Search

Mulualem Yihunie1 ,† Yohannes Abich,1 Solomon Fasika Demissie,1 Tesfa Kassa,1 Parthasarathy Ranganathan,2 Balamurugan Janakiraman3 1Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India; 3Department of Research and Faculty of Physiotherapy, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India†Mulualem Yihunie passed away in May 2022Correspondence: Yohannes Abich, Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, PO Box: 196, Gondar, Ethiopia, Email yohannesabich@yahoo.comBackground: Among different psychological predictors of outcome in low back pain (LBP) adults, the negative influence of fear-avoidance beliefs in physical activity is an area of research attention. However, there is a lack of evidence on the burden of fear avoidance about physical activity among chronic LBP adults in Ethiopia.Objective: To describe fear-avoidance beliefs about physical activity and explore its association with socio-demographic and clinical factors among low back pain patients attending physiotherapy treatment in 3 Amhara regional comprehensive hospitals.Methods: A multi-center cross-sectional study was conducted and adults with chronic LBP (n = 263) participated. Data were collected by face-to-face interview using the modified Fear-Avoidance Belief Questionnaire about Physical Activity (mFABQ-PA) tool. Multivariable logistic regression at a p-value < 0.05 significance level was used to identify predictors of fear-avoidance beliefs about physical activity.Results: Among the 263 participants, 113 subjects (43%, 95% CI (36.9– 49.0)) reported a higher cut-off (> 15) mFABQ-PA. The logistic regression model demonstrated that LBP adults with a higher mFABQ-PA score were more likely to be urban residents (AOR 2.75, 95% CI (1.32, 5.88)), and ADL-related LBP (AOR 1.97 95% CI (1.18, 3.29)). The clinical-specific factor indicative of a higher cut-off score of mFABQ-PA was using analgesic medications (AOR 2.00, 95% CI (1.19, 3.37)). The model fit was 0.21 and 0.11 (R2 = Nagelkerke’s, Cox & snell respectively).Conclusion: High fear avoidance beliefs about physical activity in adults with low back pain were found and associated with residence, work, and medication intake. These findings might urge the researchers to explore further associations and assist clinicians in choosing subgroups to use behavioral therapy and graded exposure to physical activity.Keywords: avoidance behavior, fear-avoidance beliefs, low back pain, physical activity

Introduction: Kinesiophobia has a major health impact on patients with Musculoskeletal disorders (MSDs) in their functional and physical activities, which leads to poor outcomes, loss of motivation, loss of mobility, and decreased quality of life. Despite the burden of kinesiophobia among MSDs, there is limited evidence about the burden of kinesiophobia in Ethiopia. Thus, this study aimed to assess the prevalence and its associated factors of kinesiophobia among MSD patients attending physiotherapy outpatient clinics., Method: An institutional multi-center cross-sectional study was conducted from February to April 2023 with a sample size of 424. A systematic random sampling technique and face-to-face interviews using a structured questionnaire and chart review were used. The collected data was entered into Epi-data version 4.6.0.6 and analyzed using SPSS version 25. Binary logistic regression analysis was employed to identify the potential candidates for multivariable logistic regression with a p-value less than 0.25. Finally, multivariate logistic regression analysis was employed and variables at p < 0.05 with 95% CI were considered statistically significant contributors to kinesiophobia., Result: The overall prevalence of kinesiophobia among MSD patients was 48.3% (95% CI, 43.3-53.3). Being overweight and obese BMI value (AOR = 3.98; 95% CI, 2.17-7.29), having moderate pain level (AOR = 3.31; 95% CI, 1.51-7.26), having severe pain level (AOR = 9.29; 95% CI, 3.79-22.77), physical inactivity (AOR = 3.00; 95% CI = 1.84-4.89), anxiety (AOR = 2.57; 95% CI = 1.57-4.19), and depression (AOR = 8.21; 95% CI = 3.47-19.46) were significantly associated with kinesiophobia among musculoskeletal disorder patients., Conclusion: kinesiophobia is a public health burden among patients with MSDs. Nearly half of the people with MSDs had reported kinesiophobia. Being overweight and obese BMI value, pain severity level, physical inactivity, anxiety, and depressive symptoms were significantly associated with kinesiophobia. Thus, we suggest screening for kinesiophobia, be physically active, avoiding being overweight and obese, and managing depression, anxiety and pain will help to reduce the occurrence of kinesiophobia., Competing Interests: Declarations. Ethical approval: This study was conducted following the Declaration of Helsinki. Ethical approval was obtained from the institutional ethical review board of the School of Medicine, College of Medicine and Health Sciences, University of Gondar (Ref. SOM/4034/2023). Informed consent was obtained from the study participants after the purpose and objective of the study were explained. Participants were informed that their participation was voluntary and that the information obtained from them would be kept confidential, with no individual identifiers linked to their personal information. