Assessment of functional and musculoskeletal problems, and barriers to obtaining physiotherapy services among the elderly in a rural community in Kano State, Nigeria

Abstract

Functional and musculoskeletal problems are a major cause of disability among the elderly in the rural areas. Unfortunately, rehabilitation services are presently inadequate for this population in many parts of the world. This study evaluated the pattern of musculoskeletal disorders, functional status and barriers to obtaining physiotherapy services among the elderly in a rural community in Kano, Nigeria. This cross sectional survey was carried out using a Hausa translated version of the modified Older American Resource and Services (OARS) multidimensional functional assessment questionnaire and other instruments to assess the pattern of functional and musculoskeletal problems and barriers to obtaining physiotherapy services. The questionnaires were administered to 384 elderly consenting individuals (aged 60 years and above) who were recruited using cluster sampling. The data obtained was analysed using SPSS version 16.0. The results from this study revealed that the majority of the participants were females (59.9%). The prevalence of musculoskeletal problems was significant (47%), mostly affecting the lower extremity joints and the spine. Generally, the participants were mostly independent in carrying out activities of daily living (ADL), such as feeding (92.5%), grooming (85.7%), money management (84.9%) and management of medication (83.9%). The results also showed that a few of the participants were dependent in bathing (10.2%), walking (9.9%) and dressing (9.9%). Furthermore, the majority (61.9%) of the participants who reported musculoskeletal problems had good ADL performance capacity rating. Almost all the participants (98%) reported that they have never heard of physiotherapy. Lastly, those with musculoskeletal problems reported that they mainly utilized traditional medicine or home remedies and their health-seeking behaviour was mainly determined by affordability (41.8%). It was concluded that there is a high prevalence of musculoskeletal problems among the participants of this study. Nevertheless, their level of function remained optimal. The study also identified lack of awareness, unavailability, affordability and accessibility as the major barriers to obtaining physiotherapy services among the participants. Keywords: elderly, musculoskeletal disorders, knowledge, disability, rural community, physiotherapy