Effects of trunk exercise with physioball to improve trunk balance among subjects with stroke: a systematic review and meta-analysis.

Poststroke subjects present with difficulties of reduced functional mobility and balance. Trunk impairment is common among stroke subjects which hinder the performance of upper and lower limb. In poststroke rehabilitation limbs are provided much attention than the trunk. Trunk function has been identified as an important early predictor of functional outcome after stroke. Physioball is commonly used among healthy subjects in performing trunk exercises. This systematic review with meta-analysis is conducted to investigate the effect of trunk exercises performed using physioball in improving trunk performance after stroke. Six authors identified relevant articles from the following databases: PubMed, Google Scholar, CINAHL (Cumulative Index and Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database). Articles evaluating the effect of physioball exercise for improving trunk stability among stroke subjects were included. Databases were screened from 2009 and up to 2019. Qualitative synthesis of evidence was prepared and meta-analysis was implemented to draw pooled effects of physioball exercise on improving trunk performance and balance among stroke subjects. Eight papers were included, totaling 273 participants. All the articles included in this review demonstrated moderate to good quality. Meta-analysis performed with seven papers demonstrated statistical significance of physioball in improving trunk performance during acute and subacute stages of stroke. Brunnel Balance Assessment outcomes demonstrated statistically significant improvement of balance among overall stroke survivors. Trunk exercise performed over a physioball is effective during the acute and subacute stage. This meta-analysis could not find its significant effect in improving trunk performance in the chronic stages.

Effectiveness of Home-based rehabilitation in improving physical function of persons with Stroke and other physical disability: A systematic review of randomized controlled trials.

BACKGROUND: A significant number of people with physical disabilities in the world, especially in most developing countries face a lot of impediments. There is a dearth of literature describing the consensus of effectiveness of home-based rehabilitation programs designed specifically for people living with different types of physical disabilities resulting from stroke, Parkinson's and other musculoskeletal conditions. OBJECTIVE: To determine if home-based rehabilitation is effective in improving physical function of people with physical disabilities. METHOD: A systematic review of randomized controlled trials was done. An electronic search of the literature was done by PubMed, Cochrane Library, the Physiotherapy Evidence Database and Cumulative Index to Nursing and Allied Health Literature from 1990 to March 2018 to identify full text, peer-reviewed randomized controlled trials, Published in English. Selected randomized controlled trials were critically appraised with 11 items Physiotherapy Evidence Database scale scores extracted from the Physiotherapy Evidence Database and studies were included if the cutoff of 5 points was reached on Physiotherapy Evidence Database scale score. RESULTS: Nine randomized controlled trials met the preset eligibility criteria. This systematic review found that there is the consistency of findings among the included studies which showed that home-based rehabilitation is an effective option for people with physical disabilities. CONCLUSION: Home-based rehabilitation is not superior to hospital-based rehabilitation in improving nearly all patient outcomes assessed. However, home-based exercise programs require patient enthusiasm and regular follow-up to yield positive outcomes.

Physical activity and associated factors among pregnant women in Ethiopia: facility-based cross-sectional study.

BACKGROUND: Regular physical activity (PA) has health benefits, including reducing the risk of complications during pregnancy. In Ethiopia, little is known about PA status and its determinants among pregnant women. The purpose of this study was to assess PA status and associated factors among pregnant women attending antenatal care at public and private health facilities in Mekelle, Ethiopia. METHODS: A facility-based cross-sectional study was conducted. Data was collected from 299 pregnant women using a structured questionnaire. Study participants were selected using a simple random sampling technique. A binary logistic regression was modeled to investigate the statistical significance of independent variables with PA status during pregnancy. Factors associated with PA status were estimated using adjusted odds ratios with 95% confidence intervals and statistical significance was declared at p-value < 0.05. RESULTS: 79.3% of the study participants were classified as sedentary. The age group of 26-35 years (AOR: 2.69, 95% CI: 1.07-6.78), attending non-formal education (AOR: 13.50, 95% CI: 2.65-68.91), and women who did not work outside the home (AOR: 5.23, 95% CI: 1.34-20.38) were significantly associated with a higher risk of sedentary activity status. Pregnant women who were married (AOR: 0.26, 95% CI: 0.09-0.73), had two children (AOR: 0.13, 95% CI: 0.03-0.59), traveled an hour or more to health facilities (AOR: 0.31, 95% CI: 0.11-0.89) were protected from being sedentary. CONCLUSION: Sedentary PA status was highly prevalent during pregnancy. Pregnant women in the age group of 26-35 years, with a non-formal education, and women who did not work outside the home had a greater risk of reporting being sedentary. Those who were married, had two children, and traveled an hour or more to health facilities were less likely to be sedentary. Stakeholders (Tigrai regional health bureau, Mekelle University, local NGOs working with pregnant women and societies at large) should give higher emphasis on designing appropriate strategies including educational interventions to overcome barriers to PA during pregnancy.