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Currently, the number of people with physical disability and impairment is increasing significantly in Ethiopia, especially in the northern part. In that regard, the Ethiopian government has been providing physical rehabilitation services to recover patients. However, due to the widespread problem of healthcare service and the increase in patients seeking physiotherapy service, the quality of the service might be compromised, and the evidence is limited. Thus, this study aimed to evaluate the quality of physiotherapy services at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia., Methods: A single case study with concurrent mixed method research design was conducted from June 02- August 10, 2022. The evaluation used patient-centeredness, timeliness, compliance and availability dimensions with 27 indicators. A total of 415 systematically selected patients who came for physiotherapy service for exit interviews, 9 service providers and managers for key-informant interviews, and 8 patients for in-depth interviews participated in the study. Approximately 176 patient medical charts were reviewed, and direct observation of 14 patient-provider interactions was performed. Binary logistic regression analysis was computed to identify factors associated with patient-centeredness. In the final model, variables with a p value < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to declare statistical significance. Thematic analysis for the qualitative data using OPEN CODE version 4.03 was performed. Finally, the dimensions and overall quality of physiotherapy service were judged using predetermined criteria., Result: The overall quality of the physiotherapy service was found to be fair or intermediate (66.5%), computed from the availability of resources 63.4%, compliance of service providers 68.6%, timelines 64.2%, and patient centeredness 73.1%. Qualitative findings also revealed that insufficient staffing and heavy workload, lack of resources, inconvenient facilities, relocation of resources in the academic division of physiotherapy department, lack of training and continuous professional development opportunities, lack management attention and institutional support and nonexistence of multidisciplinary approaches leads to significant gaps in quality service delivery. Attending primary school (AOR = 3.22, 95% CI: 1.56, 6.61), secondary (AOR = 4.24, 1.91, 9.41), and higher education (AOR = 4.79, 1.94, 11.84) and being a private employee (AOR = 0.34, 95% CI: 0.16, 0.76) were significantly associated with patient centeredness., Conclusion: The overall quality of physiotherapy service was deemed intermediate and needs further improvement. The required resources, such as clinical assessment tools, therapeutic exercise equipment, electrotherapy modalities and infrastructure, were not adequate. Educational level and occupation were significantly associated with patient centeredness., (© 2024 John Wiley & Sons Ltd.)

Background: Pelvic floor disorders are a group of disorders affecting the pelvic floor that include clinically definable conditions such as pelvic organ prolapse, urinary incontinence and fecal incontinence. These conditions silently affect millions of women worldwide and related problems are not well disclosed by women due to associated social stigma or lack of access to services in developing countries. Thus, the magnitude and related burden of these conditions vary, and little is known about them. This study was conducted to assess the magnitude and associated factors of symptomatic pelvic floor disorders in Debre Tabor town, Northwest, Ethiopia, from May 30-July 30, 2020., Method: A community-based cross-sectional study was conducted on child bearing women (> 15 years) who resided in Debre Tabor Town from May 30-July 30, 2020. The participants were selected through multistage systematic random sampling. The data were collected via a structured questionnaire through face-to-face interviews, entered into Epi-info-7.2, and subsequently analyzed using SPSS version 20. The prevalence of pelvic floor disorders was presented along with the 95% CI., Results: A total of 402 women participated in this study, 59 (14.7%; 95% CI; 11.4, 18.2) of whom reported one or more types of pelvic floor disorders. The most prevalently reported pelvic floor disorders were pelvic organ prolapse (13.9%; 95% CI: 10.9, 17.4), urinary incontinence (10.9%; 95% CI: 7.4, 9.2) and fecal incontinence (7.7%; 95% CI: 5.2, 10.2). Additionally, aging, multiparity and having early marriage (< 18 yrs.) were identified as potential risk factors associated with pelvic floor disorders., Conclusions: The prevalence of symptomatic pelvic floor disorders in the current study was high. Thus, early detection, preventive and treatment strategies should be considered. In addition, it is better to educate the community and women on the association of early marriage and multiparty with PFDs., (© 2024. The Author(s).)

