DSpace Collection: Theses in Physiotherapy

EFFECTS OF McKENZIE AND LUMBAR STABILISATION PROTOCOLS ON SEXUAL DYSFUNCTION IN PATIENTS WITH CHRONIC MECHANICAL LOW BACK PAIN

2019-04-18T10:24:08Z

Title: EFFECTS OF McKENZIE AND LUMBAR STABILISATION PROTOCOLS ON SEXUAL DYSFUNCTION IN PATIENTS WITH CHRONIC MECHANICAL LOW BACK PAIN Authors: ADERIBIGBE, O. I. Abstract: Chronic Mechanical Low Back Pain (CMLBP) has been associated with sexual dysfunction (SD). This problem is often not included in the management of individuals with CMLBP. McKenzie and Lumbar stabilisation are well established protocols for managing LBP. However, effects on SD have not been well elucidated. This study was designed to investigate the comparative effects of McKenzie and Lumbar stabilisation protocols on SD in patients with CMLBP. The quasi-experimental study involved 61 (males=23, females=38) individuals with CMLBP and associated SD consecutively recruited from the orthopaedic and general outpatient clinics. University of Ilorin Teaching Hospital. Participants were randomly assigned to either McKenzie Protocol Group (MPG; males=11; females=20) or Lumbar Stabilisation Protocol Group (LSPG; males=12; females=18). The MPG received McKenzie exercises (extension in prone lying, standing and side gliding exercises). The LSPG received lumbar stabilisation exercises (isometric co-contraction in prone lying, crook lying, kneeling, sitting positions, closed and open chain kinetic exercises). Both groups received treatment twice weekly for eight consecutive weeks. Sexual function questionnaire was used to assess sexual variables in females; (Sexual Desire female [SDf], Lubrication, Orgasm, Sexual Satisfaction [SSf] and SD Total female [SDTf]) and males; (Sexual Desire ma1e [SDm], Erectile Dysfunction [ED], Ejaculation [Ej], Sexual Satisfaction [SSm] and SD Total male [SDTm]. Participants were assessed at baseline, 4th and 8th week of the study. Reduction from baseline scores signifies improvement in sexual dysfunction. Data were analysed using descriptive statistics and Student t - test at ex. 0.05. The ages of MPG (49.3±12.8 years) and LSPG (52.3± 10.5 years) were comparable. At baseline, sexual variables were comparable in MPG and LSPG. In Females SDf (4.30±0.7 vs 4.5±0.8); SSf (7.9±1.6 vs 8.12±1.3); Lubrication (9.3±2.2 vs 9.7±2.7); Orgasm (11.6±2.4 vs 11.8±2.1); SDTf (33.1±5.6 vs 34.1± 5.6); and for Males: SDm (3.6±1.3 vs 4.08±0.8); SSm (7.3±1.7 VS 7.46±1.3); ED (7.2±1.2 VS 7.5±2.2); Ej (7.7±2.2 VS 6.7±2.4); SDTm (25.7±3.9 VS 26.8±6.0) for MPG and LSPG respectively. At week four sexual variables were comparable in MPG and LSPG respectively: for Females SDf (3.7±0.8 vs 3.3±1.0); SSf (7.3±1.9 vs 8.4±7.0); Lubrication (8.0±2.2 vs 7.00±2.1); Orgasm (1.4±1.7 vs 10.1±1.8); SDTf (29.4±5.3 vs 28.8±9.0); for Males: SDm (2.9±1.1 vs 3.2± 1.0); SSm (6.0± 1.6 vs 5.6± 1.1); ED (6.1 ±1.0 vs 5.8±1.7; Ej (7.3±2.2 vs 6.0± 1.3) for MPG and LSPG. At week 8, LSPG had significant greater reduction in sexual dysfunction than MPG in SDf and SSf in females: SDf (3.4±0.8 vs 2.3± 1.2); SSf (6.2± 1.5 vs 5.1 ±1.2) respectively. However, MPG and LSPG had comparable effects on Lubrication; Orgasm and SDTf at week eight: Lubrication (6.7± 1.5 vs 6.3±2.0); Orgasm (9.6± 1.5 vs 9.0± 1.8) and SDTf (25.9±4.3 vs 22.8±5.8) for females. In Males, LSPG had a significant greater reduction in all the sexual variables than MPG at week 8, SDm (2.90± 1.0 vs 2.2±0.7); SSm (5.9±1.1 vs 4.3±0.8); ED (6. 1±1.2 vs 4.6± 1.1); Ej (7.3±1.9 vs 5.0±1.1); and SDTm (22.2±3.5 vs 15.9±3.5) respectively. This study observed that Lumbar stabilisation protocol resulted in greater improvement than McKenzie protocol in sexual dysfunction, sexual desire, sexual satisfaction and erectile dysfunction in patients with chronic mechanical low back pain. Description: A Ph,D thesis in the department of Physiotherapy. Faculty of Clinical Science, College of Medicine, University of Ibadan.

