The Effect of an Aerobic Exercise Programme on Blood Glucose Level, Cardiovascular Parameters, Peripheral Oxygen Saturation, and Body Mass Index among Southern Nigerians with Type 2 Diabetes Mellitus, Undergoing Concurrent Sulfonylurea and Metformin Treatment

Impact of welding occupation on serum aluminium level and its association with physical health, cognitive function, and quality of life: a cross-sectional study

OBJECTIVE

There is an occupational health concern about welders' inhalation of toxic aluminium fumes. We investigated whether serum aluminium level (SAL) and demographic variables can significantly predict physical health parameters, cognition, and quality of life (QoL) among welders.

METHODS

The cross-sectional study involved 100 age- and location-matched men (50 welders and 50 non-welders). SAL obtained using a graphite furnace atomic absorption spectrometer, and data collected using blood pressure and body mass index (BMI) apparatuses, biodata form, pain rating scale, General Practitioner Assessment of Cognition, WHOQoL-BREF, and Nordic musculoskeletal symptoms (MSS) questionnaire were analysed using independent samples t test, chi-square, Pearson's correlation, and hierarchical linear regression.

RESULTS

Welders had significantly higher SAL (mean difference [MD] = 1.77 µg/L, p < 0.001), lower QoL (MD = 3.92, p = 0.039), and higher prevalence of MSS on the neck (χ2 = 10.187, p = 0.001), shoulder (χ2 = 9.007, p = 0.003), upper back (χ2 = 6.832, p = 0.009), and knee (χ2 = 12.190, p < 0.001) than non-welders. There was a significant bivariate association between SAL, systolic blood pressure (β = 0.313, p = 0.002), and BMI (β = 0.279, p = 0.005), but not pain intensity, cognition, or QoL. SAL remained a significant predictor of systolic blood pressure after adjustment for physical health and QoL parameters (β = 0.191, p = 0.044). The association between SAL and social QoL became significant after adjustment for physical health and other QoL domains (β = - 0.210, p = 0.032) and demographic variables (β = - 0.233, p = 0.046).

CONCLUSION

Welders had significantly higher SAL, musculoskeletal symptoms, blood pressure, and lower QoL than non-welders. SAL was associated with adverse physical health parameters and social-related QoL, not cognition. We recommend routine aluminium bioavailability and physical health checks among welders.

Characterization and critical appraisal of physiotherapy intervention research in Nigeria: a systematic review

OBJECTIVES

Clinical research is the bedrock of clinical innovation, education and practice. We characterized and critically appraised physiotherapy clinical research to avoid implementing misleading research findings into practice and to task the Nigerian physiotherapy societies on responsible conduct of clinical research.

METHODS

This is a systematic review of articles published in English between 2009 and 2023. We started with 2009 because at least few Nigerian Physiotherapy school had commenced postgraduate (research) training by then. We searched Pubmed, Medline, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO and African Journal Online, and reference lists of relevant articles. We Data were selected and extracted according to predesigned eligibility criteria and using a standardized data extraction table. Where appropriate, the Pedro and Cochrane ROBINS1 were used to examine the risk of bias.

RESULTS

A total of 76 Nigerian studies were included in this study. The mean age of the study participants was 46.7 ± 8.6 years. Approximately, 45% of the participants were males. Of the clinical experiments, the randomized controlled trial (RCT) was the most common design (87.5%). Musculoskeletal conditions (39.3%) were the most studied disorder. Approximately 86% of the RCT had studies possessed fair to good quality. Interventions constituted exercise therapy (76.3%), manual therapy (8.5%) and electrotherapy (8.5%). More than half (67.8%) of the studies recorded medium to large effect sizes. A fair proportion (48.2%) of the studies had a confounding-by-indication bias. Approximately 43% of the clinical experiments were underpowered, and a few studies conducted normality tests (10.9%) and intention-to-treat analysis (37.5%).

CONCLUSIONS

RCT is the most frequent clinical experiment, with majority of them possessing fair to good quality. The most important flaws include improper computation of sample size, statistical analysis, absent intention-to-treat approach, among others. The magnitude of effects of Physiotherapy interventions varies from nil effect to large effect. Musculoskeletal condition is the most prevalent disorder and exercise is the most important intervention in Nigerian physiotherapy practice.

