Physiotherapy
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Item ‘We don’t have to do it together’: a qualitative study of Physiotherapists’ and patients’ perceptions about collaborative goal setting in Nigeria(Taylor & Francis, 2022) Olaleye, O. A.; Agoro, Z. B.Background: The adoption of Collaborative Goal Setting (CGS) is limited in most rehabilitation settings in Nigeria despite its recommendations in clinical practice guidelines. Objective: To explore the perceptions of physiotherapists and patients about CGS at a tertiary healthcare facility in Ibadan, Nigeria. Methods: We conducted focus group discussions among purposively selected physiotherapists (n = 8) and patients (4 stroke survivors, 3 patients with brain injury) to qualitatively explore their perceptions. Audio-taped discussions were transcribed verbatim and thematically analyzed. Results: We identified four themes around CGS which were: 1) paternalistic view of goal setting; 2) physiotherapists as goal setters; 3) perceived benefits of collaborative goal setting; and 4) barriers and facilitators to CGS. The physiotherapists articulated goals as expected outcomes from treat- ment and believed they were better poised and experienced to determine what patients could achieve during each phase of treatment. Patients' view of goal setting agreed with the physio- therapists', as they also opined that goal setting is the responsibility of physiotherapists. Time constraint, inadequate knowledge and the inability of patients to appropriately articulate their goals and expectations from treatment were barriers to CGS. Concerns about who to collaborate with when dealing with patients with impaired cognition and/or disorders of consciousness were raised by the physiotherapists. Participants in both groups indicated that education on how to set patient-oriented goals could facilitate CGS. Conclusions: Though rarely practiced, participants agreed that collaborative goal setting could be beneficial. Both the physiotherapists and patients require education on how to appropriately collaborate in setting goals of rehabilitation.Item Relationship between post-stroke spasticity and functional ambulation among Nigerian stroke survivors(Nigeria Society of Physiotherapy, 2021) Olaleye, O. A.; Popoola, O. S.; Akosile, C. O.; Adegoke, B. O. A.Ambulation is a common goal of stroke rehabilitation that is often linked to lower limb spasticity. This study was conducted to investigate the relationship between paretic lower limb spasticity and functional ambulation after stroke. Thirty stroke survivors (19 males) aged 57.77 ± 9.52 years participated in this correlational cross-sectional study. Spasticity of the paretic lower limb was assessed using the Modified Tardieu Scale. Functional ambulation performance was assessed using the Emory Functional Ambulation Profile (E-FAP). Data were analyzed using Pearson's product moment correlation and stepwise regression analysis at p = 0.05. Spasticity was highest in the ankle plantaflexors (253.20 ± 32.62°). There was a significant relationship between spasticity of the affected lower limb and functional ambulation performance (r=0.61; p<0.05) Stepwise regression analysis indicated that only spasticity of the ankle plantaflexors predicted functional ambulation. Spasticity of the paretic ankle plantaflexors has discriminative power for predicting functional ambulation. This underscores the need for focused rehabilitation aimed at reducing spasticity of ankle plantaflexors for improved functional ambulation among stroke survivors.Item Expectations of Individuals with Neurological Conditions from Rehabilitation: A Mixed-Method Study of Needs(South African Society of Physiotherapy, 2021) Olaleye, O. A.; Zaki, D. A.; Hamzat, T. K.Background: Knowledge of the specific expectations of patients with neurological conditions (NCs) from rehabilitation helps in setting attainable goals. Such expectations may vary from situation to situation. There are no studies investigating rehabilitation expectations amongst individuals with NCs in Nigeria. Objectives: The aim of our study was to explore the rehabilitation expectations of individuals with NCs. Method: This convergent mixed-methods study comprised a cross-sectional survey of 105 individuals with NCs and two sessions of Focus Group Discussions (FGDS) amongst eight individuals with NCs. The modified Needs Assessment Questionnaire was used to assess rehabilitation needs as a proxy for rehabilitation expectations, whilst disability was assessed using the World Health Organization Disability Assessment Schedule 2.0. Quantitative data were summarised using descriptive statistics and analysed using