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Background: Pregnancy results in many changes, including reduced hand grip strength (HGS). However, good HGS is required for physical functions such as carrying and breastfeeding the baby after birth. The aim of this study was to determine the factors that may predict HGS during pregnancy., Methods: The study was a cross-sectional study approved by the Research Ethics Committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital in Kano, north-west, Nigeria. Pregnant women at the designated hospitals were included in the study if they had no serious comorbidities or any known neurological condition that affects the hands and the neck. Demographic characteristics and independent (predictor) variables (age, weight, height, BMI, maternity leave status, number of full-term deliveries, number of preterm deliveries, number of live births, number of abortuses, gravidity, trimester, systolic blood pressure, diastolic blood pressure, inter arm systolic BP difference [IASBP], inter arm diastolic BP difference [IADBP], and heart rate) of each of the participants were recorded by experienced therapists. The data were analysed using descriptive statistics, t-test, Pearson correlation coefficient and standard multiple regression., Result: One hundred and sixty-one pregnant women with mean age, 25.04 ± 4.83 years participated in the study. In the dominant hand, 120 participants (74.5%) had weak grip strength. In the non-dominant hand, 135 participants (83.9%) had weak grip strength. For the dominant hand, the total variance explained by the whole model was significant, 28.5%, F(11, 161) = 1.187, R 2  = 0.081, p = 0.300 . In the final model, none of the variables significantly predicted HGS. However, systolic blood pressure contributed to the model more than any other variable (Beta = -0.155). For the non-dominant hand, the total variance explained by the whole model was not significant, 33.1%, F(11, 161) = 1.675, R 2  = 0.111, p = 0.089 . In the final model, only systolic blood pressure (Beta = -0.254, p = 0.023) significantly predicted hand grip strength., Conclusion: Cardiovascular events or changes during pregnancy (such as change in systolic blood pressure) may be related to HGS in pregnant women. It is therefore, important for clinicians to pay attention to this, in planning rehabilitation strategies for pregnant women., (© 2021. The Author(s).)

Background: Post-fistula-repair incontinence (PFRI) is a common complication of vesicovaginal fistula (VVF) surgeries. It entails continuous leakage of urine after successful VVF closure. Pelvic Floor Muscle Training (PFMT) plays a vital role in the management of PFRI, however, an evolving exercise approach is the Paula Exercise Method (PEM) which has shown a promising effect in stopping urinary incontinence, but there is no data on its effect on PFRI. This study therefore, proposes to primarily investigate the effect of PEM on urine leakage and secondarily, pelvic floor strength (PFS), quality of life (QoL), sexual function (SF), and mental health (MH) in women with PFRI., Methods: This is a study protocol for a randomized controlled trial. A total of 182 participants are expected to participate in the study after satisfying the inclusion criteria. The participants will be randomized into either PEM or PFMT study groups. The demographic data of all the participants will be recorded. Each participant will be assessed for urine leakage, PFS, QoL, SF, and MH at baseline and subsequently, at four, eight and 12 weeks of intervention. Demographic parameters will be summarized using descriptive statistics. Continuous data will be computed for differences using inferential statistic of Analysis of variance, t-test and Man Whitney U as appropriate. All analyses will be performed using SPSS version 22.0 with probability set at 0.05 alpha level., Discussion: It is hoped that the outcome of this study will determine the effect of the Paula exercise method on urine leakage, pelvic floor strength, quality of life, sexual function, and mental health among women with post-fistula-repair incontinence and also provide evidence for the use of the Paula method in urinary incontinence., Trial Registration: Pan African Clinical Trials Registry ( www.pactr.org ), identifier PACTR201906515532827.

Introduction: Sleep disturbance (SD) could have negative impact on the general well-being of children with cerebral palsy (CWCP)., Objectives: The purpose of this study was to assess the prevalence of SD and its impact on quality of life and exercise participation among CWCP., Material and Methods: In the cross-sectional study, CWCP and their siblings were recruited from secondary and tertiary hospitals in Kano City. SD, gross motor function (GMF), spasticity and quality of life were assessed with SD scale, GMF classification system, modified Ashworth scale and pediatric quality of life inventory, respectively. Data was analyzed with Mann-Whitney U and chi-square tests, linear and hierarchical regressions using SPSS version 20.0., Results: There were 200 CWCP (aged 4.35±8.03 years) and 200 siblings (aged 5.89±3.06 years). The prevalence of SD in CWCP was 31.5%. CWCP suffered more SD than their siblings (p<0.001). SD in CWCP is influenced by GMF level (ß=0.378, p<0.001) and gender (ß=0.16, p<0.05). SD has negative influence on quality of life (ß=-0.18, p<0.001), active participation in home-based (ß=-0.23, p<0.000), and clinic-based exercises (ß=-0.24, p<0.00). GMF levels (ß=-0.505, p<0.0001), hamstring spasticity (ß=-0.250, p<0.005), and age (ß=-0.207, p<0.001) also have influenced on quality of life., Conclusion: One-third of the CWCP suffered pathologic SD, which has negative impact on their quality of life and the ability to actively participate in both home and clinic-based exercises. Aside SD, other factors such as child's age, spasticity level and severity of motor impairment also affected their quality of life negatively. Enhancing the motor abilities of CWCP may improve their quality of sleep and quality of life.

