Objective: Women, especially young girls affected by Primary dysmenorrhea (PD), do not pay much attention to their health. Given the significance of LTPA in promoting health, this study investigated the impact of LTPA on the menstrual cycle characteristics of female undergraduates with polycystic ovary syndrome (PCOS) in Nigeria. Methods: A convenience sample of 388 female undergraduates was cross-sectionally surveyed. The International Physical Activity Questionnaire-Long form and Numerical Pain Rating Scale assessed LTPA and pain intensity of respondents. Furthermore, a pro-forma was used to document other menstrual cycle characteristics, including menarche, regularity of menstruation, perceived volume of menstrual flow and duration of dysmenorrhea pain. The level of significance was set at p < 0.05. Results: Respondents’ mean age was 20.02 ± 2.78 years (range = 15-27 years), while 256 (67.3%) were physically active. The mean pain intensity of respondents was 6.13 ± 2.23, with 329 (84.8%) having moderate-to-severe levels of pain. LTPA was significantly associated with perceived volume of menstrual flow (Χ2 =11.44; p = 0.02) and duration of menstrual pain (Χ2 =14.86; p = 0.01). In addition, LTPA was associated with perceived volume of menstrual flow (OR = 0.413; CI: 0.258 – 0.663; p=0.001) and the duration of dysmenorrhea pain (OR = 0.584; CI: 0.381 – 0.895; p=0.014). Conclusion: Overall, LTPA is significantly associated with the volume of menstrual flow and duration of menstrual pain among females with PD. Therefore, women should be educated on the positive influence of LTPA in reducing menstrual cycle disturbances.

Background: The economic burden of musculoskeletal disorders (MSDs) is significant and will grow with increasing aging population. Objectives: To assess willingness-to-pay (WTP) and its determinants for patients with MSDs with a view to ascertaining true demand for healthcare and its correlates. Methods: A cross-sectional survey of consenting physiotherapy outpatients was carried out. Sixty-eight (female = 52.9%) consecutive adult patients with MSDs receiving physiotherapy. Health-related quality of life (QoL), patients' satisfaction and WTP were assessed using the general health status SF-12 questionnaire, physical therapy patient satisfaction survey (PTPS) and WTP questionnaire, respectively. Results: The mean age of the patients was 51.6 +/- 19.4 years. The highest and lowest WTP were found in manual therapy (91.2%) and electrical muscle stimulation (0%), respectively. The highest "no WTP" was found among females and middle socioeconomic status across all physiotherapy modalities. Ethnicity and previous exposure to physiotherapy modality significantly predicted WTP (p < 0.05). Those of "Yoruba" ethnicity compared with others were 98.3% less likely to have WTP for cryotherapy (OR = 0.017; CI = 0.001-0.347; p = 0.008). Those who had previous experience of exercise treatment were 329 times more likely to have WTP for exercise than those who had not (OR = 329.02; CI = 23.60-4586.89; p = 0.001). Those who had previous treatment with electrical muscle stimulation were 11 times more likely to have WTP for cryotherapy (OR = 11.50; CI = 1.12-117.89; p = 0.04). Conclusion: WTP for physiotherapy among patients with MSDs varies according to treatment modality, prior exposure, and sociodemographic characteristics, with manual therapy most valued and electrical stimulation least preferred. These findings provide insight into patient preferences that may inform the design and delivery of more equitable and contextually relevant rehabilitation services.

BACKGROUND:The prevalence of chronic low back pain (CLBP) and its concomitant cost implications have continued to rise across the globe. Currently, there is no effective treatment for CLBP that leads to long-term improvement. Hence, there is growing recognition of the need for behaviour techniques including motivational interviewing (MI) to address CLBP. OBJECTIVE:To determine the effect of MI and exercise on pain in individuals with CLBP. METHOD:We searched for trials in seven databases from inception to April 2024. Trials were included if MI was used alone or in addition to an exercise programme for improving CLBP in adults aged (≥ 18 years). RESULTS:From 3062 records retrieved, we included three randomized controlled trials (RCTs). Only one study was rated as having a low risk of bias. There is no evidence to support the benefit of MI and exercise on improving pain (SMD-0.23, 95% CI-0.55 to 0.09, I2 = 0%, p = 0.16), disability (MD-1.80, 95% CI-4.55 to 0.94, I2 = 85%, p = 0.20) and physical functioning (SMD 0.00, 95% CI-1.31 to 1.32, I2 = 93%, p = 0.99). CONCLUSION:There is insufficient evidence to support the effect of MI and exercise on pain in individuals with CLBP. More large-scale RCTs are needed in evaluating the effectiveness of MI and exercise in individuals with CLBP.