Background: Work-related musculoskeletal disorders are widespread among workers of informal small-scale enterprises. Specifically, lower back pain is a prevalent occupational health problem across various industries, including weaving factories. Lower back pain significantly impairs the functioning, performance, and productivity of weavers. However, information on the prevalence and associated factors of low back pain among weavers of Bahir Dar City and nationwide is scarce. Therefore, this study aimed to assess the prevalence and associated factors of lower back pain among weavers working in Bahir Dar City., Method: A multicentered institutional-based cross-sectional study was conducted on 403 weavers in Bahir Dar City, Ethiopia, from April to May 2023 using a structured face-to-face interview questionnaire. Samples were proportionally allocated to each institution, and study participants were selected using a simple random sampling technique. Variables with a P -value < 0.25 in the bivariate logistic regression were adopted for the multivariate logistic regression analysis after verifying the model fitness. In the multivariate logistic regression analysis, the adjusted odds ratio (AOR) with a 95% confidence interval (CI) and a P -value < 0.05 were considered to identify the associated factors of lower back pain among weavers., Result: The results revealed that the overall annual prevalence of lower back pain was 63.5% (95% CI = 58.8-68.5). Longer working hours [AOR = 2.580 (CI = 1.517-4.384)], lack of back support [AOR = 1.938 (CI = 2.089-3.449)], repetitive movement of the back during weaving [AOR = 5.940 (CI = 2.709-13.02)], awkward posture [AOR = 2.915 (CI = 1.677-5.065), static working posture [AOR = 4.505 (CI = 2.298-8.831)], and job stress [AOR = 3.306 (CI = 1.896-5.765)] were significantly associated with lower back pain among weavers., Conclusions: Lower back pain among weavers was found to be highly prevalent. Working longer hours, lack of back support, repetitive movement of the back, awkward posture, static posture, and job stress were significantly associated with lower back among weavers. The study recommends prompt interventions on weavers to ensure that they use sitting support, weave for <8 h per day, change positions every 2 h, reduce job-related stress, and minimize task repetition, thereby enhancing their working conditions and minimizing the occurrence of lower back pain., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zinabu, Getie, Takele, Chanie, Abich, Shibabaw and Kibret.)

Background: Caring for a child with cerebral palsy (CP) could negatively affect the Health-Related Quality of Life (HRQOL) of the mothers who are usually the primary caregivers. To the best of our 'knowledge, there is a dearth of information on the HRQOL of primary caregivers of children with CP in Ethiopia. Therefore, this study aimed to investigate caregivers' HRQOL and factors associated with it in Gondar and Bahir Dar Cities, Northwest Ethiopia, 2022., Methods: A community-based cross-sectional study was conducted among primary caregivers of Children with CP from April 20 to June 20, 2022, in Gondar and Bahir Dar cities. Convenience sampling was used to get study participants. Data were collected by trained health extension and community-based rehabilitation workers. The collected data were coded, cleaned, entered into EPI data, and exported to Stata-16 for analysis. A generalized linear model was employed to show the relationship between dependent and independent variables. A P-value≤0.05 was considered statistically significant at a 95% confidence interval., Result: In this study, HRQOL among primary caregivers of children with CP