EFFECTS OF BANEF MODEL-BASED PERSONAL PROTECRIVE EQUIPMENT EDUCATION PROGRAMME ON KNOWLEDGE ATTITUDE AND PRACTICE OF RESPIRATORY PROTECTION AMONG SAWMILL WORKERS IN IBADAN

2019-03-19T13:47:47Z

Title: EFFECTS OF BANEF MODEL-BASED PERSONAL PROTECRIVE EQUIPMENT EDUCATION PROGRAMME ON KNOWLEDGE ATTITUDE AND PRACTICE OF RESPIRATORY PROTECTION AMONG SAWMILL WORKERS IN IBADAN Authors: JAIYESIMI, A.O Abstract: Sawmill Workers (SW) are exposed to occupational hazardsthat may impact on their respiratory health. They have been reported to have poor knowledge on occupational hazards, safety measures andpractices. The Belief, Attitude, Subjective Norms and Enabling Factors (BASNEF) model of Health Education had been used to improve workers knowledge, attitude and safety practices in other countries. However, its effects on sawmill workers in Nigeria have not been adequately reported. This study investigated the effects of BASNEF model-based personal protective equipment education programme on the knowledge, attitude and practice (KAP) of respiratory protection among sawmill workers in Ibadan. The respiratory health of these workers was also assessed. Four hundred SW recruited consecutively from four randomly selected sawmills in Ibadan metropolis and 400 NSW (controls) participated in the study’s cross-sectional survey phase. The second phase was a two-group quasi-experimental pre-test-post-test study with the sawmills randomly divided into two training and two non-training centres using the fish-bowl method. Forty-five participantseach were randomly selected from the training centres (Training Group, TG) and non-training centres (Non-Training Group, NTG). Outcomes assessed were KAPusing Personal Protective Equipment Knowledge, Attitude and Practice Questionnaire (PPE-KAPQ), LFI – forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow rate (PEFR) and FEV1/FVC%) using the Micro Medical spirometer and respiratory health using the Respiratory Health Questionnaire (RHQ). The PPE-KAPQ was administered to both TG and NTG pre and four weeks post-intervention. Knowledge scores were classified as high (13-16), moderate (10-12) or low (00-09), attitude scores as positive (26-32), neutral (19-25) or negative (00-18) and practice scores as good (> 7), fair (3 – 7) or poor (<3). The TG received a 6-session health education intervention utilising the Basic Training Course in Personal Breathing Protection materials using the BASNEF concept.Data were analyzed using descriptive statistics, independent and paired t-test, Chi square and Pearson and Spearman correlation at α0.05. The SW and NSW were comparable in age (38.77±11.11 vs37.35±10.94yrs) and weight (65.82±12.10vs65.78±9.55kg) but the NSW were significantlytaller (1.69±0.11vs1.63±0.08m). The SW had mean knowledge, attitude and practice scores of 65.4±14.4%, 61.6±11.9% and 15.6±22.8% respectively. The TG and NTG pre-training knowledge (62.9±16.0 vs 63.2±14.4%), attitude (60.3±12.8 vs 62.0±12.0%), and practice (15.3±17.9 vs 14.7±16.7%) scores respectively were comparable. The 28.5%, 23.4% and 76.0% improvements in knowledge (62.9±16.0 vs 91.4±3.6%), attitude (60.3±12.8vs 83.7±8.4%) and practice (15.3 vs 91.3±9.7%) scores respectively for the TG were significantly higher than 2.2%, 0.9% and 2.2% for the NTG. The SW had significantly lower LFI than the NSW – FVC (2.52±0.60Lvs3.35±0.70L), FEV1, (1.73±0.49Lvs2.64±0.60L), FEV1/FVC (0.69±0.10 vs0.79±0.06), PEFR (270.77±91.02L/min vs402.43±94.18L/min). Sawmill workers in Ibadan had poorer respiratory health profile than non-sawmill workers. The Belief, Attitude, Subjective Norms and Enabling Factors model-based personal protective equipment education programme was effective in improving knowledge, attitude and practice of respiratory protection among the sawmill workers. It is recommended for the training of workers who are exposed to wood dust on occupational hazard and safety practices. Description: A Ph.D thesis in the department of Physiotherapy, faculty of clinical sciences, college of medicine, University of Ibadan