Abstract Background Illness perception may influence the coping behaviors of patients. There is a lack of tools to measure this construct among Yoruba speakers. Therefore, we translate, cross-culturally adapt and determine the reliability and the validity of the Yoruba version of the Brief Illness Perception Questionnaire (BIPQ-Y). Methods The translation and cross-cultural adaptation process was according to Beaton criteria. The psychometric testing of the BIPQ-Y was carried out among 28 consenting patients with low back pain attending a university teaching hospital, while only 10 of them participated in the reliability test. The convergent and discriminant validity of the BIPQ-Y was carried out using the Fear Avoidance Belief Questionnaire and Quadruple Visual Analogue scale. Confirmatory factor analysis was to assess construct validity. Results The mean age of the respondents was 47 ± 15.3 years. The concurrent validity of the BIPQ-Y was excellent (r = 0.996) for the total score of BIPQ-Y while the internal consistency was moderate (α = 0.52). The test–retest of BIPQ-Y yielded excellent results with item intra-class correlation coefficient (ICC) ranging between 0.833 and 0.973 and an overall ICC of 0.889. For the confirmatory analysis of the BIPQ-Y, the factor loading for the eight items ranged from − 0.071 to 0.799 and the composite reliability was good with a score of 0.68. Conclusion The BIPQ-Y demonstrated excellent psychometric properties that are satisfactory with standards, and it is recommended for assessing illness perceptions of patients with chronic low back pain among the Yoruba-speaking populations.

Objectives:To identify non-pharmacological fatigue interventions and determine the effectiveness of these non-pharmacological interventions in reducing fatigue immediately and over time in OA.Methods:A review protocol (CRD42020163730) was developed and registered with the PROSPERO database. Included studies comprised peer-reviewed randomized controlled trials (RCTs) that examined the effects of conservative interventions on fatigue in people with upper and lower limb OA. Cochrane Collaboration's tool for assessing the risk of bias (ROB-2) was used to assess the quality of evidence of studies. Narrative synthesis was used to summarize the effectiveness of identified fatigue interventions.Results:Out of 2644 citations identified from databases, 32 reports were included after screening for titles, abstracts and full texts. Of these reports, 30 parallel RCTs, one cluster and one cross-over RCT were included. 13 RCTs were of low ROB, 6 had some concerns and 13 had high ROB. The narrative synthesis identified interventions for fatigue including exercise, activity pacing, cognitive behavioural therapy, telerehabilitation and complementary alternative therapies. Exercise interventions showed the most significant beneficial effects on fatigue.Conclusions:Diverse interventions for fatigue management among individuals with upper and lower limb OA were identified. Of these, exercise interventions appear to be the most promising with the majority of these interventions favouring fatigue improvement. While cognitive behavioural therapy has limited evidence of beneficial effects, there is insufficient evidence regarding the effectiveness of other identified interventions, including complementary and alternative therapies, and telerehabilitation.

