Effectiveness of a physiotherapy self-management programme for adult patients with chronic non-specific low back pain in low- and middle-income countries: protocol for a systematic review and meta-analysis.

INTRODUCTION: Chronic non-specific low back pain (CNLBP) is among the most common musculoskeletal system conditions reported worldwide; however, few studies are available from low- and middle-income countries (LMICs). Self-management is a set of tasks performed by the patient aiming at managing their symptoms and interference in activities, mood and relationships due to pain. A physiotherapy-guided self-management programme (SMP) following a biopsychosocial approach has been reported as effective and affordable in the management of CNLBP in high-income countries. The objective of this systematic review is to determine the overall effectiveness of SMPs for adults with CNLBP in LMICs. METHODS AND ANALYSIS: In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocol (PRISMA-P) guidelines will be followed. A three-step search strategy will be used to search the electronic databases (PubMed, MEDLINE, SPORTDiscus, Scopus and CINAHL, Academic Search Complete and PEDro) for randomised controlled trials assessing the effectiveness of physiotherapy-guided self-management for CNLBP among adult participants in LMICs. The processes of screening search results for eligible studies, extracting data from included studies and appraising will be done independently by at least two review authors. Random effects meta-analysis will be used to synthesise results and heterogeneity will be assessed using the I2 test statistic and χ2 test. ETHICS AND DISSEMINATION: Ethics clearance was obtained for the broader PhD study on the development of a physiotherapy-guided SMP for adult people with CNLBP in Limpopo Province, South Africa. The results of the manuscript for this protocol will be published in peer-reviewed journals and also presented at conferences, symposia, and congresses. PROSPERO REGISTRATION NUMBER: CRD42023399572.

Results From South Africa's 2022 Healthy Active Kids' Report Card on Physical Activity, Body Composition Proxies, and Nutritional Status in Children and Adolescents.

BACKGROUND: Physical activity (PA) and nutrition in children have an impact on overall physical and mental well-being, cognitive, and social development. This study aims to report on the best current available evidence on PA, body composition proxies, and nutritional status of South African children and adolescents, based on the published findings between 2018 and 2022, which comprise the 2022 Healthy Active Kids South Africa Report Card. METHODS: A comprehensive literature search of online databases, along with hand searching and a gray literature search, was conducted based on PA, body composition proxies, and nutrition indicators defined, in part, by the Active Healthy Kids Global Alliance. RESULTS: Compared with the 2018 report card, there was an improvement in the majority of PA indicators which include overall PA (B-), active transportation (B-), physical fitness (B-), and government policy and programs (C). Body composition proxies and most of the nutrition indicators remained unchanged. The indicators that regressed from 2018 to 2022 included community and environmental influences (D), as well as participation in organized sport (D-). CONCLUSIONS: Despite the apparent improvement in overall PA levels in children and adolescents, there is a lack of tangible evidence of actual implementation of policies and programs. There was also a lack of nationally representative data for most indicators. Overall, there is a need to identify intersectoral, equitable approaches for promoting PA and healthy eating in South African children and adolescents and ongoing monitoring and surveillance.

Building organizational and strategic interprofessional collaboration and partnerships: a case study.

Developing organizational strategic partnerships is important to advance initiatives such as research, training/education, and interprofessional collaboration (IPC) with a global perspective. Commitments to collaborative leadership, intentional partnership, coordination, and progress, thematically represent the series of critical decisions and actions collectively required to achieve strategic alliance success. The purpose of this paper is to describe the evidenced-informed framework and systematic processes involved in building successful strategic organizational and collaborative partnerships for InterprofessionalResearch.Global to expand and enhance opportunities for IPC on mutually beneficial initiatives. The conceptual model for effective collaborative partnerships by Butt et al. (2008) provided a framework for InterprofessionalResearch.Global to develop two strategic organizational partnerships consistent with its mission, vision, and goals to explore interprofessional research and policy gaps through global research partnerships, grow and sustain communities of practice, and mobilize evidence-informed interprofessional education and collaborative practice across multiple and diverse contexts. These organizational partnerships are defined by a Memorandum of Understanding with clear expectations and mechanisms of communication, defined priority areas and timelines for collaborative efforts, mutual understanding of the purposes of each relationship, and timeline and expectations for periodic evaluation.

