Longitudinal Studies of Aging in Sub-Saharan Africa: Review, Limitations, and Recommendations in Preparation of Projected Aging Population

Background and Objectives

The United Nations has projected a 218% increase in older people in Sub-Saharan Africa (SSA) between 2019 and 2050, underscoring the need to explore changes that would occur over this time. Longitudinal studies are ideal for studying and proffering solutions to these changes. This review aims to understand the breadth and use of longitudinal studies on aging in the SSA regions, proffering recommendations in preparation for the projected aging population.

Research Design and Methods

This paper is the third of a four-part series paper of a previous systematic mapping review of aging studies in SSA. We updated the search (between 2021 and 2023) and screened the titles/abstracts and full-text articles by a pair of independent reviewers. Data were extracted using a standardized data-charting form, identifying longitudinal studies in SSA.

Results

We identified 193 studies leveraging 24 longitudinal study data sets conducted at 28 unique sites. The World Health Organization's Study on Global AGEing and Adult Health (WHO-SAGE) (n = 59, 30.5%) and Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (n = 51, 26.4%) were the most used longitudinal data sets. Four studies used more than one longitudinal study data set. Eighteen of the longitudinal study data sets were used only in 1-4 studies. Most (n = 150, 77.7%) of the studies used a cross-sectional analytical approach.

Discussion and Implications

Longitudinal studies on aging are sparingly being utilized in SSA. Most analyses conducted across the longitudinal data set were cross-sectional, which hindered the understanding of aging changes that occurred over time that could better inform aging policy and interventions. We call for funding bodies, such as WHO-SAGE, to develop funding competitions that focus on conducting longitudinal analyses, such as structural equation modeling, highlighting changes occurring among the aging population in SSA.

Minimal-contact physical interventions for pregnant women with musculoskeletal disorders: a systematic review of randomised and non-randomised clinical trials

This review summarised minimal-contact physical interventions and their effects on pain, disability and quality of life in pregnant women with musculoskeletal disorders. Twelve bibliographic databases were systematically searched until December 31 2020. PEDro Scale was used for quality assessments. Narrative synthesis of 10 eligible studies was conducted. Education and multimodal home exercises plus handbooks/multimodal individual/group exercises; and self-management programmes improved pain intensity, sick leave and disability in pregnant women with lumbopelvic pain. Individual home-based progressive muscle relaxation exercises; unsupervised water exercises plus information using handbooks/videos/music; group multimodal exercises plus home exercises and information/education; and partner massage plus information using booklets/photographs reduced pain intensity in pregnant women with low back pain. Non-rigid/customised lumbopelvic belts plus information reduced pain intensity more significantly than rigid belts or stabilisation exercises plus information among pregnant women with pelvic girdle pain. Minimal contact interventions are effective and may be utilised during infectious disease pandemics.

Physiotherapy management of acute transverse myelitis in a pediatric patient in a Nigerian hospital: a case report

BACKGROUND

Transverse myelitis is a rare neurological disorder of the spinal cord, caused by inflammation and damage of the myelin sheath of the neurons of the spinal cord across one or more spinal segments. This causes a disruption in the passage of nervous signals leading to motor, sensory, and autonomic dysfunction. This affects the physical and psychological health, as well as the functional status of the patient. This case report presents the physiotherapy evaluation and management of acute transverse myelitis in a pediatric patient.

CASE PRESENTATION

A 17-year-old Nigerian male diagnosed with acute transverse myelitis was referred to the physiotherapy team for expert management. The patient presented with severe muscle spasms and frequent jerking movements, shocking sensations, hypertonicity, and spasticity (modified Ashworth scale: 1+ on the right, > 2 on the right), and muscle strength of the lower limbs (Oxford muscle grading: 3/5 on the left, 1/5 on the left) with impaired functional status (Functional Independence Measure: 70/126).The patient tolerated and participated in the physiotherapy interventions (cryotherapy, soft tissue mobilization, splinting) and exercises (free active, resistance and functional exercises) in the ward and outpatient clinic, as well as subsequent home programmes (free active, resistance and functional exercises). The patient also received other medical and pharmacological interventions in the ward. After 23 days of therapy, the patient improved in all clinical outcomes, including muscle spasm and hypertonicity, spasticity (modified Ashworth scale: 0 bilaterally), sensation, and muscle strength (Oxford muscle grading: 5/5 bilaterally). The patient's overall functional status also improved (Functional Independence Measure: 117/126).

CONCLUSIONS

Physiotherapy improved the symptoms of acute transverse myelitis in this patient. Randomized controlled trials are required to replicate these findings.