Background. Many people continue to live with physical disabilities across the globe, especially in rural Africa despite expertise of Physiotherapists and available evidence of effectiveness of Physiotherapy. Objective. To determine the obstacles to obtaining Optimal Physiotherapy services in a rural community in Southeastern Nigeria. Methods. Population-based cross-sectional study of individuals and health facilities in a rural community in Southeastern Nigeria. Results. The obstacles to obtaining optimal physiotherapy services in this community were unavailability of physiotherapy services, poor knowledge of health workers and community dwellers of the roles and scope of physiotherapy, poor health care seeking behavior of community dwellers, patronage of traditional health workers, and poor referral practices by health workers. Conclusion. Rural health workers in Nkanu West Local Government and other rural communities in Nigeria and Africa should be educated on the roles and scope of physiotherapy. There is a need for raising awareness of the management options for movement/functional problems for rural indigenous communities in Nigeria in particular and Africa in general. Physiotherapists should be made aware of the growing need for physiotherapy in rural areas of Nigeria and Africa largely comprising of the elderly. 1. Introduction Concomitant with the aging of our population is a significant rise in the prevalence of chronic diseases. This in turn has increased the need for physical therapists and physical therapy services by all health agencies. The unprecedented need for services may outstrip the capabilities of the existing medical facilities. There is also an increasing need for out-of-hospital treatment programs with a concurrent shortage of competent physical therapists to staff them [1]. Despite the expertise in therapeutic exercises and the available evidence of effectiveness, many people continue to live with physical disabilities across the globe, especially in Africa [2–4]. Access to rehabilitation for people with disability is inadequate, more so in rural communities, with the attendant economic and social implications if the status quo is maintained [2–4]. Webster et al. in 2008 stated that despite physiotherapy being regarded positively by all referral groups of patients, there is still a distinct lack of knowledge about the profession by the general public, which affects self-referral [4]. Different referral practices exist among doctors based on the different views held by these doctors as to the conditions considered amenable to
References
[1]
J. B. Allis, “Orienting the physical therapist to public health practice,” Public Health Reports, vol. 80, no. 11, pp. 975–980, 1965.
[2]
B. L. Snow, E. Shamus, and C. Hill, “Physical therapy as primary health care: public perceptions,” Journal of Allied Health, vol. 30, no. 1, pp. 35–38, 2001.
[3]
S. Raman and S. J. Levi, “Concepts of disablement in documents guiding physical therapy practice,” Disability and Rehabilitation, vol. 24, no. 15, pp. 790–797, 2002.
[4]
V. S. Webster, L. K. Holdsworth, A. K. McFadyen, and H. Little, “Self-referral, access and physiotherapy: patients' knowledge and attitudes-results of a national trial,” Physiotherapy, vol. 94, no. 2, pp. 141–149, 2008.
[5]
C. O. Akpala, A. P. Curran, and J. Simpson, “Physiotherapy in general practice: patterns of utilisation,” Public Health, vol. 102, no. 3, pp. 263–268, 1988.
[6]
D. U. Jette, K. Bacon, C. Batty et al., “Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists,” Physical Therapy, vol. 83, no. 9, pp. 786–805, 2003.
[7]
Chartered Society of Physiotherapy. Charting the future of Physiotherapy, http://www.csp.org.uk/uploads/documents/csp_charting_the future.pdf, 2008.
[8]
S. R. A. Akinbo, D. O. Odebiyi, T. E. Okunola, and O. T. Aderoba, “Evidence-based practice: knowledge, attitudes and beliefs of physiotherapists in Nigeria,” in Nigeria Society of Physiotherapy (NSP) Conference, 2008.
[9]
L. O. Ganiyu, “Physiotherapy in primary health care: are we ready?” Journal of the Nigeria Society of Physiotherapy, 2008.
[10]
A. L. Oyeyemi and A. Y. Oyeyemi, “Professional Outlook and clinical practice pattern of physiotherapy in Nigeria,” in Nigeria Society of Physiotherapy (NSP) Conference, 2008.
[11]
B. Birabi, A. Okunuga, and U. C. Okafor, “Survey of knowledge and the use of stroke assessment scales by physiotherapists in selected Nigeria health institutions,” in Nigeria Society of Physiotherapy (NSP) Conference, 2008.
[12]
B. Birabi, “Physical fitness, a must have for the urban dweller,” in Nigeria Society of Physiotherapy (NSP) Conference, 2008.
[13]
A. L. Oyeyemi and B. O. A. Adegoke, “Neighbourhood environment as determinants of physical activity and health promotion,” in Nigeria Society of Physiotherapy(NSP) Conference, 2008.
[14]
M. O. Araoye, “Sample size determination,” in Research Methodology with Statistics for Health and Social Sciences, M. O. Araoye, Ed., pp. 115–122, Nathadox, Ilorin, Nigeria, 2004.
[15]
D. Vindigni, D. Griffen, J. Perkins, C. Dacosta, and L. Parkinson, “Prevalence of musculoskeletal conditions, associated pain and disability and the barriers to managing these conditions in a rural, Australian Aboriginal community,” Rural Remote Health, vol. 4, no. 3, article 230, 2004.
[16]
A. O. Akinpelu, A. C. Odole, and A. S. Odejide, “Prevalence and pattern of musculoskeletal pain in a rural community in Southwestern Nigeria,” Internet Journal of Epidemiology, vol. 8, no. 2, 2010.