Background: The potential moderators of the nexus between internet addiction (IA) and symptoms of anxiety are less understood. This cross-sectional study aimed to assess the moderating roles of physical activity (PA) and gender in the association between IA and anxiety. Methods: A cross-sectional study of 510 Nigerian undergraduate students was carried out. IA, anxiety, and PA levels (low, moderate, and high) were assessed using Internet Addiction Test, anxiety sub-scale of Depression Anxiety Stress Scale-21, and Patient-Centered Assessment and Counseling for Exercise Plus Nutrition, respectively. Moderation analysis was applied while controlling for important covariates. Results: The mean age of the respondents was 21.33 +/- 2.63 years. The prevalence of IA and anxiety was 57.6 % and 52.6 %. IA was positively associated with anxiety (b=0.307, 95 % CI: 0.2168-0.3982, t (498) =6.660, p < 0.001). PA level, but not gender seem to moderate the association between IA and anxiety (F (2, 498) =3.561, p=0.029, R-2 change =0.011). Moreover, interaction between PA and gender indicated that the moderating effect of PA was less pronounced among females compared with males (F (3, 498) =2.895, p=0.035, R-2 change =0.014). Conclusions: PA can attenuate the deleterious nexus between IA and anxiety in young adults. The attenuation of PA in IA-anxiety nexus is weaker among female young adults compared with male counterparts. PA is a viable low-cost intervention strategy in combating the effect of IA on symptoms of anxiety among young adults. Further longitudinal and experimental studies are needed to better understand the underlying mechanisms among IA, anxiety symptoms, PA, and gender.

Abstract Background and objective The association of clinical factors of osteoarthritis (OA) with bone mineral density (BMD) is not well understood. We aimed to synthesize evidence regarding the associated clinical factors for low BMD in people with knee and/or hip osteoarthritis. Methods A systematic literature search limited to human studies was conducted from inception to September 12, 2022. CINAHL, Cochrane, Medline, PsycINFO, PubMed, Web of Science, and African Journal online databases were searched for all clinical factors associated with low BMD (either as osteopenia or osteoporosis). Gray literature or abstracts or protocols, studies with a mixed population of OA without a subgroup analysis for hip and or KOA and non-English were excluded. Following the title and abstract, full-text, screenings, and data extraction, data from eligible studies were synthesized based on the main objective of the study. The Joanna Brigg’s Institute (JBI) Critical Assessment tool was used for quality appraisal. Narrative synthesis and best evidence synthesis were used in the study. Result Five studies (2 case–control, 3 cross-sectional) were included after screening 3355 titles and abstracts. Clinical factors reported in the five studies included: body mass index (BMI); pain, function, and stiffness; symptom duration; presence of varus/valgus deformity; quality of life; and knee function. Whilst there was limited evidence to support the association between BMD measured at any site of the body and BMI, as well as conflicting evidence for the association of BMD with age and gender, there was insufficient evidence to support the association of BMD with other identified clinical factors of hip and or/ knee OA (p < 0.05). In addition, there is conflicting evidence for the association between BMD measured at the lumbar spine and BMI. Conclusion There is insufficient evidence on the association between BMD and its associated clinical factors. With the attendant likelihood of bias in existing studies, there is a need for well-designed studies on bone health in OA.

Abstract Background Access to physical activity information provides opportunities for enduring and relevant messaging regarding physical activity. This may be a potential vehicle to optimise physical activity participation among emerging adults. This study aimed to characterise the physical activity information-seeking behaviour in a sample of university undergraduate emerging adults. Methods Five hundred and seventy-five undergraduate students (age = 21.7 ± 1.9 years) participated in the study. Respondents’ physical activity information-seeking behaviour was obtained using an adapted instrument, while physical activity and barriers were assessed using the International Physical Activity Questionnaire and the Exercise Benefits and Barrier Scale. Results Three hundred and fifty-one respondents (61%) of respondents sought physical activity information. The majority of these individuals (73.8%) sought physical activity information using social media. After identifying and controlling for confounders including engaging in physical activity programmes and faculty of study, having low physical activity levels was associated with a < 1 likelihood of seeking physical activity information compared to having high physical activity levels (odds ratio = 0.5, 95% confidence interval 0.27–0.87; p = 0.015). However, there was no association between barriers to physical activity and physical activity information-seeking behaviour (odds ratio = 1.17, 95% confidence interval 0.81–1.69; p = 0.40). Conclusion Undergraduate emerging adults seek physical activity information using social media to enhance their physical appearance and health.

