Assistive Technology utilization among stroke survivors in Kano, Northwest Nigeria: a cross-sectional study.

Mobility impairments and participation restrictions are common occurrences post-stroke, which may necessitate the need to utilize Assistive Technology (AT). This study investigated the prevalence, pattern, and satisfaction with AT utilization in stroke survivors (SS). The study was conducted in two hospitals in Kano, Nigeria. The QUBEC user evaluation of satisfaction with AT (QUEST) questionnaire and the Rivermead Mobility Index were used to assess satisfaction with AT utilization and mobility, respectively. Pearson correlation and independent t-test were used to determine the relationship and gender difference among the outcomes, respectively. A total of 280 SS participated; however, only 115 (41.07%) were AT users. The commonly used AT was wheelchair 84 (73%), while the least used was walking frame 3 (2.6%). About two-thirds of the participants were quite or very satisfied with their ATs. The duration of AT utilization is positively related to stroke duration (r = 0.940) but negatively related to mobility level (r = -0.246). There is no significant gender difference in duration and satisfaction with AT utilization. AT like wheelchairs seems uncommonly utilized among SS in Kano, Nigeria, likely due to patients' lack of knowledge of use, economic factors, and culture among others.

Mental fatigue does not affect static balance under both single and dual task conditions in young adults.

The ability to control balance and prevent falls while carrying out daily life activities may require a predominantly controlled (cognitive) or automatic processing depending on the balance challenge, age, or other factors. Consequently, this process may be affected by mental fatigue which has been shown to impair cognitive abilities. Controlling static balance in young adults is a relatively easy task that may proceed automatically with minimal cognitive input making it insusceptible to mental fatigue. To investigate this hypothesis, static single and dual task (while concurrently counting backward by seven) balance was assessed in 60 young adults (25.2 ± 2.4 years) before and after 45 min of Stroop task (mental fatigue condition) and watching documentary (control), presented in a randomized counterbalanced order on separate days. Moreover, because mental fatigue can occur due to task underload or overload, participants carried out two different Stroop tasks (i.e., all congruent, and mainly incongruent trials) on separate days in the mental fatigue condition. Results of the study revealed a significantly higher feeling of mental fatigue after the mental fatigue conditions compared to control (p < 0.001). Similarly, the performance on congruent Stroop trials decreases with time indicating objective mental fatigue (p < 0.01). However, there was no difference in balance or concurrent task performance under both single and dual task assessments between the three conditions (p > 0.05) indicating lack of effect of mental fatigue on static balance in this population. Therefore, future studies investigating this phenomenon in occupational or sport settings in similar population should consider using more challenging balance tasks.

Prevalence and correlates of undiagnosed hypertension among staff of a Nigerian university community.

Introduction: the prevalence of hypertension in Nigeria is high, with a considerable proportion of it being undiagnosed. Nevertheless, early identification of influencing variables for hypertension in different population groups is important for several reasons. This study aimed to determine the prevalence and correlates of undiagnosed hypertension among staff of a university community in Nigeria. Methods: a purposive sample of 281 staff of Bauchi State University, Gadau, Nigeria, fulfilled the inclusion criteria and were enrolled in this cross-sectional study. Demographics, blood pressure, height, weight, socioeconomic status and physical activity were measured. Diagnosis of hypertension was defined based on a systolic and diastolic blood pressure of ≥140 mmHg and ≥90 mmHg, respectively. Data obtained was analysed descriptively, and by means of Chi-square, univariate and multivariate statistics using SPSS v24 software. Results: the mean age and body mass index (BMI) of the participants was 34.5 years and 23.1 ± 5.17 Kg/m2, respectively. The prevalence rate of undiagnosed hypertension was 27.8%. Normotensives significantly differed from participants with undiagnosed hypertension in most of the clinical and demographic variables (p<0.05). Univariate and multivariate analyses revealed that a positive family history of hypertension had the highest odds of having undiagnosed hypertension (aOR: 0.833, 95%CI: 16.55-432.87, p= 0.000). Next, a higher BMI score (aOR: 0.425, 95%CI: 0.085-0.447, p= 0.000), male gender (aOR: 0.451, 95%CI: 0.141-0.829, p= 0.018), job cadre (aOR: 0.515, 95%CI: 0.073-0.550, p= 0.002) and low physical activity level (aOR: 0.572, 95%CI: 5.296-49.777, p=0.000) were other factors with about 50% odds for having undiagnosed hypertension among the participants. Lastly, smoking status and socioeconomic status of the participants were not significantly associated with undiagnosed hypertension (p>0.05). Conclusion: a high percentage of the studied population have undiagnosed hypertension that is mainly associated with non-modifiable (especially positive family history) and a few modifiable risk factors. These variables can be used for early identification and in designing appropriate preventive strategies.

