Missed appointments (MAs) contribute to the rising costs of physiotherapy and are a significant challenge to healthcare administration, organisational workflow and health outcomes for patients. This study assessed prevalence and pattern of missed physiotherapy appointments, wait time, and its impact on cost, efficiency and patient outcome in Nigeria. A retrospective study was conducted at the Outpatient Physiotherapy Clinic of Obafemi Awolowo University, Ile-Ife, Nigeria. A total of 3243 physiotherapy appointments booked between 2009 and 2018 were assessed. Data were collected on socio-demographic and patient outcomes related to Mas. MAs was defined as any appointment where a patient did not show up at all, or attend to follow up appointment or notify staff of a cancellation. The total revenue loss due to MAs was calculated as a product of the total of MAs and per treatment cost. Descriptive of mean, standard deviation and frequency and inferential statistics of t-test were used to analyse the data. MAs constituted 1701 (52.5%) of all appointments and the average wait time for first appointment was 9.6 ± 23.2 days. The proportion of MAs was higher among females (50.2%), middle-aged adults (34-55 years) (31.7%), patients who were not resident close to the clinic (45.3%), patients with orthopaedic conditions (56.2%) and patients referred from orthopaedic surgeons (32.8%). There were significant associations (p < 0.05) between MAs and age, sex, location of patient’s residence and the source of referral. Considering the per treatment schedule cost of 1000 naira, a 52.5% MAs rate resulted in a lower efficiency of 76.6% with an efficiency ratio of 0.23. MAs for physiotherapy treatment poses a significant challenge on costs, efficiency and patients’ outcome. Thus, an innovative reminder system may help reduce patients’ non-attendance of physiotherapy and its consequences.

Background: Bullying is an unexpressed part and parcel of medical education but it is largely unexplored in physiotherapy. This study assessed the prevalence and socio-demographic correlates of bullying in physiotherapy education in Nigeria.Methods: Two hundred and nineteen clinical physiotherapy students from three purposively selected Federal Universities in Nigeria participated in this study. Following a cross-sectional design, the Students Perception of Professor Bullying Questionnaire (SPPBQ) was used to obtain information on bullying. The SPPBQ includes a working definition of lecturer bullying followed by two sections inquiring about lecturers bullying experiences. Data was collected on socio-demographic characteristics, availability of adequate policy and support and the different forms of bullying experienced. Descriptive and inferential statistics were used analyze data. Alpha level was set at p<0.05. Results: Lifetime and point prevalence of bullying in physiotherapy education was 98.6% and 99.1% respectively. 94.5% of the respondents had witnessed physiotherapy students bullying and there was a 100% rate of ‘no attempt’ to stop a physiotherapy lecturer from bullying. There was no significant association between bullying and each of age (𝜒2=0.117, p=0.943), gender (𝜒2=0.001,p=0.974), university (𝜒2=1.343,p=0.511) and level of study (𝜒2=0.000,p=0.995). Conclusion: There is high lifetime and point prevalence of bullying in physiotherapy education in Nigeria, which are largely unchallenged or redressed. Also, being a clinical physiotherapy student makes prone to bullying without necessary contributions of other intrinsic and extrinsic factors.

INTRODUCTION:Low-Back Pain (LBP) is a common public health problem that is often worsened by maladaptive beliefs and disability. Thus, necessitating the need for availability of outcome measures to assess these sequelae among patients with chronic LBP. This study aimed to cross-culturally adapt and determine the psychometric properties of the Yoruba version of the ODI (ODI-Y).METHODS:The ODI-Y was cross-culturally adapted following the process involving forward translation, synthesis, backward translation, expert review, and pilot testing. Internal consistency and test-retest reliability of the ODI-Y were determined using the Cronbach's alpha and intra-class correlation. Other psychometric properties explored included the factor structure, convergent validity, standard error of measurement and the minimal detectable change.RESULTS:One hundred and thirty-six patients with chronic LBP took part in the validation of the ODI-Y; 86 of these individuals took part in the test-retest reliability (within 1-week interval) of the translated instrument. The mean age of the respondents was 50.5±10.6years. The ODI-Y showed a high internal consistency, with a Cronbach's alpha (α) of 0.81. Test-retest of the Yoruba version of the ODI within 1-week interval yielded an Intra-Class Correlation coefficient of 0.89. The ODI-Y yielded a three-factor structure which accounted for 61.56% of the variance. Correlation of ODI-Y with the visual analogue scale was moderate (r = 0.30; p = 0.001). The standard error of measurement and minimal detectable change of the ODI-Y were 2.0 and 5.5.CONCLUSIONS:The ODI was adapted into the Yoruba language and proved to have good psychometric properties that replicated the results of other obtainable versions. We recommend it for use among Yoruba speaking patients with LBP.