Background Pain and physical function are common factors targeted for osteoarthritis (OA) management. However, fatigue has been reported as an important component of OA experience and a significant concern for people with OA (Power et al., 2008). Despite this, fatigue has received very little attention. However, with increasing interests in fatigue, it is expedient that fatigue be considered a top priority in clinical practice (Overman et al., 2016). Thus, there is dire need for evidence-based fatigue interventions in OA given the paucity of evidence in this area. Objectives To identify fatigue interventions and determine the effectiveness of the interventions in reducing fatigue immediately and over time in OA. Methods A review protocol was developed and registered with the PROSPERO database, with the ID-CRD42020163730. Studies included comprised peer-reviewed randomized controlled trials (RCTs) that examined the effects of any intervention in the management of fatigue or vitality outcomes in people with upper limb and lower limb OA. Studies that used spiritual, pharmacological or surgical interventions to manage fatigue in patients with upper limb and lower limb OA were excluded. The Cochrane Collaboration’s tool for assessing the risk of bias (ROB) was used assess the quality of evidence for the included RCTs. Narrative synthesis was used to summarise the identified fatigue interventions while only studies on exercise interventions were used in the meta-analysis. Results Out of 2,586 studies identified from database search, 31 RCTs studies were included after screening for titles, abstracts and full texts. Of the 31 included RCTs, only nine studies were included in the meta-analysis comparing the effects of exercise versus non-exercise interventions on fatigue. From the ROB assessment, 11 RCTs were of low ROB whilst 11 had moderate and 9 high ROB respectively. The narrative synthesis identified 12 interventions for fatigue and these include activity pacing, cognitive behavioural therapy (CBT), yoga, exercise, acupuncture, moxibustion, pain-coping skills, BEMER therapy, modified shoes, massage/aromatherapy, education and thermotherapy. Exercises interventions included strengthening, balance, kinesthesia, and mobilization, hand-based, stretching, aquatic danced-based and web-based exercises. Activity pacing (mean difference [MD]=0.8; (standard deviation [SD]=0.3), CBT (MD=4.32; [SD]=1.85), moxibustion (vitality: MD=-2.61; [standard error]=-1.69) had statistically significant reductive immediate effect on fatigue. The meta-analysis pooled effects showed that exercise interventions on fatigue in OA was not statistically significant both immediately (SMD=-0.10; 95% CI -0.74, 0.54; I2=94%) and overtime (SMD=-0.79; 95% CI -2.30, 0.73; I2=98%), although the effects was in favour of exercise interventions relative to other comparison non-exercise interventions. Conclusion Activity pacing, CBT and moxibustion interventions showed beneficial effects on fatigue in OA immediately. Cumulatively, the pooled effect of exercise on fatigue was not statistically significant immediately and overtime but the effect was in favour of the exercise interventions relative to other control interventions. However, there is currently insufficient evidence regarding the effectiveness of majority of identified fatigue interventions in this review. Further, the findings of the meta-analysis may have been affected by high level of heterogeneity. Largely populated RCTs with low ROB are needed to ascertain the effectiveness of fatigue interventions in OA population. References [1]Power JD, Badley EM, French MR, Wall AJ, Hawker GA., 2008. Fatigue in osteoarthritis: a qualitative study. BMC Musculoskelet Disord. 9(1):63. doi:10.1186/1471-2474-9-63 [2]Overman CL, Kool MB, Da Silva JA, Geenen R. 2016. The prevalence of fatigue in rheumatic disease: An international study. Clin Rheumatol.25(2), 409-415. doi.10.1007/s10067-015-3035-6 Acknowledgements: NIL. Disclosure of Interests None Declared.

