RESUMEN
Introduction: Low back pain (LBP) is a significant musculoskeletal problem during pregnancy with potential to negatively affect the woman's quality of life. Data on LBP among pregnant women in Malawi is almost non-existent. We investigated the prevalence and risk factors of LBP and its association with functional activities in pregnant women in Malawi. Methods: We conducted a cross-sectional study in Blantyre, Malawi, from December 2017 to January 2018. Participants were drawn from low-risk antenatal clinics in selected local health facilities. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages. The association between occurrence of LBP and selected factors was assessed using the Chi-Square test (X2) (α=5%) followed by a multiple logistic regression. Odds ratios (OR) and their 95% confidence intervals were calculated. Results: We interviewed 404 pregnant women; the mean age of respondents was 25.83 years old (SD: ±5.91). Prevalence of LBP in pregnancy was 62% (n=249); 172 (69%) of these reported LBP for the first time during the current pregnancy. Gestational age was significantly associated with presence of LBP (P= 0.03). LBP was associated with the women's sleep patterns, mobility, lifting techniques and sexual activities. However, a reasonable high proportion of those with LBP (34%) did not seek care for their low back pain. Conclusion: LBP is highly prevalent and an important clinical condition among pregnant women in Blantyre, Malawi. Given the significant effect of LBP on quality of life, health workers need to be proactive in identifying LBP and provide the appropriate management.
Asunto(s)
Dolor de la Región Lumbar/diagnóstico , Complicaciones del Embarazo/diagnóstico , Calidad de Vida , Actividades Cotidianas , Adaptación Psicológica , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/etiología , Dolor de la Región Lumbar/psicología , Malaui/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: There is a paucity of data on effects of motor-level stimulation using Transcutaneous Electrical Nerve Stimulator (TENS) on ipsilateral quadriceps femoris group of muscles. The effect is also unknown on the untrained contralateral quadriceps femoris. The primary purpose of this study was to determine the effect of TENS on quadriceps muscle strength at the stimulated ipsilateral and un-stimulated contra-lateral extremities. METHODS: Participants were 50 apparently healthy undergraduate. They were recruited using sample of convenience. The right quadriceps group of muscles were stimulated for 15 minutes twice a week for 8 weeks using motor-level stimulation parameters (frequency of 85 Hz and pulse width of 100 microseconds) while the left lower limbs (control) were not stimulated. The right and left quadriceps muscle strengths were quantified using tensiometer; at onset and after 8 weeks. The data were analysed using the descriptive and inferential statistics (paired t-test and ANOVA). Alpha level was set at 0.05. RESULTS: The initial and final left strengths of the un-stimulated quadriceps muscles were 311.46 ± 58.84N and 395.60 ± 100.71N at onset and after 8 weeks respectively. After 8 weeks the un-stimulated left quadriceps strength was significantly greater than the initial value (t=-7.63, p < 0.001). Similarly, the initial and final right quadriceps strength (stimulated limb) were 351.51 ± 117.68N and 471.31 ± 112.19N; at onset and after 8 weeks respectively. The post stimulation strength of the right quadriceps was also significantly higher than the pre-intervention strength (t=-10.25, p < 0.001). However, the increment in quadriceps strength between right and left extremities after 8 weeks was insignificant (t =-1.35, p=0.18). There was also significant increase in the girth of the right quadriceps (t= -6.08, p=0.001) after 8 weeks. CONCLUSION: We concluded that there were increments in both strength and muscle size of the stimulated right quadriceps using motor level stimulation parameters of TENS modality. The un-stimulated contralateral quadriceps strength also increased after 8 weeks. This implied that there was cross-training effect at the contralateral quadriceps group of muscles.