was 28.72(±13.38) and 23.26(±12.37) in the physical summary score (PSC) and mental summary score (MSC) respectively. Age 17-30yeas (p-value = 0.03), unable to read and write (p = 0.01), privately employed (p = 0.01) and government employed (p = 0.02), monthly income<1000 Ethiopian Birr (ETB) (p = 0.01), insufficient sleeping (p = 0.001), others relationship(p = 0.001), have three and above children (p = 0.001), others house composition (p = 0.003), have no helpers (p = 0.001) and third birth order of child (p = 0.03) were all factors associated with HRQOL in PSC. On the other hand, income<1000ETB (p = 0.05), insufficient sleeping (p = 0.001), others in relation to the child (p = 0.001), others in house composition (p = 0.03), dyskinetic CP (p = 0.01) and ataxic CP (p = 0.001) were all factors associated with HRQOL of caregivers in MSC components., Conclusion: The HRQOL among primary caregivers of children with CP in Bahir Dar and Gondar cities was low. Age, monthly income, educational status, sleeping status, relationship and house composition, number of living children, birth order of child, helpers, and type of CP were all significantly associated with HRQOL of primary caregivers of children with CP., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kassa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Older adults are increasing in number in both developed and developing countries. However, as the world's aging population grows, the burden of diseases among older people also increases. Despite this, co-occurring health problems due to physical inactivity in older adults have become a concern, and physical inactivity can be caused by different conditions. As a result, for older adults to have better health outcomes, early diagnosis of physical activity status and prevention of non-communicable diseases are crucial. There is a lack of data on the prevalence and associated factors of physical inactivity among older adults that is scarce in sub-Saharan Africa, particularly in the study area, Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of physical inactivity among older adults in Gondar town, Northwest Ethiopia, in 2022., Methods: A community-based cross-sectional study was conducted from April 1st to June 30th, 2022, in Gondar town, Northwest Ethiopia. The data was collected by the Global Physical Activity Questionnaire, Volume 2 through face-to-face interviews among 838 participants. Data were entered into Epinfo version 7.1, then exported and analysed using the Statistical Package of Social Science version 25. A binary logistic regression model was performed to identify factors associated with physical inactivity. The result was considered statistically significant based on an adjusted odds ratio of 95% and a p-value less than 0.05., Result: The prevalence of physical inactivity was 65.6% (95% CI: 62.1-68.9). Being female (AOR: 3.053, 95% CI:1.487-6.267), age group > = 80 (AOR: 4.082, 95% CI:1.234-13.497), primary school level (AOR: 3.020, 95% CI:1.433-6.367), no formal education (AOR: 8.573, 95% CI:2.843-25.847), unemployed (AOR: 10.273, 95% CI:5.628-18.753), and symptoms of depression (AOR: 7.152, 95% CI: 4.786-17.965) were significantly associated with physical inactivity., Conclusion: Physical inactivity was relatively high among older adults in Gondar town. Being female, older age, having low levels of education, being unemployed, and having depression symptoms were associated with physical inactivity. We suggest promoting the health benefits of physical activity among females by reducing their burden, older age groups, and unemployed older adults, and avoiding depression among individuals., (© 2024. The Author(s).)

