. The prevalence of back pain was 59.7% among boys and 57.5% among girls. Back pain was significantly associated with age, religion and involvement in commercial activity (p < 0.05). Among those with back pain, most cases were mild (56%), but chronic in 21%, and 27% used self-medication. Prolonged sitting posture (17%) was the most implicated predisposing factor to back pain. Conclusion: Back pain is common among Nigerian adolescent students, but it is mostly mild. The prevalence of back pain increased with advancing age in both genders. More research is needed to find necessary risk factors and interventions including appropriate back education to reduce back pain.

Socioeconomic status and obesity among semi-urban Nigerians.

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.

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

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.

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

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.

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

This study investigated the effect of static or dynamic back extensors endurance exercise in combination with McKenzie Protocol (MP) in patients with Long-term Mechanical Low-Back Pain (LMLBP). This randomized controlled trial involved 84 patients, who were assigned into MP Group (MPG), MP plus Static Back Extensors Endurance (SBEE) Exercise Group (MPSBEEG), or MP plus Dynamic Back Extensors’ Endurance (DBEE) Exercise Group (MPDBEEG). Twenty-five, 22, and 20 participants in MPG, MPSBEEG, and MPDBEEG, respectively, completed the thrice weekly eight-week study (drop-out rate = 20.2%) and outcomes were measured in terms of SBEE, DBEE, and Back Muscles Fatigue (BMF) at the 4th and 8th week, respectively. There were significant differences in groups mean change scores on SBEE (, and  sec), DBEE (, , and rep), and BMF (, , and ) at week 4, and SBEE (, , and  sec), DBEE (, , and reps), BMF (, , and ) at week 8, respectively (). It was concluded that MP alone, or in combination with SBEE or DBEE, exercise was effective in the rehabilitation of back extensors’ endurance and fatigability in patients with LMLBP. However, the addition of SBEE to MP led to significantly higher positive effects.

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

Abstract Few studies have sought to gain insight into the determinants of endurance capacity of the back extensor muscles. This study investigated the influence of body fat on the endurance of the back extensor muscles using different measures of adiposity in apparently healthy Nigerian adults. Three hundred and seventy-six consecutive adults aged 38.9 ± 13.5 years participated in the study. The participants performed the Biering-Sorensen test of static muscular endurance, and their height, weight and percentage body fat (PBF) were measured using standard procedures. Body mass index (BMI), lean body mass and body fat mass were calculated. Descriptive statistics of mean and standard deviation, ANOVA and multiple regression analysis were used. The a level was set at 0.05. A significant difference ( p = 0.000) was found in the isometric holding time (IHT) of the underweight (131.04 ± 49.61 seconds), normal (125.52 ± 46.3 seconds), overweight (85.61 ± 37.24 seconds) and obese (73.02 ± 41.67 seconds) categories using the BMI definition. Significant differences ( p = 0.000) were found in the IHT among the lean, acceptable, moderately overweight and overweight categories for males and females using the PBF classification. After controlling for age, sex and other anthropometric factors, BMI was significantly associated ( p = 0.000) with IHT, accounting for approximately 40% of the variability in back muscle endurance; PBF was significantly associated ( p = 0.000) with IHT for males and accounted for approximately 50% of the variability in males and females. Overweight and obesity are important factors in the aetiology of decreased back extensor muscle endurance. Approaches to reduce decreased back muscle endurance and the risk of low back pain may include prevention of overweight and obesity.

Cross-cultural Adaptation, Reliability, and Validity of the Yoruba Version of the Roland-morris Disability Questionnaire.