TRIAL REGISTRATION

We registered the protocol with PROSPERO. The registration number: CRD42021228514.

Effect of Exercise Volume on Plantar Microcirculation and Tissue Hardness in People With Type 2 Diabetes

Objective: Exercise has been reported to be beneficial for people with type 2 diabetes (T2DM), but exercise, especially weight-bearing exercise, may increase the risk of diabetic foot ulcers (DFUs). This study aimed to explore the associations between different volumes of weight-bearing physical activities and plantar microcirculation and tissue hardness in people with T2DM.

Methods: 130 elderly people with T2DM were enrolled for this cross-sectional study. They were classified into the high exercise volume group and the low exercise volume group based on their weekly energy expenditure (metabolic equivalents per week) in the past year. Weekly energy expenditure was calculated using the International Physical Activity Questionnaire and the Compendium of Physical Activities. The plantar oxygen saturation (SO₂) and soft tissue hardness of each participant’s right foot were measured.

Results: A total of 80 participants completed the trial. The average exercise energy expenditure of the high exercise volume group and the low exercise volume group were significantly different (p < 0.05). The results showed that the SO₂ of the high exercise volume group (67.25 ± 6.12%) was significantly higher than the low exercise volume group (63.75 ± 8.02%, p < 0.05). The plantar tissue hardness of the high exercise volume group was lower than the low exercise volume group in the big toe, midfoot and hindfoot regions (p < 0.05).

Conclusion: This study demonstrates that higher volumes of exercise are associated with better plantar microcirculation and lower plantar tissue hardness in people with T2DM. The findings of this study indicate that weight-bearing exercise may not increase risk of developing diabetic foot ulcers.

Prevalence of work-related musculoskeletal symptoms and associated risk factors among domestic gas workers and staff of works department in Enugu, Nigeria: a cross-sectional study

Background

The impact of work-related musculoskeletal symptoms (WMSS) permeates various occupations.

Objective

To compare WMSS and associated risk factors among domestic gas workers (DGWs) and staff of Works Department (SWD) in Enugu.

Methods

One-hundred adults (DGW = 50, SWD = 50) participated in this cross-sectional study. The Nordic Musculoskeletal Questionnaire and a demographics questionnaire were used to assess the prevalence of WMSS and related risk factors. Data were analysed using independent t-test or Mann-Whitney U, chi-square, and logistic regression at p < 0.05.

Results

The DGWs (86%) had a significantly (χ2 = 24.45, p < 0.001) higher WMSS than the SWD (38%). Lower-back (54%) and shoulder (52%) were the most affected body parts among the DGWs in comparison to the hips/thighs (20%) among the SWD. Work-related factors such as daily work-duration (χ2 = 75.44, p < 0.001), lifting training (χ2 = 96.24, p < 0.001), and use of personal protective equipment (PPE) of facemask (χ2 = 100.0, p < 0.001) and gloves (χ2 = 96.09, p < 0.001) were significantly associated with general WMSS among the DGWs. However, diastolic blood pressure (DBP) (OR = 1.29, p = 0.018), work duration > 8 h/day (OR = 0.001, p = 0.028), female gender (OR = 6.98–10.26, p < 0.05), sleep duration < 6 h/day (OR = 0.56–0.73, p < 0.05) and poor exercise behaviour (OR = 0.15, p = 0.013) were the identified independent risk factors of WMSS among DGWs, while DBP (OR = 0.99, p = 0.012) and female gender (OR = 6.47, p = 0.032) were the only identified independent risk factors for SWD.

Conclusion

WMSS is significantly higher among DGWs than the SWD. High DBP, female gender, working beyond 8 h per day, sleeping less than 6 h per day, and insufficient exercise increase the risks of WMSDs, especially among the DGWs. To mitigate the adverse effects of WMSDs, SWD and DGWs require break and leave periods, PPE and assistive devices, exercise, medical check-up, and workplace ergonomics.