Introduction: Maternal malnutrition remains a major public health problem, particularly in low and middle-income countries and war-affected areas like Ethiopia. Malnourished pregnant and lactating women with low nutrient stores have babies with poor mental and physical development, increasing the risk of poor birth outcomes. Despite the fact that the majority of Ethiopian mothers are malnourished, there is little evidence in war-affected areas. Therefore, the objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant and lactating mothers in the war affected area of North Gondar Zone, northwest Ethiopia., Methods: A community-based cross-sectional study was conducted from April 10 to May 25, 2022. A multistage random sampling technique was used to select 1560 pregnant and lactating mothers. MUAC was to ascertain the outcome variable. Data was entered and analyzed by using EPI INFO version 3.5.3 and SPSS version 24, respectively. A multivariable logistic regression analysis was employed to identify the factors associated with acute malnutrition. An adjusted odds ratio (AOR) with a 95% confidence interval was used to show the strength of the association, while a P-value of 0.05 was used to declare the significance of the association., Results: The prevalence of acute malnutrition among pregnant and lactating women was 34.3% at the 95% CI (31.9-36.8). The age of the mothers (AOR = 0.73; 95% CI: 0.54, 0.99), family size 6-8 (AOR = 1.21; 95% CI: 1.03, 1.82), and greater than or equal to 9 family sizes (AOR = 0.44; 95% CI: 0.19, 0.97), were significantly associated with acute malnutrition., Conclusions: In the current study, the prevalence of acute malnutrition among pregnant and lactating mothers is high in the study area. Mother's age and family size were factors associated with acute malnutrition in war-affected areas. As a result, mothers with large families will require special assistance to reduce the impact of malnutrition., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Frailty is a multidimensional geriatric condition that increases vulnerability to stressors, increases the risk of negative health outcomes, and lowers quality of life in older people. However, little attention has been paid to frailty in developing countries, particularly in Ethiopia. Therefore, the aim of the study was to investigate the prevalence of frailty syndrome and the sociodemographic, lifestyle, and clinical factors associated with it., Methods: A community-based cross-sectional study design was conducted from April to June 2022. A total of 607 study participants were included using a single cluster sampling technique. The Tilburg frailty indicator, which is a self-reported schedule for assessment of frailty, required respondents to answer 'yes' or 'no' and the total attainable score ranged from 0 to 15. An individual with a score of ≥ 5 considered frail. Data were collected by interviewing the participants using a structured questionnaire, and the data collection tools were pre-tested before the actual data collection period to check for the accuracy of responses, language clarity, and appropriateness of the tools. Statistical analyses were performed using the binary logistic regression model., Results: More than half of the study participants were male, and the median age of the study participants was 70, with an age range of 60-95 years. The prevalence of frailty was 39% (CI 95%, 35.51-43.1). In the final multivariate analysis model, the following factors associated with frailty were obtained: older age (AOR = 6.26 CI (3.41-11.48), presence of two or more comorbidities (AOR = 6.05 CI (3.51-10.43), activity of daily life dependency (AOR = 4.12 CI (2.49-6.80), and depression (AOR = 2.68 CI (1.55-4.63) were found to be significant factors., Conclusion and Recommendations: Our study provides epidemiological characteristics and the risk factors of frailty in the study area. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially for older adults aged 80 and above years, and those with two or more comorbidities., (© 2023. The Author(s).)

Background: In the absence of a standardized work environment, insurance system, occupational safety measures and expanding workload an uptrend of musculoskeletal disorders secondary to occupational hazards is observed among a wide range of occupations in developing countries including street sweepers/cleaners. The aim of this study is to determine the burden and potential factors associated with musculoskeletal disorders among street cleaners/solid waste collectors in Gondar town, Ethiopia., Methods: A cross-sectional study design was used to determine the burden and identify potential risk factors of musculoskeletal disorders among street cleaners. Street cleaners (n = 422) working experience of at least one year were randomly selected from the community at their respective work sites (street). A face-to-face interview recorded the participant's response addressing socio-demographic, occupational, job satisfaction, disability related to basic ADL, physical measurements, and self-reported pain using the Nordic-Musculoskeletal questionnaire. The logistic regression model was created to identify potential factors associated with self-reported MSDs., Results: The sample consists of women street sweepers/cleaners (100%, n = 422, response rate 100%) with at least one-year of work experience with a mean age of 37.03 ± 8.26. About 40% of women sweepers were illiterate and 95% reported no job satisfaction. The overall prevalence of MSDs was 73% (n = 308, 95% CI; 68.5, 77.2), among them nearly 65% reported having experienced disability in performing basic ADL in the past 12 months. Low back pain was the most prevalent region (n = 216, 70.1% case versus MSDs n = 308). In univariate and multivariate logistics analysis, being overweight/obese (AOR of 4.91 (95%, 2.22, 10.87)), age group 35 and above (AOR 2.534 (1.51, 4.26)), not-satisfied with job (AOR 2.66 (1.05, 6.75)), and street cleaning distance of longer than 2 km (AOR 2.82 (1.64, 4.83)) were significantly associated with self-reported musculoskeletal disorder.., Conclusion: This study demonstrated higher self-reported MSDs among street sweepers/cleaners. Modifiable predictors like overweight, lack of job satisfaction, and cleaning longer distance were identified to be associated. Hence, there is a need for ergonomic measures and policy to curb these factors to reduce the burden of MSD among women street sweepers., (© 2023. The Author(s).)

