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BACKGROUND: Self-efficacy has been defined as "people's beliefs about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives." In stroke survivors, impairments in motor, sensory/perceptual, and cognitive functions greatly reduce self-efficacy. AIM: To translate and cross-culturally adapt the Stroke Self-Efficacy Questionnaire (SSEQ) into Hausa language. METHOD: Two independent experts who are fluent in Hausa and English languages did the forward and backward translations, respectively. A group of experts reviewed the translation according to Beaton's guidelines. The English and the final Hausa versions were administered to 75 patients with stroke once and twice, respectively (on the first day and a week later). Construct validity between the English and the Hausa version, and internal consistency and structural validity of the Hausa version were assessed using Spearman's correlation coefficient, kappa statistics, and Rasch analysis, respectively. RESULTS: There was a significant correlation (r = 0.96, p < .001) between the Hausa version of the SSEQ and the original English version. The scale also demonstrated an excellent test-retest reliability (r = 0.99, p < .001) on two different administrations. The Hausa version also demonstrated an excellent internal consistency on two different administrations, Cronbach alpha, 0.99. Similarly, the two versions were found to be perfect fit, having the same measure of construct [infit and outfit mean-square (MNSQ) and standardized (ZSTD) fit statistics values for the Hausa version and the English version of SSEQ were (1.00, Z = -0.2)]. CONCLUSION: Hausa version of SSEQ is valid and reliable at assessing self-efficacy among Hausa-speaking stroke survivors.

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OBJECTIVES: Stroke is a leading cause of disability and one of the most debilitating conditions especially in the developing world. Rehabilitation focuses on improving functional ability which may enhance quality of life (QoL). The aims of this study were to investigate the association between QoL and each of functional independence (FI), self-reported fatigue (SRF) and exercise self-efficacy (ESE) in stroke survivors. METHODS: This is a descriptive cross-sectional survey, documenting QoL, FI, SRF and ESE of stroke survivors seen at the physiotherapy outpatient clinics of two health care facilities in Oyo state, Nigeria. Descriptive and inferential statistics were used to analyse the data with significance level set at 0.05. RESULTS: Participants were 110 stroke survivors (64 males; 46 females) aged 60.9 ± 11.9 years. Significant associations were found between QoL and each of FI and ESE (p < 0.01) while no significant association was observed for SRF. FI strongly predicts good QoL in stroke survivors (OR = 16.34; p < 0.01) and high ESE is a determinant of QoL (OR = 6.46; p = 0.04). Stroke survivors with SRF were less likely to report good QoL. DISCUSSION: Functional independence and exercise self-efficacy were directly associated with QoL and were also major predictors of good QoL in stroke survivors.

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BACKGROUND: Telerehabilitation can facilitate multidisciplinary management for people with nonspecific chronic low back pain (NCLBP). It provides health care access to individuals who are physically and economically disadvantaged. OBJECTIVE: This study aimed to evaluate the clinical and cost-effectiveness of telerehabilitation compared with a clinic-based intervention for people with NCLBP in Nigeria. METHODS: A cost-utility analysis alongside a randomized controlled trial from a health care perspective was conducted. Patients with NCLBP were assigned to either telerehabilitation-based McKenzie therapy (TBMT) or clinic-based McKenzie therapy (CBMT). Interventions were carried out 3 times weekly for a period of 8 weeks. Patients' level of disability was measured using the Oswestry Disability Index (ODI) at baseline, week 4, and week 8. To estimate the health-related quality of life of the patients, the ODI was mapped to the short-form six dimensions instrument to generate quality-adjusted life years (QALYs). Health care resource use and costs were assessed based on the McKenzie extension protocol in Nigeria in 2019. Descriptive and inferential data analyses were also performed to assess the clinical effectiveness of the interventions. Bootstrapping was conducted to generate the point estimate of the incremental cost-effectiveness ratio (ICER). RESULTS: A total of 47 patients (TBMT, n=21 and CBMT, n=26), with a mean age of 47 (SD 11.6) years for telerehabilitation and 50 (SD 10.7) years for the clinic-based intervention, participated in this study. The mean cost estimates of TBMT and CBMT interventions per person were 22,200 naira (US $61.7) and 38,200 naira (US $106), respectively. QALY gained was 0.085 for TBMT and 0.084 for CBMT. The TBMT arm was associated with an additional 0.001 QALY (95% CI 0.001 to 0.002) per participant compared with the CBMT arm. Thus, the ICER showed that the TBMT arm was less costly and more effective than the CBMT arm. CONCLUSIONS: The findings of the study suggested that telerehabilitation for people with NCLBP was cost saving. Given the small number of participants in this study, further examination of effects and costs of the interventions is needed within a larger sample size. In addition, future studies are required to assess the cost-effectiveness of this intervention in the long term from the patient and societal perspective.