Purpose: To evaluate disability profile and accessibility limitations among Persons Living with Disabilities (PLWDs) in Nigeria. Methods: 61 PLWDs (44 men, 17 women) consented for this study. World Health Organization Disability Assessment Schedule 2.0, Facilitators and Barriers Survey for People with Mobility Limitations version 2, Barthel Index, and Medical Expenditure Panel Survey Questionnaires were used to obtain data on physical disability profile, level of access barriers, activities of daily living and quality of access to health care respectively. A proforma was used to collect information on socio-demographic characteristics. Data were analyzed using descriptive and inferential statistics. Alpha level set at p< 0.05. Results: Prevalence of mobility, visual and hearing impairments were 60.7%, 21.3% and 6.6% respectively, There was a 11.5% rate of functional limitation while mild difficulty with ‘cognition’ and ‘life activities’ were reported among 96.7% and 65.6% of the respondents. 24.6% of the respondents had partial mobility dependence. There was low quality of access to health care (67.2%), high access barrier to home environment (73.8%) and transportation (93.4%). Conclusion: The PLWDs have high mobility impairment and face barriers in accessing healthcare, transportation and environment.

COVID-19 lockdown, targeted at preventing the spread of coronavirus, had deleterious effects on physical and psychosocial health.This study examined the association between physical activity (PA), sedentary behaviour, health-related quality of life (HRQoL), loneliness and quality of sleep of 507 Nigerian adults during the COVID-19 lockdown.Five hundred and seven respondents (aged 18-67 years) from 12 States completed an online survey on RedCap.Questionnaires comprising the Stages of Change scale, Pittsburgh Sleep Quality Index, International Sedentary Assessment Tool, UCLA Loneliness Questionnaire, Short Form-12 Health Survey, and International Physical Activity Questionnaire were used.Respondents were categorised based on exercise behaviour as non-exercisers, non-regular exercisers, or regular exercisers; and based on age into 18-24, 25-34, 35-44 and > 44 years categories.Descriptive and inferential statistics were used to analyse the data.About 33.1% of respondents did not meet moderate-to-vigorous PA levels.The physical component of HRQoL was positively associated with total PA (p = 0.04).Among the non-exercisers, the odds of being regular exercisers during pre-COVID-19 lockdown were significantly higher for the 35-44 (odds ratio [OR] = 3.49; 95% CI = 1.44, 8.48, p = 0.01) and > 44 years age groups (OR = 2.98; 95% CI: 1.16, 7.62, p = 0.02) relative to 18-24 years age category.During COVID-19 lockdown, > 44 (OR = 3.65; 95% CI: 1.47, 9.07, p = 0.005), 35-44 (OR = 6.42; 95%CI 2.75, 14.96, p = 0.001) and 25-34 (OR = 2.35; 95% CI: 1.15, 4.80, p = 0.02) years age categories had significant higher odds of being regular exercisers compared to the 18-24 years age group.There was a high rate of physical inactivity among Nigerian adults during the COVID-19 lockdown, which was directly influenced by the physical components of HRQoL.Older age was an independent predictor of exercise behaviour before and during the COVID-19 lockdown among Nigerian adults.

BACKGROUND:Typically, bricklayers in developing countries' contexts manually lay bricks, concrete blocks and other similar materials to construct walls and buildings which make them susceptible to work-related musculoskeletal disorders (WRMSDs). The burden of WRMSDs among this high-risk group seems has not been well documented.OBJECTIVES:This study examined the prevalence of WRMSDs among bricklayers in Nigeria.METHODS:A cross-sectional survey of 118 consenting bricklayers from a Nigerian setting was carried out. The standardized Nordic musculoskeletal disorder questionnaire and a proforma were used to profile the prevalence of WRMSDs and socio-demographic information of the respondents. Data was analyzed using descriptive and inferential statistics. Alpha level was set at p < 0.05.RESULTS:The 12-months and 7-days prevalence of WRMSDs were 87.3% and 67.4%. Shoulder (61.0%) and the low-back (59.3%) were the two most affected anatomical sites based on 12-month prevalence. WRMSDs affecting the knees (6.8%) was the most disabling in carrying normal work routines. Working for less than 10 years was significantly associated with high prevalence of WRMSDs in the shoulder (odd ratio (OR) = 0.27, 95% confidence interval (CI) = 0.09 to 0.87) and wrist region (OR = 0.24, 95% CI 0.08 to 0.73). Having neck pain led to higher odds (OR = 0.29, 95% CI 0.13 to 0.68) of taking a break from work among the bricklayers.CONCLUSIONS:WRMSDs were high among Nigerian bricklayers. Years of work experience was associated with high prevalence of WRMSDs in the shoulder and wrist. In addition, taking work breaks was associated with neck pain.