Falls among community-dwelling older adults in Ethiopia; A preliminary cross-sectional study.

BACKGROUND: Falls among older adults is a common precipitating factor for unintentional injuries and represent a major health problem associated with increased morbidity, mortality, and health care cost in low-and-middle-income countries. The burden of fall in this population is well established in high-income countries and scant attention is given to this precipitating factor in low-and-middle-income countries, including Ethiopia. Therefore, this study aimed to estimate the prevalence and factors associated with fall among community-dwelling older adults in Ethiopia. METHODS: A community-based cross-sectional study was conducted among community-dwelling older adults of Gondar. Multi-stage random sampling technique was used across administrative areas. Six hundred and five households were selected proportionally using systematic random sampling technique. Physical measurement and face to face interview method were employed using a structured questionnaire for data collection. Data were analyzed descriptively and through uni- and multivariate logistic regression model. RESULTS: One hundred and seventy (n = 170, 28.4%; 95% CI 24.7-32.1) community-dwelling older adults reported having experienced fall in the past 12 months. Sex (OR = 1.91, 95% CI: 1.24-2.95), low educational status (OR = 2.37, 95% CI: 1.19-4.74), uncomfortable home environment (OR = 2.02, 95% CI: 1.34, 3.04), having diagnosed medical condition (OR = 4.659, 95% CI: 1.20-18.02), and use of medication (OR = 5.57, 95% CI: 1.19-26.21) were significantly associated risk factors of self-reported fall in the past 12 months. Most outdoor falls are associated with females and participants aged below 66 years. CONCLUSION: In conclusion, more than 1/4th of the community-dwelling older adults experienced at least one episode of fall and about 60% of them reported recurrent falls. Identifying risk group and risk factors that could be modified so as to prevent falls in older adults deserves attention. Outdoor falls are usually attributable to modifiable environmental aspects and improvements in outdoor environment needed.

Epidemiology and factors associated with peripheral neuropathy among HIV infected patients in Gondar, Ethiopia: A cross-sectional study.

BACKGROUND: Antiretroviral therapy has surely increased the life expectancy of people living with HIV. However, long term complications like HIV associated sensory neuropathy has a negative impact on quality of life among people living with HIV (PLHIV). In Ethiopia, lack of data on magnitude of the burden and predictors of HIV associated sensory neuropathy in many resource limited setting has led to under diagnosis and eventually under management of HIV-SN. Hence, this study was set out to establish the burden of HIV-associated sensory neuropathy and, its association with demographic, health and clinical characteristics among people living with HIV in Ethiopia. METHODS: Cross-sectional study was conducted to assess the prevalence of HIV-associated sensory neuropathy and the associated factors among adult HIV patients at University of Gondar Teaching Hospital, Gondar, Ethiopia. Brief Peripheral Neuropathy Screening tool validated by AIDs Clinical trial group was used for screening HIV-associated sensory neuropathy. Data were analyzed descriptively and through uni- and multivariate logistic regression. RESULTS: In total 359 adult PLHIV with a mean age of 36.5± 9.07 years participated, their median duration of HIV infection was 60 months (IQR 36-84) and their median CD4 count 143cells/µL (IQR 69.5-201.5). Age above 40 years, anti-tuberculosis regimen, tallness, and exposure to didanosine contained antiretroviral therapy were found to be associated with HIV-associated sensory neuropathy (AOR 1.82, 1.84, 1.98 and 4.33 respectively). CONCLUSIONS: More than half of the HIV patients who attended HIV care clinic at University of Gondar hospital during the study period were found to present with peripheral sensory neuropathy. Higher age, tallness, TB medication, and didanosine in ART were significantly associated with HIV-SN as screened by effective diagnostic (BPNS) tool.