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Background: There is emerging evidence that Guillain-Barré syndrome (GBS) may be associated with coronavirus disease 2019 (COVID-19) infection. The aim of this review was to investigate the strength of the evidence. Method: The review was registered in PROSPERO (CDR42020184822). Three electronic databases, MEDLINE, PubMed, and Web of Science, and three preprint servers, MedRvix, ChemRvix, and BioRvix, were searched from December 2019 to 24th September 2020. Studies were included if they were on COVID-19 and of any design. Articles that are reviews or opinion were excluded. The selection process was carried out using EndNote and Rayyan software. The main outcomes in the study were study design, sample size, sex, age, overall GBS symptoms, other COVID-19 symptoms, comorbidity, timing between infection and the onset of neurological symptoms, CT, MRI, and EMG results. Methodological quality of the studies was assessed using the McMaster Critical Review Form. The collected data was analyzed using qualitative synthesis. Findings: Fifty-one high-quality studies (mostly) consisting of 83 patients were included in the study. All of the patients (except in a very few) in the included studies had confirmed diagnosis of COVID-19. Similarly, the diagnosis of GBS was based on standard clinical, electrophysiological, and cerebrospinal fluid (CSF) criteria. Conclusion: GBS may be associated with COVID-19, and therefore, testing for COVID-19 is recommended in patients presenting with GBS during this pandemic.

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Studies on validation of telerehabilitation as an effective platform to help manage as well as reduce burden of care for Low-Back Pain (LBP) are sparse. This study compared the effects of Telerehabilitation-Based McKenzie Therapy (TBMT) and Clinic-Based McKenzie Therapy (CBMT) among patients with LBP. Forty-seven consenting patients with chronic LBP who demonstrated 'directional preference' for McKenzie Extension Protocol (MEP) completed this quasi experimental study. The participants were assigned into either the CBMT or TBMT group using block permuted randomization. Participants in the CBMT and TBMT groups received MEP involving a specific sequence of lumbosacral repeated movements in extension aimed to centralize, decrease, or abolish symptoms, thrice weekly for eight weeks. TBMT is a comparable version of CBMT performed in the home with the assistance of a mobile phone app. Outcomes were assessed at the 4th and 8th weeks of the study in terms of Pain Intensity (PI), Back Extensors Muscles' Endurance (BEME), Activity Limitation (AL), Participation Restriction (PR), and General Health Status (GHS). Data were analyzed using descriptive and inferential statistics. Alpha level was set at p< 0.05. Within-group comparison across baseline, 4th and 8th weeks indicate that both CBMT and TBMT had significant effects on PI (p=0.001), BEME (p=0.001), AL (p=0.001), PR (p=0.001) and GHS (p=0.001) respectively. However, there were no significant differences (p>0.05) in the treatment effects between TBMT and CBMT, except for 'vitality' (p=0.011) scale in the GHS where TBMT led to significantly higher mean score. Mobile-app platform of the McKenzie extension protocol has comparable clinical outcomes with the traditional clinic-based McKenzie Therapy, and thus is an effective supplementary platform for care of patients with low-back pain.

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Background. Engagement in physical exercise in pregnancy is hamstrung by safety concerns, skepticism about usefulness, and limited individualized prescription guidelines. This study assessed knowledge and attitude of pregnant women towards antenatal exercises (ANEx). Methods. The cross-sectional study recruited 189 pregnant women from six selected antenatal clinics in Ile-Ife, South-West, Nigeria. Data were obtained on maternal characteristics, knowledge, and attitude towards ANEx. Results. Relaxation and breathing (59.8%), back care (51.3%), and muscle strengthening (51.3%) exercises were the most commonly known ANEx. Prevention of back pain risk (75.9%) and excess weight gain (69.1%) were perceived as benefits, while lower extremities swelling (31.8%) and extreme weight gain or loss (30.7%) were considered as contraindications to ANEx. 15.8% of the respondents had negative attitude towards ANEx resulting from insufficient information on exercise (83.3%) and tiredness (70.0%). Age significantly influences knowledge about contraindications to ANEx (P = 0.001), while attitude was influenced by age and occupation, respectively (P < 0.05). There was significant association between attitude and knowledge about benefits and contraindications to ANEx (P < 0.05). Conclusion. A majority of Nigerian pregnant women demonstrated inadequate knowledge but had positive attitude towards ANEx. Knowledge about benefits and contraindications to ANEx significantly influenced the attitude towards exercise in pregnancy.