Background Exercise provokes psychological responses that results in an increase in positive affect and mood, and a reduction in negative affect in patients with musculoskeletal problems including knee osteoarthritis (KOA) (Hoffman and Hoffman, 2007; Ekkekakis and Petruzzello, 1999). However, there is no consensus on the optimum duration of exercise that will bring about such positive effects among individuals with KOA. Objectives The objective of this study was to compare the acute effects of 10- and 15- minute bicycle ergometry exercise on affect, mood and pain in patients with KOA. Methods A quasi-experimental study with a follow-up arm. Forty-six participants with KOA were randomly assigned to either a 10-minute bicycle ergometer (10BE) exercise group or a 15-minute bicycle ergometer (10BE) exercise group. Participants’ affect, mood and pain were assessed at baseline, pre-exercise, immediately after the exercise, 10 minutes post-exercise, and 20 minutes post-exercise using the International Positive and Negative Affect Scale, Visual Analogue Mood Scale, and Visual Analogue Scale, respectively. Descriptive statistics, Friedman’s ANOVA, Mann-Whitney-U and generalised estimating equation were used to analyse the data with P-value at 0.05. Results Participants’ (94.23% females) age ranged from 40-79 years for the two groups. The mean age for 10BE and 15BE groups was 67.09±1.85 and 66.96±2.03 years, respectively. At baseline, the median scores for positive (19.00; interquartile range (IQR=18.00-20.00 vs. 20.00; IQR=18.00-21.00) and negative (8.00; IQR=7.00-11.00 vs. 9.00; 5.00-14.00) affect, mood (6.00; IQR= 3.00-8.00 vs. 7.00; IQR=4.75-8.00) and pain (5.00; IQR=5.00-8.00 vs. 5.50; IQR=5.00-7.00) were not significantly different between10BE and 15BE. Ten minutes of aerobic exercise significantly improved PA ( P =0.001; Effect size (Es)=0.25)) and mood ( P =0.001; Es=0.58), and reduced NA ( P =0.001; Es=0.44) and pain ( P =0.001; Es=0.73) of participants across the time points of the study. A 15-minute aerobic exercise also significantly improved PA ( P =0.001; Es=0.25), mood ( P =0.001; Es=0.45) and reduced NA ( P =0.001; Es=0.49) and pain ( P =0.001; Es=0.84) of participants across the time points of the study. There was no significant difference between groups and group-time interactions regarding effect of aerobic exercise on the outcomes (p>0.05). Conclusion Both 10- and 15-minutes single bouts of bicycle ergometry exercise had positive effects on affect and mood in individuals with KOA. Ten and 15- minutes single bout of bicycle ergometry exercise had comparable effects on affect and mood improvements in individuals with KOA. References [1]Ekkekakis P, Petruzzello SJ (1999). Acute Aerobic Exercise and Affect. Sports Medicine, 28(5):337–374. doi:10.2165/00007256-199928050-00005. [2]Hoffman MD, Hoffman DR (2007). Does aerobic exercise improve pain perception and mood? A review of the evidence related to healthy and chronic pain subjects. Current Pain and Headache Reports, 11(2):93–97. doi:10.1007/s11916-007-0004-z Disclosure of Interests None declared

Purpose: Fatigue is a significant debilitating symptom which is often neglected by health care professionals in clinical practice. Moreover, patients with knee osteoarthritis (KOA) have reported fatigue as a major symptom that negatively affects daily functioning and quality of life. Currently, there is evidence to suggest that long-term physical activity has the potential to reduce fatigue both in chronic conditions and KOA populations. However, there are also indications that some of forms of exercise may worsen fatigue symptom even though the evidence is still accruing.

