Theses and Dissertation (Medical Rehabilitation)

Evaluation of Three Selected Therapeutic Exercise Protocols in Retraction of Abdominal Muscles Andresolution of Diastasis Recti Abdominis in Postpartum Women

Tue, 01 Sep 2015 00:00:00 GMT

Evaluation of Three Selected Therapeutic Exercise Protocols in Retraction of Abdominal Muscles Andresolution of Diastasis Recti Abdominis in Postpartum Women Igwe, Sylvester Emeka This study was undertaken to evaluate isotonic, isometric and isotonic/isometric combination exercises in the retraction of abdominal muscles,and to assess the effectiveness of isometric contraction in resolving diastasis recti abdominis in postpartum women. A total ofninetywomenof four to eight weeks postpartum who consented to the study were randomly selected. They comprised respectivelyof 29 (32.2%) primigravids and 61 (67.8%) multigravids with the mean age of 32.59±5.79 years.A batch of 60 women were grouped into four:group A, 15(Isotonic abdominal exercises), group B, 15 (Isometric abdominal exercises), group C, 15 (combination of isotonic and isometric exercises) and control group D, 15 who received no abdominal exercises for six weeks. Another batch of30 subjects for diastasis recti abdominis study were grouped into two: 23 (isometric group A) and 7 (control group B). For subjects in the first category, both initial and weekly abdominal girth were measured and recorded for six consecutive weeks, using a portable electronic myotape device, while category two subjects had initial and weekly inter-recti distance (IRD)measured at 2.5cm above and below the umbilicususing ultrasound imaging technique. The category one results showed no significant decrease (p> 0.05) in the mean abdominal girth at baseline, first week and second week across the groups. However, there was a significant decrease (p< 0.05) in the mean abdominal girth across the groups at the third to sixth weeks. The mean abdominal retraction value in the multigravid group (7.0 ± 1.8cm) was found to be higher than that of the primigravid group (6.2 ±1.9cm) and this was consistent through the periodsand statistically significant (p< 0.05). The mean abdominal retraction index (RI ≥ 50%) was achieved by all groups except the control, at different periods. An overall view of category two results revealed statistically significant increase in closure of inter-recti distance of experimental group over the control, though not statistically significant (p< 0.05). There was significant relationship between closure at the upper and lower margins of the umbilicus(p < 0.05), in favour of the former.Closure of inter-recti distance was alsosignificant (p< 0.05) at the fourth week when compared with the baseline. Result also showed that younger postpartum women achieved significantly better recovery from diastasis recti abdominis than their older counterparts. Thus these therapeutic exercise qualities should be recommended for the retraction of abdominal muscles as well as resolution of diastasis recti abdominis in postnatal women.

Post Partum Urinary Incontinence and Its Predisposing Factors in Enugu Metropolis

Tue, 01 Sep 2015 00:00:00 GMT

Post Partum Urinary Incontinence and Its Predisposing Factors in Enugu Metropolis Chukwu, Sylvester Caesar The aim of this study was to determine the prevalence of postpartum urinary incontinence and its predisposing factors in Enugu metropolis. The study adopted a cross sectional survey. A total of 864 postpartum mothers within the age range of 16 and 45 years, who gave their informed consent, were conveniently selected from the post-natal clinics of the nine public health institutions in Enugu metropolis. Women continence and pelvic health centre questionnaire was adopted. The questionnaire sought information on the continence status of the subject. Body mass index, waist-hip ratio, percentage body fat and percentage body water was also determined. The major findings revealed high prevalent rate (59.7%) of postpartum urinary incontinence, especially in those without formal education (78.7%), those who were centrally obese (100%) and (74.1%) of those within the age of 36years and above. Result showed a significant association (p<0.05) between postpartum urinary incontinence and educational qualification, weight of the baby, parity, age of the mother, and obesity, and no significant association with mode of delivery (p>0.05). It was also observed that most women affected (96%) do not seek for medical attention, higher percentage of those who sought medical attention (2.2%) are not referred for physiotherapy intervention which was confirmed to be effective in this research. Based on the findings of this study, it could be concluded that; educational attainment, age of the mother, baby weight, parity and obesitymay be predisposing factors to urinary incontinence in postpartum mothers. It was thus recommended that there is a need to involve women’s health physiotherapist in maternal care.

Assessment of Normal Thyroid Volume by Ultrasonography among Children in Uyo, Akwa Ibom State, Nigeria

