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Panorama: Osteoarthritis and the Role of Physiotherapy



By Fatima Suleiman Halilu and Maryam Bashir Galadanci

Osteoarthritis (O.A), popularly known as a degenerative joint disease (DJD) is commonly defined as the gradual ‘’wear’’ and ‘’tear of the protective tissues at the end of bones that occurs over time with aging. Recent research and clinical evidence have shown that O.A is beyond ‘’ wear’’ and ‘’tear’’ and is an interplay of Physical, biological, and mechanical factors that affects the repair of joint cartilage (protective soft tissue for shock absorption) and surrounding structures leading to changes in joint structures. It is the most common type of arthritis and a major cause of pain in the elderly.

Osteoarthritis affects over 520 million people globally. According to research, there has been a 48% increase in osteoarthritis cases from the year 1990 to the year 2019 and the figures are expected to rise in the coming years. It is a major cause of disability in developing and developed countries and is expected to increase as the population ages. In age groups below 50yrs, men are more often affected, while in the older population the disease is more common in women with a ratio of 2:1 (due to a decrease in sex hormones with menopause). Research on the prevalence of O.A in Africa remains scarce, but a study carried out in South Africa revealed 55.1% of those affected in the urban population and about 87.2% in the rural population are adults aged 65 and above. A certain study on reported cases in healthcare facilities in Nigeria estimated that about 3.3 -7.1% of the population of the country have O.A. This figure is however believed not to be the true value of the cases in the community as there is still little awareness of the condition and more research needs to be carried out.

Osteoarthritis can affect any joint, but the most commonly affected of them are the weight-bearing joints (knee, hip, and spine). With aging over time and repetitive weight bearing on these joints, they start to deteriorate in function. Knee O.A accounts for about 60% of diagnosed O.A cases.

There are two types of O.A: Primary O.A and secondary O.A. The causes of primary O.A are still unclear but genetics is believed to play a role in it. Secondary O.A is caused by s specific triggers that exacerbate cartilage breakdown. Examples of such triggers are joint, injuries, metabolic and inflammatory diseases, Inactivity, and Abnormal mechanical forces.

Signs and symptoms include Pain, stiffness, limitations in movement, a snap/crackle and pop Sound (crepitus) while moving the joints, Muscle weakness, Mild Swelling, tenderness and decreased quality of life. Some joint-specific symptoms might also set in.

Risk factors include Age above 45, Female gender, Overweight or Obesity, Genetics, Trauma or injury to the joints, repetitive stress, sports injuries, joint malalignment, Bone deformities, Occupations that involve certain repetitive movements like bending and prolonged standing, and living a sedentary lifestyle.

Complications that might arise due to O.A include Loss of muscle bulk(atrophy), joint instability, joint deformity, balance impairments and fall risks, neurological symptoms, disability, and depression.

Osteoarthritis is diagnosed through detailed patient history taking, physical examinations, and some special tests. An X-ray may sometimes be done to determine the extent of changes in the affected joint or to eliminate other similar conditions like gout arthritis. CT and MRIs are rarely done. Lab tests might also be carried out if there is a need to rule out conditions like septic arthritis and rheumatoid arthritis.

Osteoarthritis is a chronic, progressive lifelong condition that cannot be cured. Symptoms can, however, be managed conservatively and the disease progression slowed down through the use of medications, supplements, intra-articular injections, diet, lifestyle adjustments, weight loss, and Physiotherapy. In severe cases, joint replacement surgery might be required.

The World Health Organisation recommends Physiotherapy as the first line of management for osteoarthritis. Physiotherapists are specialized health care professionals concerned with improving human function, and movement and maximizing physical potential. On September 8th each year, World Physiotherapy (formerly the World Confederation of Physical Therapy, WCPT) marks World Physiotherapy day as a day to celebrate the profession worldwide and create awareness of health issues concerned with the profession. The 2022 World Physiotherapy theme is ‘’Osteoarthritis and the role of Physiotherapy’’.

Physiotherapists play a vital role in the management of O.A. Their roles span from preventive, to conservative management to pre-and post-joint replacement surgery management. In the preventive stage, Physiotherapists educate patients, clients, and the general public on, the causes, effects, and risk factors of osteoarthritis. Modifiable risk factors like being overweight/ obese and sports injuries can be addressed and managed by a Physiotherapist. Preventive measures are also given.