Background: Vacillation between conventional healthcare professionals and traditional bone setters (TBS) for musculoskeletal (MSK) disorders is still common despite shortcomings and complications associated with TBS services. Objectives: This study assessed knowledge and attitude about the practice of TBS and its use for MSK disorders among Nigerian rural dwellers. Methods: This cross-sectional study utilized a multistage sampling method based on the World Health Organization procedures for a community-based survey to recruit 398 (213 males and 185 females) respondents from two randomly selected rural communities. A validated questionnaire adapted from relevant previous studies was used as a tool in this study. A household was served as the Primary Sampling Unit (PSU) and 60 PSUs were randomly selected. Results: The lifetime and 12-month prevalence of MSK disorders were 27.6% and 25.6%, respectively. Based on 12-month prevalence, neck (16, 21.6%) and shoulder (12, 17.6%) were the most affected body parts. The lifetime (i.e. “ever use”) and point (“current use”) prevalence of treatment by TBS were 19.3% and 3.8%, respectively. Among those who had ever experienced MSK disorders, 13.3% had experienced only treatment by TBS services, whereas 6.0% had used both treatment by TBS and orthodox medicine. Common services received by TBS were massage (61.0%), splinting (14.3%), traction (11.7%), and scarification (10.4%). Cost-effectiveness (42.9%), distance/accessibility (35.1%), and cultural beliefs (15.9%) were the major reasons for TBS patronage. Using TBS services was not significantly associated with socio-demographic variables (P > 0.05). Also, 57.3% of the respondents acknowledged that TBS services were associated with complications, such as gangrene (19.7%), malunion/nonunion of fractures (36.0%), paralysis (19.3%), joint instability (7.5%), and chronic osteomyelitis (6.6%). Users of the TBS services believed that they were effective in maintaining a healthy life (40.7%), with fewer side effects (30.0%), more effective (11.7%), and healthier than orthodox medicine (23.1%). Conclusions: There was a positive attitude towards treatment by TBS for MSK disorders, despite the complications and shortcomings that arise from the practice. Cost-effectiveness, socio-cultural beliefs, and easy access have increased patronage of treatment by TBS regardless of the socio-demographic characteristics of the people.

PurposeThe objective was to determine the correlations between age, body mass index, foot length, tibia length, and calf circumference – and unipedal non-dominant lower limb balance (UNLLB), on the basis of the contributions of each physical attribute to UNLLB performance among professional football players in a Nigerian National Football League club.MethodsThis descriptive correlational study involved 32 purposively recruited male professional football players who met the inclusion criteria. The participants’ age was recorded along with height, weight, foot length, tibia length, and calf circumference, measured with standardized procedures, while their UNLLB was assessed with the use of a Wii Balance Board. The primary outcome measure was UNLLB, reflecting the centre of pressure parameters. The data were analysed with the Spearman rank order correlation; stepwise multiple linear regression analysis was used to explore the contributions of the selected variables to UNLLB at 0.05 alpha levels.ResultsAll physical attributes except age were significantly correlated with UNLLB. The stepwise regression analysis showed limb length (13.2%, p = 0.023, f2 = 0.191), calf circumference (22.3%, p = 0.004, f2 = 0.329), and weight (11.5%, p = 0.033, f2 = 0.167) to be significant contributors to UNLLB with visual input allowed, while tibia length (14.9%, p = 0.017, f2 = 0.215) and foot length (9.5%, p = 0.048, f2 = 0.142) were significant predictors with visual input denied.ConclusionsLimb length, calf circumference, body weight, tibia length, and foot length are significant predictors of UNLLB among professional footballers.

Hamstring tightness has been documented not to be related to the pelvic tilt position during static standing posture, but there is limited data on the relationship between hamstring muscle length (HML) and pelvic tilt range (PTR) during the dynamic movement of forward bending.This ex-post facto study was designed to compare each of HML and PTR in individuals with low back pain (LBP) and counterparts without LBP, and the relationship between HML and PTR in individuals with and without LBP. The study involved 30 purposively recruited individuals with LBP and 30 height and weight-matched individuals without LBP. Participants' PTR and HML were assessed using digital inclinometer and active knee extension test respectively. Data were analyzed using t-test and Pearson Correlation (r) at alpha = 0.05.Participants without LBP had significantly longer (p = 0.01) HML than those with LBP but the PTR of both groups were not significantly different. HML and PTR had indirect but not significant correlations in participants with and without LBP.Hamstring muscle length is significantly reduced in individuals with LBP but it has no significant correlation with pelvic tilt range. Pelvic tilt range reduces as hamstring muscle length increases. (C) 2016 Elsevier Ltd. All rights reserved.