Background:Health literacy is an important multidimensional concept of public health concern and a determinant of health outcomes and access to healthcare which requires robust measurement. The objective of this study was to culturally adapt and establish the psychometric properties of the Yoruba version of the Health Literacy Questionnaire.Methods:A cross-sectional survey of Nigeria Yoruba speaking adults was conducted with the Health Literacy Questionnaire following its translation and adaptation. Data were subject to psychometric evaluation (confirmatory factor analysis, composite reliability, Cronbach's alpha, intra class correlation) and association with sociodemographic variables.Results:A total of 258 adults with mean age 26.7 years participated in the study. The easiest scale to score highly was 'Actively managing my health' and hardest was 'Ability to find good health information' and 'Navigating the healthcare system'. Six one-factor models fitted well without correlated residuals but the other three had a good fit after model modification. Composite reliability and Cronbach's α of ≥ 0.7 were observed for all scales, suggesting good internal consistency of the scales. Test-retest reliability of the Yoruba translation of the Health Literacy Questionnaire was moderate to good in all scales, intra class correlation ranging from 0.66 to 0.76.Conclusion:The Health Literacy Questionnaire was successfully translated and culturally adapted and demonstrated good content and construct validity and high composite reliability. The Yoruba translation of the Health Literacy Questionnaire has the potential of being a useful clinical tool for the assessment of health literacy, especially among Yoruba speaking community of Nigeria. Thereby helping to improve the health outcomes through access to healthcare.

Abstract Background Graded activity is gradually emerging as a preferred choice in improving psychosocial outcomes including pain self-efficacy, fear-avoidance beliefs, and back-pain beliefs in the general population with low back pain (LBP). Such evidence is, however, lacking among patients with concomitant LBP and type-2 diabetes mellitus (T2DM). This secondary analysis of a randomized control trial aimed to compare the efficacy between graded activity augmented with additional daily-monitored-walking and graded activity alone on disability, pain self-efficacy (PSE), fear-avoidance beliefs (FAB), back-pain beliefs (BPB) and glycaemic control (HbA1c) in patients with concomitant LBP and T2DM. Methods Fifty-eight patients with concomitant LBP and T2DM were randomised into two groups, graded activity with daily-monitored-walking group (GAMWG = 29) or (graded activity group (GAG = 29) in this 12-week single-blind trial. Both groups received graded activity (home/work-place visits, back school and sub-maximal exercises) while the GAMWG received additional daily-monitored-walking. Disability and selected psychosocial outcomes were assessed at weeks 0, 4, 8 and 12 using Roland-Morris disability, fear-avoidance behaviour, pain self-efficacy and back belief questionnaires. Glycaemic control was assessed at weeks 0 and 12 using a point-of-care system (In2it, Biorad Latvia). Data were analysed using mean, median, Friedman’s ANOVA, Mann-Whitney test and t-tests. Results Participants’ mean age was 48.3 ± 9.4 years (95%CI: 45.6, 50.9) while 35.3% were males. The GAMWG participants (n = 25) had better outcomes (P < 0.05) than GAG participants (n = 26) on PSE (1.0, 3.0; r = − 0.1) and FAB (0.01, − 2.0; r = − 0.1) at week 4, LBP-related disability (0.01, − 2.0; r = − 0.2) at week 8 and glycaemic control at week 12 (− 0.59 ± 0.51%,-0.46 ± 0.22%). No other between-group comparisons were statistically significant. Conclusion Graded activity with daily-monitored-walking provided earlier improvements on disability, pain self-efficacy, fear-avoidance beliefs, and glycaemic control, but not back pain beliefs, in patients with concomitant LBP and T2DM. Trial registration PACTR201702001728564 ; 26 July, 2016 (retrospectively registered).

