Extent of involvement in social rehabilitation among obstetric fistula patients at Kitovu Hospital, Uganda
Shallon Atuhaire1*, Akin-Tunde A. Odukogbe2, John F. Mugisha3, Oladosu A. Ojengbede
1Pan African University of Life and Earth Sciences Institute, University of Ibadan, Nigeria
2Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan / University College Hospital, Ibadan, Nigeria
3Cavendish University, Kampala, Uganda
Introduction: Obstetric fistula is highly debilitating with effects acknowledged as beyond treatment thus, it requires physical and social rehabilitation. The study described the extent to which obstetric fistula patients have been involved in social rehabilitation services at Kitovu Hospital in Uganda.
Methods: A cross-sectional survey that used mixed methods was done among 390 obstetric fistula patients and 12 key informants at Kitovu Hospital in Uganda. The 390 patients responded to a semi-structured questionnaire, and 10 of them were involved in in-depth interviews. The 12 key informants were hospital staffs actively involved in the management of obstetric fistula, and patients’ partners who were involved in care giving. The variables under investigation included: socio-demographic and obstetric factors alongside whether the patients had been empowered, earned daily, had received aid to startup an income generating activity, had skills training, counseling, physiotherapy, health education, needs assessment and whether their needs had been addressed.
Results: Among the 390 participants, 192 (49.2%) had had fistula repair, 198 (50.8%) had not had repair, 215 participants felt they had not been empowered at all, 215 did not earn daily. Again, 211 indicated that they had not received aid to startup an income generating activity, 235 had not received skills training, 195 had not received counseling, and 299 had not had physiotherapy. A significant difference was noted across all the variables (empowerment, daily earning, having received aid to startup an income generating activity, skills training, counseling, physiotherapy, health education, needs assessment and having their needs addressed) and their repair category with a P-value of <0.001. Qualitative findings also indicated that patients received inadequate social rehabilitation due to inadequate resources. Patients preferred fistula repair before they could be socially rehabilitated as they still felt incapacitated.
Conclusions: A larger proportion of patients with unrepaired fistula had not been involved in social rehabilitation compared to those whose fistula had been repaired. More repair and rehabilitation centers ought to be constructed and adequately facilitated for the patients to receive the services they desire for effective social rehabilitation.View / Download Pdf
Edwards David*, Brickner Joseph, Hadadzedeh Mohammad, Molek Joseph, Shapiro Elina
Wheeling Jesuit University, United States
Background: Often clinicians attempt to correct the longitudinal arch of the foot in those with pes planus to improve physical performance, this theory has not been studied extensively. The purpose of this study was to determine the correlation between increased navicular drop/low arched feet and explosive jump performance in young adults.
Methods: A correlational design was used to carry out this study. The study took place at four centers and a convenience sample was selected from these locations. One-hundred and five healthy adults between the ages of 18 and 35, with a mean age of 23.23 (+/- 2.62) participated. The participant’s measurement of hyper pronation was quantified through navicular drop test. Explosive performance was then measured through vertical and broad jump. A Pearson correlation and follow-up Spearman correlations were then performed to analyze the relationship between navicular drop and vertical and broad jump while keeping level of significance at alpha= .05.
Findings: There was no signifigant correlation between an individual’s navicular drop and their vertical jump measurement (r=-0.077, p=.268; rs=.-.059, p=.550). or broad jump (r= 0.012, p=.382; rs= .007, p= .945).
Interpretation: There was no correlation between navicular drop and vertical and broad jump measurements in young adults. A low arched foot did not predispose an individual to decreased explosive performance in the form of vertical and broad jump measurements. This could have implications on the decision to attempt to correct pes planus with measures such as orthotics or taping to improve performance.View / Download Pdf
A critical period for rehabilitation of unilateral vestibular hypofunction patients with the unidirectional rotation paradigm
Michel Lacour1*, Laurent Tardivet2, Alain Thiry3
1Neurosciences Department, Aix-Marseille University/CNRS, Marseille, France
2Otorhinolaryngology Department, CHU Nice, 30 Voie Romaine, 06000 Nice, France
3Physiotherapist, 29 Bd Dubouchage, 06000 Nice, France
Unilateral vestibular hypofunction (UVH) patients were submitted to a vestibular rehabilitation (VR) program with two different protocols based on the unidirectional rotation paradigm. One group (N=28) was submitted to active gaze stabilization exercises with the head impulse test (HIT), and a second group (N=31) with the passive whole-body rotation on a rotatory chair. Head or body rotations were always performed to the hypofunction side and a similar number of training sessions were used in each group (2 times a week for four weeks). Patients in each group were subdivided into three subgroups based on the time delay between onset of the disease and beginning of VR (early VR: the first two weeks after onset; late 1 VR: third and fourth weeks after onset; late 2 VR: one month and more after onset). The angular vestibulo-ocular reflex (aVOR) and the directional preponderance (DP) regarding the horizontal canals were the main outcomes. The results pointed to similar findings with the two protocols, characterized by a significant improvement of the aVOR gain on the hypofunction side, responsible for the significant decrease of the DP in the horizontal canals. These powerful changes were observed in the early subgroups only. No significant modifications were found in the late 1 and late 2 subgroups. The data clearly attest to the effectiveness of the unidirectional rotation paradigm when performed in the acute phase of the disease, thus extending to UVH patients the concept of critical period for VR already demonstrated in animal models.View / Download Pdf