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Background: Traditionally, stroke rehabilitation outcomes are based on indicators of physical function, such measures may underrate the all-inclusive impact of stroke such as oral health.Objectives: To investigate the relationship between upper extremity motor function and oral hygiene status as well as the impact of stroke on Oral Health-Related Quality of Life (OHRQoL).Methods: Sixty stroke survivors were included in this cross-sectional survey. Spasticity and motor function/mobility of the affected upper extremity were assessed using the Modified Ashworth Scale and Action Research Arm Test, respectively. Oral hygiene was assessed using the Simplified Oral Hygiene Index and oral health impact was assessed using the 14-item Oral Health Impact Profile. Pearson's moment correlation coefficient was used to determine the relationship between oral hygiene and upper extremity motor function variables.Results: There were significant relationships between the oral hygiene index and Shoulder muscles spasticity (r = 0.374, p =.01), wrist muscles spasticity (r = 0.352, p =.01), as well as basic mobility (r = 0.423, p =.01). An estimated 8% (n = 5) of study participants have their QoL strongly impacted by their oral health.Conclusions: Upper extremity motor function variables such as spasticity and basic mobility matters in determining oral hygiene status after stroke. Stroke has little impact on oral health-related quality of life. [ABSTRACT FROM AUTHOR]

Background: Extrapyramidal syndromes (EPS) represent neurological side effects of antipsychotic medications, characterized by motor disturbances. While previous studies have indicated the neuroprotective effects of vitamin D and A against EPS, the underlying mechanisms of this protection remain unclear., Methods: Twenty-four adult mice were categorized into four groups: positive and negative control groups, one receiving a dopamine antagonist, and the other receiving both a dopamine antagonist and vitamins D and A. Sections of the corticobasal loop, specifically the motor cortex (M1) and basal nuclei (CPu), were prepared for Immunohistochemistry (IHC) and stained with Glial Fibrillary Acidic Protein (GFAP) to visualize reactive astrocytes. ELISA assays for TNF-α, IL-6, IL-4, IL-13, and dopamine levels were performed on homogenized brain sections., Results: The EPS group exhibited a significant increase in TNF-α and IL-6 levels in M1 and CPu. Treatment with dopamine agonists and vitamin D&A resulted in significant reductions in IL-6 levels. Only the Vitamin D&A group showed a significant decline in TNF-α. The EPS group recorded significant decreases in IL-4 and IL-13, with IL-13 significantly elevated in the dopamine agonist and Vitamin D&A groups. IL-4 was notably increased in the Vitamin D&A groups. Dopamine concentration significantly declined in the EPS group, with improvements observed in the groups treated with dopamine agonists, and vitamin D&A. Reactive astrocytes were significantly expressed in the M1 and CPu of the EPS group but poorly expressed in other groups., Conclusions: EPS is linked to astrocyte activation, an upsurge in pro-inflammatory cytokines, a decline in anti-inflammatory cytokines, and dopamine in the corticobasal loop. Administration of vitamin D3 and A was found to suppres pro-inflammatory cytokines and repress anti-inflammatory cytokines associated with astrocyte activation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: To translate and cross-culturally adapt the Northwick Park Neck Pain Questionnaire (NPQ) into Hausa and assess its psychometric properties., Materials and Methods: The NPQ was translated and cross-culturally adapted into Hausa using recommended guidelines. A consecutive sample of 92 Hausa-speaking patients with non-specific neck pain recruited from three tertiary hospitals in north-western Nigeria, completed the questionnaire to assess factorial validity (using confirmatory factor analysis), convergent validity (by correlating the Hausa-NPQ with the Numerical Pain Rating Scale [NPRS]), and internal consistency (using Cronbach's α). A subsample of 50 patients completed the questionnaire again 3 days after the first administration to assess relative reliability using intraclass correlation coefficients (ICC) and absolute reliability using standard error of measurement (SEM), smallest detectable change (SDC), and 95% limits of agreement (LOA)., Results: The factor analysis confirmed a single-factor structure with excellent internal consistency (α = 0.94). The questionnaire showed a strong positive correlation with the NPRS ( rho  = 0.68). The ICC was 0.86, with SEM and SDC of 6.32 and 17.5, respectively. The LOA was - 29.3 to + 37.1 with no evidence of proportional bias., Conclusions: The Hausa-NPQ is a valid and reliable measure of disability due to neck pain.

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 : Social factors modulating stroke outcomes are found to be culturally and gender inclined. We examined social support and social constraints in Hausa women stroke survivors. Aim : To determine social support and social constraints in Hausa women after stroke. Materials and methods : Seventy-four (74) Hausa women stroke survivors were conveniently recruited from three tertiary health centers to participate in this cross-sectional study. Sociodemographic and stroke-related attributes of the participants were obtained. Perceived social support and social constraints were assessed using multidimentional scale of perceived social support (MSPSS) and the social problem questionnaire (SPQ), respectively. The relationship and association between different variables were assessed using Pearson's correlation and chi-square test, respectively. Results : Majority of the participants (60.8%) reported adequate level of social support. Similarly, most participants reported fairly low level of social constraints in total family stress (91.9%) and nonchild-related stress (90.5%). None of the participants' sociodemographic features had a significant relationship with either social support or social constraints ( p > .05). Findings indicated an inverse relationship between social support and social constraint. Conclusion : Findings of this study suggest that adequate social support potentially limits the level of social constraint encountered by women who suffered stroke. The Hausa culture seems to be impressive in characteristically demonstrating high level of social support as found in this study. It is recommended that physiotherapist should assist by providing educative programs that would increase caregiver's knowledge of social support and how to develop it and cultural values that emphasize positive social interaction should be encouraged.

Purpose: An important focus of poststroke rehabilitation is the attainment of community participation. However, several factors may influence participation some of which vary from setting to setting. The aim of this study is to investigate the factors influencing community participation among community-dwelling stroke survivors in the Western Cape, South Africa. Materials and methods: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Social Support Questionnaire 6 (SSQ6) were the instruments used to collect data. Participant demographics, clinical features and domain-specific scores of the WHODAS 2.0 were used as potential predictors. Correlation analysis and multiple regression models were used to examine determinants of community participation. All assessments were conducted using face-to-face interviews. Results: One hundred and six stroke survivors enrolled in this cross-sectional study. Risk factors, cognition, mobility, self-care, getting along with people, household activities and total WHODAS 2.0 score were associated with participation. Four predictors of community participation were identified from multiple regression, namely mobility (38%), cognition (11%), life activities (4%) and stroke risk factors (1%). Determinants varied by gender and age group. Mobility predominated in males and younger adults, while cognition was more pronounced in females and the elderly. Lastly, the influence of social support on community participation was largely defined by the gender and age of stroke survivors. Conclusion: The findings suggest focusing stroke rehabilitation on important factors such as mobility, cognition, life activities and risk factors to advance patients' participation. It also emphasizes giving specific consideration to key factors specific for gender and age of stroke survivors. Implications for Rehabilitation Community participation in the general population of stroke survivors' is largely determined by their mobility function. Determinants of community participation among stroke survivors essentially vary according to age and gender. Clinically, this study suggests that focusing on specific determinants of improved community participation according to stroke patients' demographic categories (gender and age) may be an important impetus to enhance rehabilitation outcome.

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.