inferential statistics at p < 0.05. Thematic analysis was conducted on the qualitative data. Results: Sixty-one (58.1%) stroke survivors, 33 (31.4%) individuals with spinal cord injury (SCI) and 11 (10.5%) with traumatic brain injury (TBI) aged 46.48 ± 15.91 were surveyed. The need for social/recreational activity was the most expressed need (100%) amongst the participants. Mobility was reported as an important need constituting a barrier to enjoying life by 93 (88.6%) participants. Individuals with SCI expressed the greatest needs compared with the other two groups. Needs were significantly correlated with severity of disability (p < 0.05). Four overarching themes (physical health, financial, healthcare services/rehabilitation and emotional/social) representing major areas of needs emerged from the FGD data. Conclusion: Individuals with NCs in Nigeria have specified expectations of rehabilitation. Disability was a major driver of these expectations, irrespective of NC subtype. Clinical implications: Rehabilitation programmes for individuals with NCs should target expressed needs or expectations of each patient cohort and minimise disabilities associated with these conditions.Item Early Mobilisation of Patients with Acute Stroke: A survey of knowledge, attitude and practice health care professionals in South-west, Nigeria(African Journals Online., 2020) Olaleye, O. A.; Amusan, O. I.; Adeyinka, A. O.BACKGROUND: Early mobilisation of acute stroke survivors has been associated with fewer deaths and better clinical outcomes. Yet, there are conflicting reports about the knowledge, attitude and practice of early mobilisation among clinicians. We investigated the knowledge, attitude and practice of early mobilization among health care professionals in South-West, Nigeria. MATERIALS AND METHODS: All the 159 health care professionals comprised 68(42.8%) nurses, 45(28.3%) physicians and 46(28.9%) physiotherapists involved in acute stroke care were surveyed using a content-validated questionnaire. Pearson’s Product Moment correlation and ANOVA were used to analyse data at p < 0.05. RESULTS: Most (n=147; 92.5%) of the participants agreed that early mobilization reduces complications of immobility. Majority of the HCPs were knowledgeable and had positive attitude towards early mobilisation (n=139; 87.4%). Attitude differed significantly across different healthcare professions (p=0.02). Most health care professionals (n=149; 93.7%) reported practicing early mobilization of acute stroke patients. There was a significant relationship between years of work experience and each of knowledge and attitude (p<0.05) CONCLUSIONS: Although, many health care professionals expressed concerns about the risks of early mobilization, including possibility of death, they reported practicing early mobilisation. It may be necessary to conduct a risk-benefit analysis of early mobilisation and provide appropriate practice guidelines to promote implementation. This could further enhance the health care professionals’ confidence in practicing early mobilisation and improve stroke care.Item Utilization of Physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria(Faculty of Medicine, Makerere University, 2017) Olaleye, O. A.; Lawal, Z. I.Objectives: To investigate the pattern of referral for and utilisation of physiotherapy in the continuum of stroke care at a tertiary hospital in Ibadan, Nigeria. Methods: Referral notes and medical records of patients admitted in the University College Hospital, Ibadan with a clinical diagnosis of stroke between January, 2009 and December, 2013 were retrospectively reviewed. Information on age, sex, type of stroke, length of hospital stay, referral for physiotherapy and utilisation of physiotherapy were retrieved. Data were summarised using descriptive statistics and analysed using Chi-square test. Results: A total of 783 patients with stroke were admitted in the hospital during the period under study. The in-patient mortal ity rate was 37.2%. The mean Length of Hospital Stay (LoHS) was 16.17±12.34 days. Referral rate for physiotherapy was high (75.8%) and the mean time from admission to referral for physiotherapy was three days. Majority of patients referred utilised physiotherapy (63.4%) and mean number of physiotherapy sessions received during in-patient care was 8.69±6.45. There was a significant association between LoHS and utilisation of in-patient physiotherapy (p=0.02). Conclusion: The referral rate of stroke patients for physiotherapy was relatively high. Utilisation of in-patient physiotherapy reduced length of hospital stay among patients with stroke. Utilisation of out-patient physiotherapy was