The relationship between kinaesthesia, motor performance, physical fitness and joint mobility in children living in Nigeria.

PURPOSE: This study aimed to determine the relationship between kinaesthesia, motor performance, fitness, and joint mobility in children. METHODS: A descriptive cross-sectional study was conducted involving children from two primary schools in the South-Eastern part of Nigeria. The Beighton criteria were used to measure joint mobility. Motor performance, fitness, and kinaesthesia were measured in all the children. Spearman's rank correlation was used to evaluate the relationship between the outcomes. RESULTS: A total of 91 children (51.6% girls) participated in the study. The mean age of the children was 8.20 ± 1.98 years. Using a Beighton score of ≥ 6, Generalized Joint Hypermobility (GJH) was identified in a total of 35 (38.46%) children and was more prevalent in females (60.0%). Joint mobility had significant correlations with most fitness and motor performance items, but not kinaesthesia. Agility & power, and motor performance seem to be reduced if mobility is larger. Kinaesthesia was correlated with most fitness and motor performance items, indicating that better fitness and better motor performance cooccur with better kinaesthesia or vice versa. CONCLUSION: Joint mobility may have a significant influence on fitness and motor performance in children. Hence, it may be useful for future studies to investigate how fitness and motor performance modulate the onset and progression of musculoskeletal symptoms in GJH.

Physical activity interventions implemented for older people in sub-Saharan Africa: protocol for a scoping review.

INTRODUCTION: The global population of older people (OP) is on an upward trajectory, with predictions that the number of OP would surpass the population of younger people by 2050. In sub-Saharan Africa (SSA), death from infectious diseases in the younger population and lower fertility rates are influencing a double burden contributing to an exponential growth in the ageing population. Non-communicable diseases (NCDs) are the leading cause of mortality and disability in the population of OP in SSA. Physical activity (PA) has been proven to have positive benefits in reducing the prevalence of NCDs in OP. The objective of this scoping review is to summarise the evidence on the feasibility and effectiveness of PA interventions that have been implemented among OP to address PA levels, blood pressure, blood glucose levels, cognitive function, quality of life and body mass index in SSA. METHODS AND ANALYSIS: The Joanna Briggs Insitute (JBI) methodology will be followed for this scoping review. An electronic search of PubMed, EBSCOhost (Academic Search Premier AfricaWide Information, CINAHL, Health Sources Premier Academic/Nursing), Scopus and ProQuest (grey literature) will be done from 2010 onwards to identify reports of randomised controlled studies published in English using relevant keywords. 2010 was selected as the cut-off point for inclusion in order to focus only on relatively recent evidence, as it is more likely to remain relevant and applicable to present-day settings. The searches will be performed by the primary reviewer in conjunction with a senior librarian. Full independent review of the uploaded articles will be done by two reviewers, by title and abstract, and thereafter by full text, based on specified inclusion and exclusion criteria. The reference list of included articles will be scanned for additional relevant articles. Disagreements will be arbitrated by a third reviewer. Results will be presented in a descriptive form as well as in tabular, graphical and diagrammatic formats, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. ETHICS AND DISSEMINATION: The review will be extracting and reporting on data from published literature so there is no requirement for ethics approval. The findings of the review will be submitted for publication in a peer-reviewed journal.

Understandings and practices: Towards socially responsive curricula for the health professions.

