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Item Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review(Frontiers Media S.A., 2020) Ekechukwu, E. N. D.; Olowoyo, P.; Nwankwo, K. O.; Olaleye, O. A.; Ogbodo V. E.; Hamzat, T. K.; Owolabi, M. O.Background: Given the limited healthcare resources in low and middle income countries (LMICs), effective rehabilitation strategies that can be realistically adopted in such settings are required. Objective: A systematic review of literature was conducted to identify pragmatic solutions and outcomes capable of enhancing stroke recovery and quality of life of stroke survivors for low- and middle- income countries. Methods: PubMed, HINARI, and Directory of Open Access Journals databases were searched for published Randomized Controlled Trials (RCTs) till November 2018. Only completed trials published in English with non-pharmacological interventions on adult stroke survivors were included in the review while published protocols, pilot studies and feasibility analysis of trials were excluded. Obtained data were synthesized thematically and descriptively analyzed. Results: One thousand nine hundred and ninety six studies were identified while 347 (65.22% high quality) RCTs were found to be eligible for the review. The most commonly assessed variables (and outcome measure utility) were activities of daily living [75.79% of the studies, with Barthel Index (37.02%)], motor function [66.57%; with Fugl Meyer scale (71.88%)], and gait [31.12%; with 6min walk test (38.67%)]. Majority of the innovatively high technology interventions such as robot therapy (95.24%), virtual reality (94.44%), transcranial direct current stimulation (78.95%), transcranial magnetic stimulation (88.0%) and functional electrical stimulation (85.00%) were conducted in high income countries. Several traditional and low-cost interventions such as constraint-induced movement therapy (CIMT), resistant and aerobic exercises (R&AE), task-oriented therapy (TOT), body weight supported treadmill training (BWSTT) were reported to significantly contribute to the recovery of motor function, activity, participation, and improvement of quality of life after stroke. Conclusion: Several pragmatic, in terms of affordability, accessibility and utility, stroke rehabilitation solutions, and outcome measures that can be used in resource-limited settings were found to be effective in facilitating and enhancing post-stroke recovery and quality of life.Item Motor function, community reintegration and quality of life in stroke survivors with pre-stroke driving history(College of Medicine, University of Ibadan, and the University College Hospital, Ibadan, Nigeria., 2018) Olaleye, O. A.; Nwankwo, O. K.; Hamzat, T. K.Background: Driving is an important activity of daily living associated with improved community reintegration and better quality of life. It is however unclear if there is a definite difference in the motor function, community reintegration and quality of life of stroke survivors who returned to driving and those who did not. Methods: Stroke survivors with pre-stroke driving history participated in this cross sectional survey. Socio-demographics, clinical characteristics and driving history were documented. Motor function, community reintegration and quality of life were assessed using the Modified Motor Assessment Scale (MMAS), Reintegration to Normal Living Index (RNLI) and Health-Related Quality of Life in Stroke Patients (HRQOLISP-40) respectively. Returners and non-returners were compared using Mann Whitney U test at á0.05 . Results: Fifteen out of the 44 stroke survivors (34.1%) who participated in this study had returned to driving after their stroke. There was no significant difference in age, time since stroke onset and years of driving experience prior to stroke onset (p >0.05) between returners and non-returners. There was however a significant difference in the motor function, community reintegration and quality of life between the two groups (p<0.01) Conclusion: Stroke survivors with pre-stroke driving who returned to driving after stroke had better motor function, community reintegration and quality of life compared to their counterparts who had not returned to driving.Item Disability and Quality of Life among People Living With HIV/AIDS in Ibadan, Nigeria(Zambia Medical Association, 2017) Olaleye, O. A.; Adetoye, A. A.; Hamzat, T. K.Background: Improvements in medical and pharmacologic management of HIV/AIDS has led to increased life expectancy for the afflicted individuals. Hence, the focus of management for People Living With HIV/AIDS (PLWHA) has shifted to issues relating to function and Quality of Life (QoL). Information is scarce on disability issues and quality of life among people living with HIIV/AIDS in Nigeria. This was the premise of this study that assessed the level of disability and how it related to quality of life among people living with HIV/AIDS in Ibadan, the largest city in Nigeria. Methods: 360 PLWHA (274 females; 86 males) aged 37.79±9.37 years participated in this study. They were recruited from the anti-retroviral clinics of one secondary and one tertiary healthcare facilities in Ibadan, Nigeria. Disability and QoL were assessed using the 12-item WHO Disability Assessment Schedule (WHODAS 2.0) and the WHOQOL_HIV Bref respectively. Data were analysed using Chi square and Kruskal Wallis test at p = 0.05. Results: Almost a quarter (23.6%) reported being currently ill, with HIV/AIDS-related symptoms accounting for the highest perceived illness (42.5%). Majority of these participants (71.1%) had mild to extreme disabilities. There were no significant associations (p > 0.05) between disability and each of age, sex and employment status. Disability was however, significantly associated with level of education, alcohol use, CD4 count, history of tuberculosis and QoL (p<0.005) between disability and each of age, sex and employment status. Disability was however, significantly associated with level of education, alcohol use, CD4 count, history of tuberculosis and QoL (p<0.001) Conclusion: Disability was relatively high among people living with HIV/AIDS in Ibadan, Nigeria. Although mostly rated mild, disability was associated with poor QoL. This underscores the need for early identification of disability in people living with HIV/AIDS to minimise its impact on their QoL.Item Psychosocial Impact of Wheelchair Usage on Individuals with Mobility Disability in Ibadan, Nigeria(College of Medicine, University of Ibadan, and University College Hospital, Ibadan, Nigeria, 2015) Hamzat, T. K.; Olaleye, O. A.; Agbomeji, O. T.Background: Wheelchairs provide individuals with mobility impairments opportunity for independent living within their environment. However, using this device may have psychosocial impacts with consequent influence on the quality of life of the users. The psychosocial impact of wheelchair usage among individuals with mobility disability in a Nigerian community was investigated. Methods: The study is a descriptive cross-sectional survey. People who have been independent users of wheelchair for a minimum of six months prior to the study were recruited from centres for people with disabilities in Ibadan, Nigeria into the study. A profile of their use of the device was documented and the psychosocial impact of wheelchair was assessed using the Psychosocial Impact of Assistive Devices Scale. Data were analysed using descriptive and inferential statistics at p = 0.05. Results: Sixty consenting individuals with mobility disability participated in this study. Their mean age was 38.7±14.1 years. Majority (90%) were manual wheelchair users and two-thirds (63.3%) had been using the wheelchair for d” five years. Approximately a third of the participants use their wheelchairs occasionally. There was no significant difference (p=0.26) in the psychosocial impact of wheelchair usage between male and female users. Conclusion: The psychosocial impact of wheelchair was similar between male and female users. However, the impact was higher on the self-esteem of male than female users and lower on their competence than that of their female counterparts. This may be due to stigmatization or a culturally related unwillingness of men in our environment to be dependent on others.