low. Strategies to enhance out-patient utilisation should be explored.Item Comparison of Community Reintegration and Selected Stroke Specific Characteristics in Nigerian Male and Female Stroke Survivors(Department of Physiotherapy, College of Medicine University of Ibadan, Nigeria, 2014) Hamzat, T. K.; Ekechukwu, N. E.; Olaleye, O.A.This study investigated the difference between community reintegration of male and female stroke survivors and the association between gender of stroke survivors and some selected stroke specific characteristics (type, side of paresis and occurrence) Fifty-two patients (25 males and 27 females) recruited from hospitals in Nigeria took part in the study. Community reintegration (CR) was assessed three months post-admission discharge using the Reintegration to Normal Living Index (RNLI). Demographic and stroke-specific characteristics were obtained using a data form. Data were analysed using descriptive statistics, the Mann-Whitney U test and the chi-square test. Level of significance was set at p = 0.05. The mean age of the participants was 61.21 ± 11.25 years (range 31 – 86 years). There was no significant difference (p = 0.173) between the community reintegration scores of male and female participants. There was also no significant association between gender and each of the selected stroke specific characteristics such as type of stroke (p = 0.279); side of paresis (p = 0.250) and occurrence of stroke (p = 0.670). Community reintegration scores of male and female stroke survivors are not significantly different. There is no significant association between gender and each of the selected stroke specific characteristics.Item Informal Stroke Caregivers’ Satisfaction with Healthcare Services in a Tertiary Healthcare Centre in Ibadan, Nigeria(Athens Alexander Technological Educational Institute, 2014) Akinpelu, A. O.; Olaleye, O. A.; Odole, A. C.; Otaiku, O. A.Background: Many of the consequences of stroke affect not only the stroke survivor but also the informal caregiver. Most studies on informal stroke caregivers in literature are on the effects of care giving on the physical, emotional and psychological well-being of these carers. Considering the important role informal caregivers play in the rehabilitation process of the stroke survivor, there is the need to consider their views and expectations from care received by their care recipients. Objectives: This study investigated the satisfaction of informal stroke caregivers with healthcare services being received by their care recipients in a tertiary hospital in Ibadan. Methodology: Fifty consenting informal caregivers (12 males, 38 females) of stroke survivors receiving in-patient care on the medical wards of a tertiary healthcare facility participated in this cross-sectional survey. A self-developed, 3-part questionnaire adapted from the Caregivers’ Satisfaction with Stroke Care Questionnaire was used for this study. Results: The data collected was summarized using descriptive statistics of mean and percentages and illustrated with pie charts. Most of the participants (44%) were children of the patients. The results obtained showed that 48% of the participants were highly satisfied, 48% were satisfied while only 4% reported dissatisfaction. Areas of dissatisfaction were quality of food, water supply, electricity supply, waiting time and information about the condition of their care recipients. Conclusion: This study showed that the extent of satisfaction of informal stroke caregivers with inpatient care at the University College Hospital was good. It has also shown the need to routinely assess the satisfaction of informal carers with services being provided in the hospital for the purpose of quality assurance.Item Functional Ability, Community Reintegration and Participation Restriction among Community-Dwelling Female Stroke Survivors in Ibadan(Jimma University (Research and Publications Office), 2014) Hamzat, T. K.; Olaleye, O. A.; Akinwumi, O. B."BACKGROUND: Stroke is not gender-discriminatory. Yet, the subject of stroke among females has apparently not received significant attention from clinical researchers. The consequences of stroke include functional and psychosocial sequelae which may cause disability, hinder community reintegration and restrict participation. The inter-relationships among functional ability, community reintegration and participation restriction of community-dwelling, female stroke survivors in Ibadan were assessed in this descriptive study. METHODS: Fifty-two community-dwelling female stroke survivors (mean age = 56.55±9.91 years) were surveyed using consecutive sampling technique. Their functional ability level