Global health inequities have created an urgency for health professions education to transition towards responsive and contextually relevant curricula. Such transformation and renewal processes hold significant implications for those educators responsible for implementing the curriculum. Currently little is known about how health professions educators across disciplines understand a responsive curriculum and how this understanding might influence their practice. We looked at curricula that aim to deliver future health care professionals who are not only clinically competent but also critically conscious of the contexts in which they serve and the health care systems within which they practice. We conducted a qualitative study across six institutions in South Africa, using focus group discussions and in-depth individual interviews to explore (i) how do health professions educators understand the principles that underpin their health professions education curriculum; and (ii) how do these understandings of health professions educators shape their teaching practices? The transcripts were analysed thematically following multiple iterations of critical engagement to identify patterns of meaning across the entire dataset. The results reflected a range of understandings related to knowing, doing, and being and becoming; and a range of teaching practices that are explicit, intentionally designed, take learning to the community, embrace a holistic approach, encourage safe dialogic encounters, and foster reflective practice through a complex manner of interacting. This study contributes to the literature on health professions education as a force for social justice. It highlights the implications of transformative curriculum renewal and offers insights on how health professions educators embrace notions of social responsiveness and health equity to engage with these underlying principles within their teaching.

Factors associated with team sport participation in South African children.

The study purpose was to determine if sex, anthropometry, age or birth period are associated with team sport participation in children aged 9-11 years. Data from the International Study of Childhood Obesity, Lifestyle and the Environment were used (n=550, 59% girls). Anthropometric measurements included height, body mass, waist circumference, mid-upper arm circumference and body fat percentage. Birth period and team sport participation were measured using a questionnaire. Girls had a 69% lower odds (OR=0.31, 0.19-0.49, p<0.001, n=528) of participating in team sport. For every centimetre of waist circumference, the OR for participating in team sport was 0.94 (0.88-1.00, p<0.05, n=528).

Addressing change in physiotherapy education in South Africa.

BACKGROUND: Recent demands for the decolonisation of curriculum in South Africa present challenges to students, academics and other stakeholders. This resulted in tensions in tertiary institutions, cumulating in student-led protests. The authors hypothesised that the lack of shared understanding of what this unexplored process may entail contributed to the dilemma. OBJECTIVE: The aim of this opinion article is to highlight some of the possible contributors to the uncertainties in addressing this critical issue, especially as it relates to the demands for change in physiotherapy education. METHOD: To formulate our opinion, the authors reviewed literature relating to transformation in education in South Africa generally, and physiotherapy education specifically. RESULTS: While there is an opportunity to address the demand for change in physiotherapy education in South Africa, there is the possibility that the use of words, such as transformation, decolonisation and decoloniality, present different connotations to students and academics. CONCLUSION: It is of vital importance to create formal discourse which includes students, academics and other stakeholders that will facilitate shared understanding about what the previously unexplored and unmapped processes of engagement entail. The change process in physiotherapy education is envisaged to be a partnership between students and academic staff having common understanding about the processes and responsibilities, and must be addressed comprehensively. CLINICAL IMPLICATIONS: Aligning the change process in physiotherapy education with the decolonisation agenda will strengthen the South African health care system by ensuring that physiotherapy students are adequately prepared to provide service to patients within a context that acknowledges the uniqueness of South African communities.

Health Promotion in a Low-income Primary School: Children with and Without DCD Benefit, but Differently.

UNLABELLED: Poor motor performance and reduced physical fitness are characteristic of children with Developmental Coordination Disorder (DCD). These features have also been identified more frequently among children living in low socio-economic circumstances. AIMS: To evaluate the outcomes of a nine-week health promotion program (HPP) on the motor performance and fitness levels of children (6-10 years) with and without DCD attending a low-income primary school. METHODS: The HPP was designed and implemented by undergraduate physiotherapy students using guidelines from the World Health Organization School Health Initiative and their physiotherapy curriculum. Children with DCD (n = 22) and a control group without DCD (n = 19) participated in the evaluation. Motor skill, functional strength, aerobic capacity, and anaerobic power were measured at baseline and after nine weeks. RESULTS: Both groups of children improved on all measures at the conclusion of the HPP. Children with DCD showed greater improvement than the control group in motor performance and the control group showed greater improvement on one of the anaerobic fitness outcomes. CONCLUSIONS: A school-based HPP that focuses on increasing opportunities for physical activity may be effective in improving motor performance in children with DCD and can increase fitness levels in general.