Background: Children with cerebral palsy require effective, accessible and affordable medical and rehabilitation care., Objective: The aim of this study was to evaluate the direct monthly cost of outpatient hospital-based care for children with cerebral palsy (CP) in Kano City, Nigeria., Methods: The study was a cross-sectional survey. Consenting participants were recruited using the purposive sampling technique. Data on cost of medical and physiotherapy consultations, number of consultations per month, cost of diagnostic investigations, and out-of-pocket expenditures were captured using a researcher-designed questionnaire. Data were analyzed with descriptive statistics using Microsoft Excel and SPSS version 20., Results: A total of 106 children with CP and their caregivers participated in this study. The mean age of the children was 3.18 ± 1.90 years and that of their caregivers was 27.32 ± 4.63 years. The average direct cost of outpatient care per month was ₦14 295.38 (Nigerian naira) ($46.87) ± ₦13 211.52 ($43.32). The average monthly cost of physiotherapy was ₦503.77 ($1.65) ± ₦220.79 ($0.72), whereas those for transportation and radiological investigations were ₦1861.49 ($6.10) ± ₦1435.06 ($4.71) and ₦3771.46 ($12.37) ± ₦5135.32 ($16.84), respectively., Conclusion: The average direct monthly cost of providing outpatient hospital-based care for children with CP in Kano City, Nigeria may not be affordable because most of the participants earned very meager monthly incomes. The highest medical cost was incurred from radiological investigation, whereas transportation was the most important out-of-pocket cost. The Nigerian government should make a policy decision for the automatic enrollment of all children diagnosed with CP into the National Health Insurance Scheme., (Copyright © 2019 ISPOR–The professional society for health economics and outcomes research. Published by Elsevier Inc. All rights reserved.)

Background: Currently, the key advocacy in neuroscientific studies for stroke rehabilitation is that therapy should be directed towards task specificity performed with multiple repetitions. Circuit Class Therapy (CCT) is well suited to accomplish multiple task-specific activities. However, while repetitive task practice is achievable with circuit class therapy, in stroke survivors repetitive activities may be affected by poor neurologic inputs to motor units, resulting in decreases in discharging rates which consequently may reduce the efficiency of muscular contraction. To accomplish multiple repetitions, stroke survivors may require augmented duration of practice. To date, no study has examined the effect of augmented duration of CCT in stroke rehabilitation, and specifically what duration of CCT is more effective in influencing functional capacity among stroke survivors., Methods/design: Using a randomised controlled trial with blinded outcome assessment, this study is aimed at determining the effectiveness of structured augmented CCT in stroke rehabilitation. Sixty-eight stroke survivors (to be recruited from a tertiary health institution in Kano, Northwest, Nigeria) will be randomised into one of four groups: three intervention groups of differing CCT durations namely: 60 min, 90 min, and 120 minuntes respectively, and a control group. Participants will take part in an 8-week structured intensive CCT intervention. Participants will be assessed at baseline, post-intervention, and six-month follow-up for the effectiveness of the varied durations of therapy, using standardised tools. Based on the WHO-ICF model, the outcomes are body structure/function, activity limitation, and participation restriction measures., Discussion: It is expected that the outcome of this study will clarify whether increasing CCT duration leads to better recovery of motor function in stroke survivors., Trial Registration: Pan African Clinical Trial Registry (PACTR): PACTR201311000701191.

Background: Incarceration has been associated with reduced physical activity. However, physical inactivity is a major cause of morbidity and mortality. The aim of the present study was therefore, to evaluate the incidence and relationship between the measures of physical fitness and the duration of incarceration in of inmates in Kano-Nigeria prisons., Method: A cross-sectional study was done to determine the relationship between the measures of physical fitness and the duration of incarceration of inmates in Kano prisons. Subjects' physical fitness level (cardio-respiratory fitness, body mass index and waist circumference) was assessed using standardized protocols. Simple percentage, Pearson moment correlation test and student's t-test were used to analyze variables of interest., Result: One hundred and sixteen inmates; 108 (93.1%) males and 8 (6.9%) females participated in the study. The study revealed high (93.1%) prevalence of low cardio-respiratory fitness among inmates and significant correlation between the selected indices of physical fitness (cardio-respiratory fitness, body mass index and waist circumference) and duration of incarceration., Conclusion: The prevalence of low cardio-respiratory fitness was high among inmates and long period of inadequate physical activity may be implicated as causative factor of low physical fitness among inmates in Kano prison. Prison administration and staff should encourage healthy inmate behavior. Provision of adequate facilities to encourage physical activity and sports participation is highly needed.