Musculoskeletal Symptoms among Family Caregivers of Community-Dwelling Stroke Survivors in Nigeria.

Introduction: Caring for stroke survivors may be burdensome with adverse consequences on caregivers' physical health. This study examined the prevalence of musculoskeletal symptoms and associated factors among family caregivers of stroke survivors in Nigeria. Methods: A hospital-based cross-sectional study involving 90 stroke caregiver and stroke survivor dyads was conducted. Data on the participants' demographics and post-stroke duration were obtained. Seven-day prevalence of musculoskeletal symptoms among the caregivers and level of stroke survivors' disability were respectively assessed using the Nordic Musculoskeletal Questionnaire and Modified Rankin Scale. Prevalence of musculoskeletal symptoms was presented as percentages while participants' characteristics associated with prevalence of musculoskeletal symptoms were examined using inferential statistics. Results: Mean (SD) age of caregivers and stroke survivors was 33.2 (10.7) years and 58.9 (9.7) years respectively. Majority of the caregivers were females (61.1%), and children of the stroke survivors (58.9%). Prevalence of musculoskeletal symptoms was 82.2%. The low back was the most affected body region (72.2%) followed by the upper back (40%) while musculoskeletal symptoms in the wrist was least prevalent (3.3%). Female caregivers, caregivers of female stroke survivors and spousal caregivers had significantly higher prevalence of musculoskeletal symptoms compared to other categories of caregivers. Only 5 (5.6%) caregivers had however received any training on safe care giving methods while only 21 (28.4%) caregivers with musculoskeletal symptoms had received treatment. Conclusion: With the high prevalence of musculoskeletal symptoms among family caregivers of stroke survivors, effective preventive strategies including training and education as well as timely access to treatment would be required.

Diagnostic reference levels for common computed tomography (CT) examinations: results from the first Nigerian nationwide dose survey.

PURPOSE: To explore doses from common adult computed tomography (CT) examinations and propose national diagnostic reference levels (nDRLs) for Nigeria. MATERIALS AND METHODS: This retrospective study was approved by the Nnamdi Azikiwe University and University Teaching Hospital Institutional Review Boards (IRB: NAUTH/CS/66/Vol8/84) and involved dose surveys of adult CT examinations across the six geographical regions of Nigeria and Abuja from January 2016 to August 2017. Dose data of adult head, chest and abdomen/pelvis CT examinations were extracted from patient folders. The median, 75th and 25th percentile CT dose index volume (CTDIvol) and dose-length-product (DLP) were computed for each of these procedures. Effective doses (E) for these examinations were estimated using the k conversion factor as described in the ICRP publication 103 (EDLP = k × DLP). RESULTS: The proposed 75th percentile CTDIvol for head, chest, and abdomen/pelvis are 61 mGy, 17 mGy, and 20 mGy, respectively. The corresponding DLPs are 1310 mGy.cm, 735 mGy.cm, and 1486 mGy.cm respectively. The effective doses were 2.75 mSv (head), 10.29 mSv (chest), and 22.29 mSv (abdomen/pelvis). CONCLUSION: Findings demonstrate wide dose variations within and across centres in Nigeria. The results also show CTDIvol comparable to international standards, but considerably higher DLP and effective doses.

Caregiving Appraisal by Family Caregivers of Stroke Survivors in Nigeria.

Introduction: Attending to caregiving experiences of family caregivers of stroke survivors is important in person-centered stroke rehabilitation. This study explored caregiving appraisals by family caregivers of stroke survivors in Nigeria. Methods: A cross-sectional survey of family caregivers' negative and positive appraisals of caregiving was conducted using the 24-item 4-domain revised Caregiving Appraisal Scale (rCAS). Mann Whitney U and Kruskal-Wallis tests were used to identify differences in caregiving appraisals based on specific caregiver and stroke survivor variables. Results: Seventy-three caregiver and care recipient dyads participated in the study. Mean age of the caregivers was 31.51 (9.82) years. From a score of 5, and higher scores depicting higher appraisal, mean (SD) score for caregiving satisfaction and caregiving mastery (positive appraisal domains) was 4.23 (0.97) and 4.04 (0.92) respectively while 2.29 (0.98) and 2.11 (0.93) were respectively recorded for caregiving burden and environmental impact (negative appraisal). Caregivers' gender, age, and employment status resulted in significantly different appraisals with female caregivers having higher caregiving mastery (U = 446, P<0.05), caregiving satisfaction (U = 384.5, P<0.01), and also caregiving burden (U = 382.5, P<0.01) compared to their male counterparts; while older (U = 330; P<0.05) and employed (U = 437.5, P<0.05) family caregivers reported higher caregiving satisfaction and burden respectively than younger and unemployed family caregivers. Conclusion: Given the comparatively higher positive caregiving appraisal, and the documented benefits of positive caregiving appraisal, efforts should be geared towards identifying effective means of reinforcing positive appraisal, and reducing negative stroke caregiving appraisal, especially for female, older and employed family caregivers.

Impact of social support on participation after stroke in Nigeria.

BACKGROUND: Participation which entails involvement in life situations and represents a higher level of functioning can be severely restricted after a stroke. This study investigated the impact of social support on participation of stroke survivors in Nigeria. METHODS: Ninety-six community-residing stroke survivors were recruited from physiotherapy outpatient departments of two tertiary care hospitals in Northern Nigeria. Socio-demographic, clinical, participation (London Handicap Scale), and social support (Multidimensional Scale of Perceived Social Support) data were obtained. The impact of social support on global and domain-specific participation was examined using bivariate analyses and multiple regression analyses. RESULTS: Mean (SD) age of the stroke survivors was 56.6 (12.0) years. Social support was a significant (ß = 0.41, p < 0.0001) and independent determinant of the economic self-sufficiency domain of participation (p < 0.0001) in a regression model that accounted for 27% of the variance in the domain (R(2) = 0.27). Social support, however, had no independent effect on overall participation and the other participation domains namely mobility, physical independence, occupation, social integration, and orientation. CONCLUSION: The impact of social support was significant only in the economic self-sufficiency domain of participation with higher availability of social support related to better economic self-sufficiency. This finding provides additional information on the importance of social support post-stroke.

Prevalence of Low Back Pain among Undergraduate Physiotherapy Students in Nigeria.

Background. Low back pain (LBP) is a major cause of disability and the most common work-related musculoskeletal disorder among physiotherapists. This study examined the prevalence of low back pain among students undergoing training to become physiotherapists. Methods. Participants were 207 undergraduate clinical physiotherapy students at three universities in Nigeria. A modified version of a questionnaire used in a previous study was utilized to obtain demographic, educational activities, and LBP data. Prevalence of LBP was examined with descriptive statistics while factors associated with prevalence were explored using chi-square statistics. Results. More male students (53.1%) and those in the penultimate year of study (53.1%) participated in the study. Lifetime, 12-month, 1-month, and 7-day prevalence of LBP were 45.5%, 32.5%, 17.7%, and 11.5%, respectively. Prevalence of LBP was not significantly associated with any of the demographic variables. Educational activities, namely, "having techniques practiced on self for ≤10 hours" and "treating patients for ≥30 hours," a month prior to the study were significantly (P < 0.05) associated with higher 1-month and 7-day LBP prevalence, respectively. Conclusions. Although the prevalence of LBP was comparatively low, its association with educational activities emphasizes the need to incorporate effective LBP preventive strategies in the training of physiotherapy students.