Conclusion The Y-SBT have acceptable psychometric properties. It is recommended for use among Yoruba speaking patients with LBP. Background Translating questionnaires into local languages is essential as it aids easy accessibility and understanding of such questionnaires by patients and their health caregivers. The STarT Back Tool (SBT), validated tool used to classify subgroups of persons with Low-Back Pain, has few translated versions. We translated the STarT Back Tool into the Yoruba language and established its psychometric properties among patients with long-term non-specific Low-Back Pain. Methods Following the Lenz protocol, the SBT was successfully cross-culturally adapted into the Yoruba language. One hundred consenting patients (mean age = 57.0±11.43 years, 55% females) took part in the validation phase, while 53 of them participated in the test-retest phase. Psychometric indices of the Y-SBT assessed showed internal consistency, intraclass correlation coefficient (ICC), ceiling and floor effects and divergent validity. Results The sub- and total Cronbach's α score for Y-SBT was 0.704 and 0.857, respectively. The test-retest reliability of the sub- and total scores of the Y-SBT yielded an ICC of 0.82 (95% CI: 0.74 - 0.87) and 0.89 (95% CI: 0.84 - 0.93), respectively. The divergent validity for sub- and total-scores of the Y-SBT based on Quadruple Visual Analogue Scale score for on-going pain was r = 0.374 (p = 0.001) and r = 0.432 (p = 0.001), respectively. The Y-SBT had no ceiling or floor effects.

Conclusion This is the first study to assess the psychometric properties of the Y-SF-12. It appears to be valid and may be an appropriate tool for assessing health-related quality of life among Yoruba population. The tool may help to improve the health outcomes of individuals, and redress health inequalities in low and middle-income countries. Background Short Form 12 (SF-12) health survey has found its utility in clinical and research settings because of its short length that spares time. Though several translations into other languages do exist there is none available in Yoruba language. Hence, this study's objective was to culturally adapt and determine the reliability and validity of the Yoruba translated version of the SF-12. Methods Forward and backward translations of SF-12 into Yoruba version of SF-12 (Y-SF-12) were done using the International Quality of Life Assessment Project Guidelines. Healthy participants were assessed using both English and Yoruba versions of SF-12 for the validation phase, and two weeks later were reassessed with the Y-SF-12 for the reliability phase. Results Participants were 225 males and 171 females. The mean scores for each scale range from 73.4 to 86.1, with no gender difference. All scale and domain scores evidenced a negative skew and ranges from -1.79 to -0.62. Concurrent validity (0.879 - 0.938) and convergent validity (0.786 - 0.907) appeared to be good as reflected by their correlation values. The internal consistency of Y-SF-12 was good as Cronbach's Alpha ranged between 0.899 and 0.968, while the Intraclass Correlation Coefficient (ICC) ranged between 0.775 and 0.949.

STUDY DESIGN:Cultural adaptation and psychometric analysis. OBJECTIVE:This study determined the test-retest reliability, acceptability, internal consistency, divergent validity of the Yoruba pain self-efficacy questionnaire (PSEQ-Y). It also examined the ceiling and floor effects and the small detectable change (SDC) of the PSEQ-Y among patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA:There are various indigenous language translations of the PSEQ and none adapted to African language. However, translations of the PSEQ into Nigerian languages are not readily available. METHODS:The validity testing phase of the study involved 131 patients with LBP, while 83 patients with LBP took part in the reliability phase. Following the Beaton recommendation for cultural adaptation of instruments, the PSEQ was adapted into the Yoruba language. The psychometric properties of the PSEQ-Y determined comprised: internal consistency, divergent validity, test-retest reliability, and SDC. RESULTS:The mean age of the participants was 52.96 ± 17.3 years. The PSEQ-Y did not correlate with the Yoruba version of Visual Analogue Scale (VAS-Y) scores (r = -0.05; P = 0.59). The values for the internal consistency and the test-retest reliability of the PSEQ-Y were 0.79 and 0.86, with the 95% confidence interval of the test-retest reliability ranging between 0.82 and 0.90. The standard error of measurement (SEM) and the SDC of the PSEQ-Y were 1.2 and 3.3, respectively. The PSEQ-Y had no floor or ceiling effect, as none of the respondents scored either the minimal or maximal scores. CONCLUSION:This is the first study in Nigeria to culturally adapt PSEQ. The PSEQ-Y showed adequate psychometric properties similar to existing versions. Therefore, the tool can be used to assess pain self-efficacy in clinical and research settings and help to improve the health outcomes of patients chronic LBP.Level of Evidence: 3.