was measured using the Functional Independence Measure (FIM) while London Handicap Scale (LHS) was used to assess their participation restriction. Data were analyzed using Spearman Rank Correlation Coefficient (rho) and Mann-Whitney U test at p = 0.05. RESULTS: Significantly positive correlations (p< 0.05) were found between functional ability and community reintegration (r = 0.54; p = 0.01) as well as between participation restriction and community reintegration (r = 0.34; p = 0.05). Individuals with left hemiplegia had significantly higher mean rank scores in functional ability (30.41) than those who had right hemiplegia (mean rank scores = 21.94). CONCLUSION: Functional ability which appears to be related to stroke laterality showed positive association with both community reintegration and participation restriction. This suggests that improving the functional ability of the stroke survivors may reduce participation restriction and enhance their reintegration into the community. A similar study which compares male and female stroke survivors in the same community is thus necessary. "Item Development and Evaluation of a Primary HealthCare-based Physiotherapy Intervention and its Effects on Selected Indices of Stroke Recovery(MA Healthcare Ltd, 2013) Olaleye, O. A.; Hamzat, T. K.; Owolabi, M. O.Aim: To develop a Primary Healthcare-Based Physiotherapy Intervention (PHCPI) that requires simple, inexpensive, easy-to-use equipment for stroke rehabilitation and evaluate its effects on selected clinical indices of recovery among post-acute stroke survivors over a 10-week period. Methods: Three databases (Medline, Pubmed and PEDro) were used to identify treatment approaches with proven efficacy. The authors synthesised these treatment approaches to develop the PHCPI, which was used in a repeated measure design involving 25 (mean age=60.6 ± 10.2 years) consenting individuals with first-incidence stroke. These individuals were treated at a primary health centre, twice weekly for 10 consecutive weeks. Outcomes were assessed using the Modified Motor Assessment Scale (MMAS), the Short Form Postural Assessment Scale for Stroke (SF-PASS) and the Reintegration to Normal Living Index (RNLI), before the intervention and fortnightly thereafter. Walking speed and quality of life were also assessed before the intervention and at week 10 of it. Results: Within-subject multivariate analysis, after controlling for gender, showed a significant increase in motor function, postural balance, walking speed and quality of life. Their community reintegration scores also improved over the period. Conclusion: The PHCPI resulted in improved motor function, community reintegration, walking speed, postural balance and quality of life among community-dwelling stroke survivors. This intervention can be used for stroke rehabilitation at primary health centres.Item Standing asymmetry and functional ability in relation to gait parameters in hemiparetic stroke patients(Joint Centre for Research in Prosthetics & Orthotics and Rehabilitation Programmes, 2006) Hamzat, T. K.; Olaleye, O. A.; Adeniyi, A. F.; Awolola, E. O.Objective: Relationships between some temporospatial gait parameters and each of functional ability and standing asymmetry (measured as asymmetry ratio) in hemiparetic stroke patients were investigated. Design: Ex-post facto research design. Sample Size: Thirty-one (18 males and 13 females) patients with hemiparesis, aged between 35 and 65 years (56.97 ± 11.53) were consecutively recruited from the physiotherapy out-patient facility of a Nigerian teaching hospital. Measurements: Two weighing scales were used to measure relative standing weight distribution on each lower limb and subsequently converted to asymmetry ratio (AR), while functional ability was determined using the modified motor assessment scale. Gait parameters were assessed using foot print analysis, obtained during a 10-metre walk test. Pearson's correlation matrix (r) was calculated to establish relationship at 0.05 alpha. Results: Results showed a significantly negative correlation between asymmetry ratio and each of stride length, step length and functional ability (p<0.05). Significantly positive correlation was found between motor function and cach of stride length, step length, cadence, walking speed and step time (p<0.05) were obtained. Conclusion: The lesser the standing asymmetry in stroke patients, the better their motor functions and gait performance. Programmes aimed at enhancing weight bearing activities through the paretic lower limb, to attain standing symmetry, may be used to enhance functional ability and produce better gait functions in post-stroke patients.