Mon, 01 Feb 2010 00:00:00 GMT

Assessment of Normal Thyroid Volume by Ultrasonography among Children in Uyo, Akwa Ibom State, Nigeria Okon, Ime Edet The purpose of this study was to assess the normal thyroid volume among children in study population by ultrasonography and compare with values from previous works. The research was a prospective cross sectional study. A sample population of children between 2months to 17years was selected. They were volunteers drawn from daycare centres, nursery, primary and post primary schools in Uyo metropolis. Those that met the inclusion criteria were scanned at the school clinics where their height and weight were also obtained prior to the scan. Five hundred volunteers were scanned from September 2011 - November 2012. Kaimax 2200G portable ultrasound machine manufactured in 2011, a gray scale real-time scanner fitted with a 7.5 MHz transducer was used for the study. The study was conducted by one dedicated operator and the scan protocol was drawn and checked by a Sonographer and a Radiologist to establish the measurement technique and address the intra-observer variability. For each thyroid lobe, the volume was obtained by multiplying Length, Thickness and Width (L x T x W). The result was multiplied by a correction factor, 0.497. The Right and Left volumes were summed to obtain the total thyroid volume (Tvol). Data processing and statistical analyses were performed using Microsoft EXCEL 2010. The range and mean thyroid volume for the pre-school age groups were 0.11-3.2 cm3 and 1.22 ±1.61cm3 respectively while 0.84 – 8.22cm3 and 2.68 ± 2.53cm3 were the range and mean for the school-age subject respectively. Statistically, there is no sex difference in thyroid volume as well as between the right and left lobe. The study has derived a nomogram for thyroid dimensions from 0-17years of age. A statistically significant lower thyroid gland volume than the WHO/ICCIDD reference values (p>0.05) was noted in the study population. However there is significant similarity with data obtained in similar environment. Keywords: Comparison, children, thyroid volume and ultrasonography.

Effects of Aerobic Exercise Training on Some Physiological And Biochemical Parameters in Subjects With Chronic Low Back Pain

Fri, 01 May 2015 00:00:00 GMT

Effects of Aerobic Exercise Training on Some Physiological And Biochemical Parameters in Subjects With Chronic Low Back Pain Ezugwu, Uchechukwu Anthonia Low back pain (LBP) is the leading cause of occupational- related sickness, injuries, absences, and disability. Inflammation may be one of the mechanisms causing lumbo-sciatic pain. Exercise has been found to reduce pain and increase function which promotes a return to work in subjects with low back pain. Little is known about the potential mechanisms responsible for the effect of exercise on low back pain. The aim of this study was to determine the effects of eight weeks of interval aerobic exercise training programmes on cardiovascular fitness/ parameters such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), maximum volume of oxygen consumed (VO2 max.). Furthermore, pain level as measured by visual analogue scale scores (VAS) and Aberdeen low back pain questionnaire (ABD) scores, level of disability as measured by (Roland Morris Questionnaire [RMDQ]), interleukin-6 (IL-6), white blood cell count (WBC), prostaglandin-E (PGD-E), body mass index (BMI), and c-reactive protein (CRP). A randomized independent control (pretest-posttest) groups design was used to determine the influence of training programmes on the variables of interest. Population for the study was male and female subjects with chronic low back pain attending the General Outpatient clinic of National Orthopedic Hospital, Enugu, Nigeria and University of Nigeria Teaching Hospital Ituku Ozalla Enugu State. The study subjects were volunteers, sedentary, non-diabetic subjects with chronic low back pain. Eighty (80) male and female subjects met the inclusion criteria; they were age matched and randomly assigned to exercise (40) and control (40) groups. Sixty subjects, exercise (33) and control (27) groups completed the eight weeks programme. The exercise group exercised on a bicycle ergometer three times a week at moderate intensities of between 50% and 70% of their age predicted maximum heart rate (HR max) for a period of between 48 to 72 minutes. The control group did not engage in any organized exercise programme. Before the actual tests, a pilot survey in which ten (10) male and female subjects with chronic low-back pain participated was conducted using test-retest method. High positive correlation coefficient, (r =0.06-0.89) was achieved in the pilot study. Descriptive statistics was used to describe the physical characteristics of subjects. Independent t-test and Pearson’s product moment correlation coefficient test was used to find relationship among variables of interest. The results showed significant groups difference in VO2max (p < 0.05) resting SBP (p < 0.05), resting DBP (p <0.05), resting HR (p < 0.05), BMI (p < 0.005), CRP (p < 0.005), VAS (p < 0.05), ABD (p < 0.05), RMDQ (p < 0.05), PGD-E (p < 0.05), IL-6 (p < 0.05) and WBC (p <0.05) between and among the groups . Also the result showed significant difference among pre exercise males and females HR (p < 0.05), DBP (p < 0.05), BMI (p < 0.05), VAS (p < 0.05), PGDE (p < 0.05), VO2max (p < 0.05) while no significant difference was observed in the other variables such as SBP (P> 0.05), ABD (p > 0.05), RMDQ (p > 0.05), WBC (p > 0.05), IL-6 (p > 0.05), CRP (p > 0.05) . Significance difference was also observed among post exercise males and females HR (p < 0.05), DBP (p < 0.05), BMI (p < 0.05), RMDQ (p < 0.05), VO2max (p < 0.05) while no significant difference was observed in other variables such as SBP (p > 0.05), VAS (p > 0.05), ABD (p > 0.05), WBC (p > 0.05), IL-6 (p > 0.05), PGDE (p > 0.05), CRP (p > 0.05). Since exercise training programme had beneficial effects on VO2max, resting SBP, resting DBP, resting HR, BMI, CRP, VAS, ABD, PGD-E, IL-6, WBC and level of disability of subjects with chronic low back pain, such training programme should form part of the treatment programmes in the management of chronic low back pain.