Background: The state of depression that can lead to substance and drug abuse, as well as an increased risk of suicide. Without a doubt, the link between musculoskeletal pain and depression compromises a person's health and drastically lowers their quality of life, resulting in increased incapacity. Depression and musculoskeletal discomfort are two well-known risk factors for long-term sickness absence, which is defined as a period of sickness lasting more than a week, which means chronic musculoskeletal pains, particularly multiple pains, are linked to depression. And early diagnosis and care of depression in musculoskeletal disorder are critical to patients' physical, functional, and occupational results. This study aimed to assess the magnitude of depression and associated risk factors among patients with musculoskeletal disorder., Method: Multi-institution cross-sectional study conducted in Amhara region Comprehensive specialized Hospitals from April 1st to May 30th, 2021. The data was collected from 217 participants through interview administrative questioner and patient medical record review. Binary logistic regression was used to identify associated risk factors of depression. The strength of the association was detected by the adjusted odds ratio., Result: A total of 217 participate in this study with the age range of 18-80 years. Among the study participants, 57.1% (n = 124) (AOR: 95% CI: 50.7-63.6) were had depression. Treatment duration, and social support were significantly association with depression among patient with musculoskeletal disorder with P < 0.05., Conclusion: The magnitude of depression was relatively high among musculoskeletal disorder patients treated in physiotherapy out-patient department. The length of treatment duration (hospital stay) and the status of social support from families and friends were significantly associated with depression among patients with musculoskeletal disorders. A multidisciplinary strategy is required for diagnosing and treating depression in patients with musculoskeletal disorder., (© 2023. The Author(s).)

Objective: This study aimed to explore the perceptions of parents and physiotherapists regarding home-based therapy programs for children with cerebral palsy and to understand the factors affecting adherence to home-based therapy programs., Materials and Method: Thematic analysis method was used to identify, analyse and report findings. Twelve physiotherapists and five caregivers were purposively sampled and interviewed., Results: All transcripts were coded line by line, and the codes were then organized into categories for the development of descriptive themes and the generation of analytical themes. The data analysis followed the steps of the thematic analysis process. Seven themes emerged during the analysis: Why Home-Based Therapy? Ways of Teaching, Types of the therapy, Strategies of assessing adherence, Environmental factors, Attitude and knowledge; and Family participation. Physiotherapists use home-based therapy to prevent complications and improve functioning. They use various ways of teaching, such as explaining, demonstrating, and using pictures and videos. Physiotherapists consider several factors such as severity, age, and availability of resources before they decide the type of home therapy programs. However, parent's participation was low; and strategies to monitor and evaluate adherence were also low. Low family support, limited recourse, lack of knowledge and poor attitude negatively affected adherence to home-based therapy., Conclusions: Our finding revealed that physiotherapists use quite limited methods of teaching, and do not properly monitor adherence of the home-based therapy. Additionally, family participation to select type of therapy and to set goal were low., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Demeke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Ankle joint mobilization with movement has been speculated to be an important intervention for enhancing range of motion, balance, and gait functions in chronic stroke survivors. Nonetheless, there is a scarcity of recent conclusive evidence that evaluates its efficacy in chronic stroke patients. The purpose of this review was to synthesize existing evidence on the efficacy of mobilization with movement therapy on range of motion, balance, and gait performance in subjects after stroke., Methods: A comprehensive systematic search of literature was performed using the following databases: PubMed/Medline, CINAHL, AMED, PEDro, Cochrane Library, and Scopus. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of included trials. The primary outcome measures of this review were dorsiflexion range of motion (DF-ROM), and Berg balance scale (BBS). This review was reported in accordance with PRISMA statement guidelines. Due to variations in relevant trials, meta-analysis was not carried out., Results and Conclusions: Seven randomized controlled trials with a total of 224 subjects were analyzed. Evidence of overall quality was graded from moderate to high. This review found that mobilization with movement therapy could be an alternative rehabilitative intervention for subjects with chronic stroke to increase range of motion, balance, and gait ability. However, the evidence remains preliminary due to the small number of participants. Large-scale RCTs in the future are warranted to investigate the efficacy of mobilization with movement in subgroups of chronic stroke subjects., Competing Interests: The authors report no conflicts of interest for this work., (© 2021 Alamer et al.)