EFFECTS OF A TWELVE-WEEK ARM ERGOMETRY TRAINING ON SELECTED HEALTH INDICES OF LOWER LIMB PARALYTIC POLIOMYELITIS SURVIVORS

2019-04-30T12:25:09Z

Title: EFFECTS OF A TWELVE-WEEK ARM ERGOMETRY TRAINING ON SELECTED HEALTH INDICES OF LOWER LIMB PARALYTIC POLIOMYELITIS SURVIVORS Authors: ATOWOJU, A. A. Abstract: Reduced mobility consequent to motor paralysis is associated with Secondary Health Conditions (SHC) among Lower Limb Paralytic Poliomyelitis Survivors (LLPPS). Arm ergometry, an effective aerobic exercise, can be used to improve the overall health of LLPPS with SHC, but no clinical trial has comprehensively and concurrently assessed its potential benefit in this population using a Randomised Clinical Trial (RCT) design. The study investigated the effects of a twelve-week arm ergometry training on selected health indices or LLPPS with SHC. The RCT involved 60 LLPPS from eleven local government centres in Ibadan, Oyo State. They were randomly selected from the 252 who had SHC as determined using Tate SHC Questionnaire in a Cross-Sectional Survey. Participants were randomly assigned into Exercise Group (EG) and Control Group (CG). The EG received thrice-weekly arm ergometry training for twelve consecutive weeks in addition to flexibility exercises which was received by the CG. Participants' Resting Heart Rate (RHR), Resting Systolic Blood Pressure (RSBP), Resting Diastolic Blood Pressure (RDBP), Percent Body Fat (PBF), and Body Mass Index (BMI) were assessed using standard methods, while Cardio -Respiratory Fitness was assessed using Six-Minute Walk Test (6-MWT). The General Health Status (GHS), Quality of Life ( QoL) and Depressive Symptoms (DS) were assessed using Dartmouth COOP Health Chart (higher scores indicate reduced activity), Ferrans and Powers QoL measure and Beck Depression Inventory respectively. Assessments were carried out at baseline and end of 4TH 8th and 12th weeks. Data were analysed using ANOVA independent t- test and Mann Whitney-U at p = 0.05. Twenty eight participants in EG (15 males, 13 females) and 26 in CG(11 males, 15 females) completed the study. Twenty six participants had bilateral, while 28 had unilateral lower limb affectation. Twelve were independently ambulant while 42 used assistive devices. Most participants were unmarried and had only secondary school education. They were predominantly traders and artisans with average monthly income of 4,556 naira. The mean ages of EG (38.43±6.97) and CG (38.08 ±5.75 years) were not significantly different. The common SHC observed were hypertension, depression, obesity, back pain and spinal deformities. At baseline, the health indices of EG and CG were not significantly different. At twelfth week, CG had significantly higher R SBP (126.69 ±7.18 vs 121.50 ± 6.29) and PBF (30.52±6.01 vs 23.43±11.24) than the EG respectively. The CG had significantly higher scores than EG in daily activities (at 4th/8th, 0/8th, 4th/12th and 0/12th weeks) and social activities (at week 8th/ 12TH) domains of GHS, Groups were not significantly different in QoL, and DS. Within-group comparison showed significant decreases in EG's RHR (F=I6.33), RSBP (F= 8.99), RDBP (F=14.37), PBF (F=20.78). DS (Xr2= 19.61) and increases in 6-MWT (F=33.45) and QoL (xr²=23.53). CG had significant increase in PBF (F= 20.78) and decrease in pain (xr²13.67) and Feelings (xr²=8.01) domains of GHS. No gender variation was observed in all the variables. Twelve-week arm ergometry training improved the health indices of lower limb paralytic poliomyelitis survivors with secondary health conditions. Arm ergometry should be incorporated into the rehabilitation programme of these individuals. Description: A Thesis in the Department of Physiotherapy, submitted to the Postgraduate School,University of Ibadan in partial fulfillment of the requirements for the Degree of Doctor of Philosophy (Physiotherapy) of the University of Ibadan, Ibadan, Nigeria