Development and Comparative Efficacy of Lagos Neuropathy Protocol for Improving Recovery of Symptom and Functional Independence Performance in Individuals with Diabetic Peripheral Sensorimotor Polyneuropathy.

BACKGROUND: Diabetic peripheral sensorimotor polyneuropathy (DPSP) has been treated with sketchy outcomes and available approaches are not applicable for self-administration. This study developed protocol for managing symptoms of DPSP and assessed its comparative efficacy. METHODS: Study developed Lagos Neuropathy Protocol (LNP) through existing concept in DPSP and tested its safety, clinical applicability, and ease of self-administration. Its efficacy was compared with Buerger-Allen Exercise (BAE) by involving 31(11males) with DPSP, randomized into LNP and BAE and treated for 10-week. Toronto Clinical Scoring System was used to diagnose DPSP while Diabetic Neuropathy Examination was used to diagnose distal polyneuropathy. Sensory/pressure perception was assessed using 10 g-monofilament while Short Physical Performance Battery, Bergs Balance Scale and Visual Analogue Scale was used to assess functional performance, strength and balance, and pain respectively. RESULTS: LNP has three domains: sensory/pressure/proprioception, strength/balance, and pain/swelling. Most (80%) of the participants rated the LNP as excellently safe while the rest (20%) rated as very good in safety. All the participants rated LNP excellent in terms of self-administration and suitability for clinical use without adverse effect. The mean age of the participants for the comparative phase was 66.20±9.48years while their length of diagnoses of diabetes was 15.80±13.35years. About a third (32.5%) had DPSP. Both LNP and BAE had significant improvement (p<0.05) in sensory/pressure perception, pain, strength and balance, and functional performance but LNP had better significant improvement. CONCLUSION: LNP is safe, good for self-administration, clinically applicable and efficacious in improving sensory/pressure perception, balance, pain and functional performances in individuals with DPSP.

Evaluation of Predictive Factors Influencing Community Reintegration in Adult Patients with Stroke.

OBJECTIVES: Patients with stroke are faced with gait, balance, and fall difficulties which could impact on their community reintegration. In Nigeria, community reintegration after stroke has been understudied. The objective of this study was to evaluate the predictors of community reintegration in adult patients with stroke. MATERIALS AND METHODS: Participants were 91 adult patients with stroke. Gait variables, balance self-efficacy, community balance/mobility, and fall self-efficacy were assessed using Rivermead Mobility Index, Activities-specific Balance Confidence Scale, Community Balance and Mobility Scale, and Falls Efficacy Scale-International respectively. Reintegration to Normal Living Index was used to assess satisfaction with community reintegration. Pearson Product-Moment Correlation Coefficient was used to determine the relationship between community reintegration and gait spatiotemporal variables, balance performance, and risk of fall. Multiple regression analysis was used to determine predictors of community reintegration (P ≤ 0.05). RESULTS: There was significant positive relationship between community reintegration and cadence (r = 0.250, P = 0.017), functional mobility (r = 0.503, P = 0.001), balance self-efficacy (r = 0.608, P = 0.001), community balance/mobility (r = 0.586, P = 0.001), and duration of stroke (r = 0.220, P = 0.036). Stride time (r = -0.282, P = 0.073) and fall self-efficacy (r = 0.566, P = 0.001) were negatively correlated with community reintegration. Duration of stroke, balance self-efficacy, community balance/mobility, and fall self-efficacy (52.7% of the variance) were the significant predictors of community reintegration. CONCLUSION: Community reintegration is influenced by cadence, functional mobility, balance self-efficacy, community balance/mobility, and duration of stroke. Hence, improving balance and mobility during rehabilitation is important in enhancing community reintegration in patients with stroke.