Study Design. A translation, cross-cultural adaptation, and psychometric analysis. Objective. The aim of this study was to translate, cross-culturally adapt, and validate the Yoruba version of the RMDQ. Summary of Background Data. The Roland-Morris Disability Questionnaire (RMDQ) is a valid outcome tool for low back pain (LBP) in clinical and research settings. There seems to be no valid and reliable version of the RMDQ in the Nigerian languages. Methods. Following the Guillemin criteria, the English version of the RMDQ was forward and back translated. Two Yoruba translated versions of the RMDQ were assessed for clarity, common language usage, and conceptual equivalence. Consequently, a harmonized Yoruba version was produced and was pilot-tested among 20 patients with nonspecific long-term LBP (NSLBP) for cognitive debriefing. The final version of the Yoruba RMDQ was tested for its construct validity and re-retest reliability among 120 and 87 patients with NSLBP, respectively. Results. Pearson product moment correlation coefficient (r) of 0.82 was obtained for reliability of the Yoruba version of the RMDQ. The test-retest reliability of the Yoruba RMDQ yielded Cronbach alpha 0.932, while the intraclass correlation (ICC) ranged between 0.896 and 0.956. The analysis of the global scores of both the English and Yoruba versions of the RMDQ yielded ICC value of between 0.995 (95% confidence interval 0.996–0.997), with the item-by-item Kappa agreement ranging between 0.824 and 1.000. The external validity of RMDQ using Quadruple Visual Analogue Scale was r = -0.596 (P = 0.001). The Yoruba version of the RMDQ had no floor/ceiling effects, as no patient achieved either of the maximum or the minimum possible scores. Conclusion. The Yoruba version of the RMDQ has excellent reliability and validity and may be an appropriate outcome tool for clinical and research purposes among Yoruba-speaking patients with LBP. Level of Evidence: 3

Comparative efficacy of three active treatment modules on psychosocial variables in patients with long-term mechanical low-back pain: a randomized-controlled trial

BackgroundPsychosocial factors precipitate and perpetuate the risk of developing long-term Low-Back Pain (LBP) with resultant disability. However, management of psychosocial aspects of LBP still remains a major challenge. This study investigated the effect of static or dynamic back extensors endurance exercise on psychosocial variables of Fear-Avoidance Behaviour (FAB), Pain Self-Efficacy Belief (PSEB) and Back Pain Consequences Belief (BPCB) in patients with LBP.MethodsA randomized-controlled trial of 67 patients assigned into McKenzie Protocol (MP) group (n = 25), MP and Static Endurance Exercise Group (MPSEEG; n = 22); and MP and Dynamic Endurance Exercise Group (MPDEEG; n = 20) was carried out. Treatment was applied thrice weekly for eight weeks.ResultsThe groups were comparable in general and baseline psychosocial parameters (p > 0.05). The different regimens had significant effects on all outcome parameters across baseline, 4th and 8th week (p < 0.05). The regimens were comparable in mean change scores on BPCB and FAB at the 4th and 8th week respectively (p > 0.05). MPDBEEG had higher mean change in PSEB at the 4th and 8th week respectively.ConclusionsMcKenzie Protocol alone, or in combination with static or dynamic back extensors endurance exercise has comparable effect on FAB, PSEB and BPCB in patients with LBP. The addition of dynamic endurance exercise to the MP led to significantly higher positive effects on PSEB.

Incidence of back pain among women of child bearing age and its management during pregnancy

OBJECTIVE: There is a dearth of studies on history of back pain (BP) among women of child bearing age in Nigeria. The aims of this study were to investigate the history of incidence of BP among women of child bearing age and how pregnancy-related BP is being managed among this population. METHODS: A survey of 2,187 pregnant women attending ante-natal clinics in selected Medical facilities in Ibadan and Ogbomoso, Nigeria was carried out over a period of 2 years and 3 months using pre-tested close-ended questionnaire. Data obtained was analyzed using both descriptive and inferential statistics. RESULTS: One thousand and eight (52.5%) of the 1919 respondents had back pain during their current pregnancy. The mean age of those with and without back pain was 26.8 ± 5.3 and 27.1 ± 5.4 years respectively. Mean number of pregnancy was higher among respondents with back pain 2.6 ±1.50 than those without back pain 2.4±1.40. Incidence of BP was highest during current pregnancy 52.5%, during menses 341(17.8%) and it was least post-delivery 69(3.6%). Analgesics (50 .4%) and physical approaches (49. 6%) were nearly equally utilized in managing BP among the studied population. Side lying (78.2%) was the most preferred therapeutic position for relieving BP and supine lying was the least favored (22.6 %,) among the respondents in relieving BP. Standing up and walking around was found useful to relieve BP induced or aggravated by prolonged sitting or maintenance of static posture. CONCLUSIONS: Back pain is most prevalent during pregnancy and also troublesome during menses among women of child bearing age. Analgesic and postural modifications were the two major interventions utilised in managing BP among the pregnant women in this study. More treatment options needs to be promoted for holistic management of pregnancy-related back pain. KEYWORDS: Incidence, back pain, pregnancy, management.