Background: The Foot health of a child plays a pivotal role in their participation in play, locomotive activities, healthy lifestyle, somatic development, and weight management. The burden of flatfoot among children in Ethiopia is not known. The objective of this study was to analyze the structure of the medial foot arch using Staheli plantar arch index and investigate its associated factors among larger sample school children, aged 11-15 years in Ethiopia., Methods: A school-based cross-sectional study was conducted among children aged 11-15 years from eleven randomly selected primary schools. The sample size was determined proportionally across school strength and governmental and private schools to ensure variety within the sample. Data collection consisted of physical measurements, footprint-based measures whilst full weight-bearing, and a structured questionnaire on foot pain, footwear type, and physical activity. Data were analyzed descriptively and through uni- and multivariate logistic regression model., Results: A total of 823 children participated. The overall prevalence of flatfoot was 17.6% with a significant difference between age, gender, type of school, BMI, and type of footwear. Being younger (OR 3.3, 95% CI 1.6-6.7), male (OR 1.6, 95% CI 1.0-2.4), experiencing foot pain (OR 1.9, 95% CI 1.0-3.5), wearing closed shoe (OR 4.4, 95% CI 1.6-11.9), overweight (OR 3.8, 95% CI 1.2-8.7), obese (OR 4.2, 95% CI 2.5-10.9), and low level of physical activity (OR 2.1, 95% CI 1.0-4.6) were significantly associated with flatfoot. Children who were overweight, obese, and also experiencing foot pain have a 2.8 (95% CI 1.62-5.94) and 4.1 (95% CI 2.85-8.31) times greater chance of having flatfoot respectively. The prevalence of flatfoot among 560 normal weight children was 17.5%., Conclusions: The findings of this study demonstrated that the overall prevalence and the prevalence of flatfoot among normal-weight children are almost the same. There is a definite need to develop a screening algorithm for diagnosis and treatment indication for this children's lower extremity disorder., Competing Interests: The authors have declared that no competing interests exist.

Background: Falls among older adults is a common precipitating factor for unintentional injuries and represent a major health problem associated with increased morbidity, mortality, and health care cost in low-and-middle-income countries. The burden of fall in this population is well established in high-income countries and scant attention is given to this precipitating factor in low-and-middle-income countries, including Ethiopia. Therefore, this study aimed to estimate the prevalence and factors associated with fall among community-dwelling older adults in Ethiopia., Methods: A community-based cross-sectional study was conducted among community-dwelling older adults of Gondar. Multi-stage random sampling technique was used across administrative areas. Six hundred and five households were selected proportionally using systematic random sampling technique. Physical measurement and face to face interview method were employed using a structured questionnaire for data collection. Data were analyzed descriptively and through uni- and multivariate logistic regression model., Results: One hundred and seventy (n = 170, 28.4%; 95% CI 24.7-32.1) community-dwelling older adults reported having experienced fall in the past 12 months. Sex (OR = 1.91, 95% CI: 1.24-2.95), low educational status (OR = 2.37, 95% CI: 1.19-4.74), uncomfortable home environment (OR = 2.02, 95% CI: 1.34, 3.04), having diagnosed medical condition (OR = 4.659, 95% CI: 1.20-18.02), and use of medication (OR = 5.57, 95% CI: 1.19-26.21) were significantly associated risk factors of self-reported fall in the past 12 months. Most outdoor falls are associated with females and participants aged below 66 years., Conclusion: In conclusion, more than 1/4th of the community-dwelling older adults experienced at least one episode of fall and about 60% of them reported recurrent falls. Identifying risk group and risk factors that could be modified so as to prevent falls in older adults deserves attention. Outdoor falls are usually attributable to modifiable environmental aspects and improvements in outdoor environment needed., Competing Interests: The authors have declared that no competing interests exist.