COMPARATIVE EFFECTS OF HIGH AND LOW FREQUENCY TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION ON UPPER LIMB SPASTICITY, HAND DEXTERITY AND FUNCTIONAL INDEPENDENCE IN STROKE SURVIVORS

2019-04-30T12:26:55Z

Title: COMPARATIVE EFFECTS OF HIGH AND LOW FREQUENCY TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION ON UPPER LIMB SPASTICITY, HAND DEXTERITY AND FUNCTIONAL INDEPENDENCE IN STROKE SURVIVORS Authors: OLUWATOSIN, U. I. Abstract: Upper limb spasticity and poor hand dexterity may affect functional independence in stroke survivors. High or low frequency Transcutaneous Electrical Nerve Stimulation (TENS) can be used in rehabilitating hand function after stroke, but it is not clear which is more effective. This study was carried out to compare the effects of high and low frequency TENS on upper limb spasticity and hand dexterity in stroke survivors. Interrelationships among functional independence, upper limb spasticity and hand dexterity were also investigated. This quasi-experimental study involved 49 consenting stroke survivors recruited from the outpatient Physiotherapy clinics of Federal Medical Centre, Umuahia and University of Port-Harcourt Teaching Hospital, Nigeria. Participants were consecutively assigned to either Low Frequency TENS Group (LFTG; n=24) or High Frequency TENS Group (HFTG; n=25). However, 18 and 20 participants in the LFTG and HFTG, respectively completed the six-week treatment period. The Low frequency TENS and high frequency TENS were applied to the wrist flexors in both groups. Participants also received conventional physiotherapy for stroke. Outcomes assessed at baseline, 2nd, 4th, and 6th week included: spasticity using Modified Ashworth Scale, functional independence using Functional Independence Measure, hand dexterity using Jebsen Hand Function Test. Data were analysed using descriptive statistics, Spearman correlation coefficient. Wilcoxon signed rank and Kruskal-Wallis test at p=0.05. At baseline, there was no significant difference in duration of stroke, hand dexterity, functional independence and spasticity between the two groups. The pre-treatment spasticity at each session were not different between LFTG and HFTG across the six weeks. The post-treatment spasticity for the LFTG compared with HFTG for 2nd week (3.2 ± 0.8 vs 2.6 ± 0.6), 4th week (3.1±0.5 vs 2.7±0.6) and 6th week (3.1±0.6 vs 2.6±0.6) were significantly different, respectively. Spasticity significantly reduced in the HFTG pre-treatment to post-treatment from (3.2±0.6 to 2.8±0.6) at baseline, from (3.1±0.6 to 2.7±0.7) at 2nd week from (3.1±0.6 vs 2.7±0.5) at 4th week and from (3.1±0.6 to 2.6±0.6) at 6th week. There were no significant differences in hand dexterity and functional independence between LFTG and HFTG over the treatment period. However, significant within-group changes were observed between pre and post intervention scores for hand dexterity (LFTG: 16.4±2.5 vs 15.3±2.8) and (HFTG: 16.3±3.2 vs 15.3±3.2), and functional independence, (LFTG: 84.7±18.7 vs 86.6±17.6) and (82.2±20.1 vs 86.2±18.6) respectively. Only hand dexterity was significantly correlated to functional independence (r=- 0.4) in this study. High and low frequency transcutaneous electrical nerve stimulation exerted similar effects on hand dexterity and functional independence. However, high frequency stimulation reduced spasticity better than the low frequency transcutaneous electrical nerve stimulation. Either of the two can be used in the management of hand dexterity and functional independence in stroke survivors. Description: A Thesis in the Department of Physiotherapy, submitted to the Faculty of Clinical Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Neurological Physiotherapy) of the University of Ibadan