[17]
R. Blau, S. Bolus, T. Carolan et al., “The experience of providing physical therapy in a changing health care environment,” Physical Therapy, vol. 82, no. 7, pp. 648–657, 2002.
[18]
C. Kigin, “A systems view of physical therapy care: shifting to a new paradigm for the profession,” Physical Therapy, vol. 89, no. 11, pp. 1117–1119, 2009.
[19]
V. A. Obajuluwa, O. K. Abereoje, and M. O. B. Olaogun, “First-contact physiotherapy practice in Nigeria,” Physiotherapy Theory and Practice, vol. 6, no. 2, pp. 85–89, 1990.
[20]
M. Hurley, K. Dziedzic, L. Bearne, J. Sim, and T. Bury, The clinical and cost effectiveness of physiotherapy in the management of older people with common rheumatological conditions. The chartered Society of Physiotherapy, 2002, http://www.csp.org.uk/.
[21]
S. Ambwani, “Pain management in the elderly,” Journal of the Indian Academy of Geriatrics, vol. 5, no. 4, pp. 191–196, 2009.
[22]
CSP, Inquiry into Out-of-Hours Care Provision in Rural Areas, CSP, Newcastle, UK, 2007.
[23]
O. Abereoje, “An evaluation of the effectiveness of itinerant and community physiotherapy schemes in meeting the primary health care needs in Oyo State, Nigeria,” Physiotherapy Practice, vol. 4, no. 4, pp. 194–200, 1988.
[24]
T. Miller Mifflin and M. Bzdell, “Development of a physiotherapy prioritization tool in the Baffin Region of Nunavut: a remote, under-serviced area in the Canadian Arctic,” Rural and Remote Health, vol. 10, no. 2, article 1466, 2010.
[25]
M. Ellangovin, “Innovations in community physiotherapy,” The Journal of Field Actions, vol. 2, 2009.
[26]
B. U. Ngohi, U. Aliyu, U. N. Jibril, A. Lawal, and M. B. Ngohi, “Causes of bone injuries and patronage of traditional bone setters in Maiduguri, Nigeria,” Sierra Leone Journal of Biomedical Research, vol. 1, no. 1, pp. 50–54, 2009.
[27]
J. D. Ogunlusi, I. C. Okem, and L. M. Oginni, “Why patients patronize traditional bone setters,” Internet Journal of Orthopaedic Surgery, vol. 4, no. 2, pp. 1–7, 2007.
[28]
A. M. Udosen, O. O. Otei, and O. Onuba, “Role of traditional bonesSetters in Africa: experience in Calabar, Nigeria,” Annals of African Medicine, vol. 5, no. 4, pp. 170–173, 2006.
[29]
T. O. Alonge, A. E. Dongo, T. E. Nottidge, A. B. Omololu, and S. O. Ogunlade, “Traditional bonesetters in South Western Nigeria—friends or foes?” West African Journal of Medicine, vol. 23, no. 1, pp. 81–84, 2004.
[30]
B. A. Solagberu, “Long bone fractures treated by traditional bonesetters: a study of patients' behaviour,” Tropical Doctor, vol. 35, no. 2, pp. 106–108, 2005.
[31]
H. Ulusoy, N. Sarica, S. Arslan, C. Olcay, and U. Erkorkmaz, “The efficacy of supervised physiotherapy for the treatment of adhesive capsulitis,” Bratislava Medical Journal, vol. 112, no. 4, pp. 204–207, 2011.
[32]
W. J. J. Assendelft, E. M. Hay, R. Adshead, and L. M. Bouter, “Corticosteroid injections for lateral epicondylitis: a systematic overview,” British Journal of General Practice, vol. 46, no. 405, pp. 209–216, 1996.
[33]
L. Bisset, A. Paungmali, B. Vicenzino, and E. Beller, “A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia,” British Journal of Sports Medicine, vol. 39, no. 7, pp. 411–422, 2005.
[34]
R. P. Calfee, A. Patel, M. F. DaSilva, and E. Akelman, “Management of lateral epicondylitis: current concepts,” Journal of the American Academy of Orthopaedic Surgeons, vol. 16, no. 1, pp. 19–29, 2008.
[35]
E. Ernst, Desktop Guide to Complementary and Alternative Medicine, Mosby, London, UK, 2001.
[36]
J. J. Wilson and T. M. Best, “Common overuse tendon problems: a review and recommendations for treatment,” American Family Physician, vol. 72, no. 5, pp. 811–818, 2005.
[37]
P. A. Margolis, C. M. Lannon, R. Stevens et al., “Linking clinical and public health approaches to improve access to health care for socially disadvantaged mothers and children: a feasibility study,” Archives of Pediatrics and Adolescent Medicine, vol. 150, no. 8, pp. 815–821, 1996.
[38]
S. Ueki, T. Kasai, J. Takato et al., “Production of a fall prevention exercise programme considering suggestions from community-dwelling elderly,” Nippon Koshu Eisei Zasshi, vol. 53, no. 2, pp. 112–121, 2006.
[39]
R. L. Craik, “A responsibility to put ‘health policy in perspective’,” Physical Therapy, vol. 89, no. 11, pp. 1114–1115, 2009.
[40]
World Bank, The World Bank Activities and Position on Ageing, Oxford University Press, New York, NY, USA, 1994.