The conservative role of physiotherapy in osteoarthritis is aimed at slowing down the disease progression, preventing occurrences in other joints, fall prevention, and management of symptoms like pain, swelling, joint stiffness, joint instability, tenderness, impaired mobility, or balance. Physiotherapy also helps improve muscle strength, joint motion, and flexibility, and encourages participation in daily activities with ease. Additionally, Physiotherapists encourage weight loss and design exercises to cater to that. All this ultimately improves the patient’s quality of life. Methods and techniques applied to achieve this include Range of motion exercises, muscle strengthening exercises, stretching exercises, balance exercises, aerobic exercises, functional activity exercises, manual therapy, joint mobilizations, hot and cold therapy, electrotherapy, hydrotherapy (exercises on water) Muscle energy techniques, use of orthotic devices like a knee brace, splint, neck collar, use of a cane and other mobility aids. The type, frequency, and intensity of the exercises, treatment plan, and materials used are dependent not only on the joint structures and muscles affected or the extent of their affectation but also on other factors like the Patient’s goals, age, gender, occupation, body mass index and the presence of other medical conditions. lifestyle. activity level, exercise tolerance, and sometimes beliefs influence management plans. A well-detailed history taking, physical assessment, investigations, and special tests will help your Physiotherapist design a personalized treatment plan that best suits you. These treatment plans are progressive and will usually get improved or adjusted over time with patient improvement or lack of it. Your Physiotherapist will also advise you on a diet, lifestyle adjustments, coping strategies, proper posture, ergonomic/workplace adjustments, and practices.

In cases where conservative management like Physiotherapy fails or certain symptoms and complications set in, Surgery is required. Physiotherapy plays an important pre-and post-operative role in joint replacement surgeries. In the pre-operative phase, patients are assessed holistically and educated on what to expect after surgery including precautions to take and absolute restrictions. They are informed of symptoms to expect like pain, possible swelling, restricted movement, and muscular weakness and how their Physiotherapists can help address them. Their goals are being put into consideration and they are being taught bed exercises and safe transfer methods.

Physiotherapy may commence a few hours after surgery taking into consideration the general health status of the patient and the type of surgical procedure done. A Physiotherapist would perform a detailed assessment and design an appropriate treatment plan according to patient needs, goals, and capabilities. This aims to promote patient independence, address post-surgical symptoms, prevent complications, improve the general health status of the patient and reduce hospital stay. Strengthening exercises, aerobic exercises for improved cardiovascular function, mobility and transfer training, balance and coordination exercises, and walking re-education are among the strategies employed by Physiotherapists post-joint replacement surgeries. Your physiotherapist will be responsible for training you to make use of assistive aids like a wheelchair, walking frames, and canes, graduating you in stages and eventually weaning you off to encourage functional independence. In-patient discharge rules and outpatient appointment sessions for follow-ups, monitoring, and progression are usually given to patients. This has proven to improve the outcome of surgery.

For consultations, and more information about Physiotherapy and Osteoarthritis, contact the nearest Physiotherapist to you. Also, check and


O.A is a disease of old age While most cases of O.A are diagnosed from ages 45 and above, younger people do get O.A
Exercises and activities worsen O. A While certain movements, exercises, and activities might worsen O.A symptoms, a carefully planned exercise regimen by a qualified Physiotherapist can help manage the symptoms of O.A and improve quality of life.
O.A is caused or triggered by cold weather There is no evidence that cold weather causes O.A. However, people are more likely to be inactive during cold seasons. This triggers O.A symptoms in an already affected joint

Fatima Suleiman Halilu PT, and Maryam Bashir Galadanci PT,  are members of Kano State Chapter of Nigeria Society of Physiotherapy (NSP)

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Voice of Emancipation: Yoruba National Day: Lessons from the Kiriji War




By Kayode Emola

As we Yoruba descendants all over the world celebrate today the end of the Kiriji war that happened on this day in 1886, we remember those who sacrificed their lives for the freedom we all enjoy today. Many people in our generation may not appreciate the sacrifice our ancestors paid to give us the freedom, liberty, and peace we enjoy today. Many of them back then did not live to see the peace and freedom they fought for, nor did they know they were going to pay the ultimate price, however, that did not deter them from pursuing freedom with all that they had including their lives.

As we celebrate 137 years to the end of the Kiriji war today, I would like to dedicate this column to those who paid the ultimate price for the freedom we Yoruba have enjoyed so far. Although the war brought freedom to the entire Yorubaland and its people; especially those towns and villages that were under Oyo rule, the end of the war brought in a new master (the British overlords) over our affairs.

Shortly after the war ended, the British capitalised on our frailty and war fatigue to gradually colonise our land and take our inheritance by stealth. We did not suspect the actions of the new colonisers because we thought they had our best interest at heart. The rest they say is left to the history books and the journey to freedom continues.

Those who fought to see us free would be mad in their graves to see that the freedom they fought to gain from Oyo who is their neighbour was eventually lost to the British colonisers. They would be asking those of us around this day what we are doing to liberate Yorubaland from the corruption of Nigeria passed down by the British colonisers, since that was what led them to fight the Oyo rulers.

I do not believe that we have an excuse today not to stand up for Yorubaland and her over 50 million population who are being subjected to Nigeria’s misrule. The Yoruba people never signed any document anywhere with her eastern and northern neighbours on becoming one country, therefore we have no business being in Nigeria.

For some people who say that a Yoruba man is now the president of Nigeria, therefore we have the upper hand in directing its affairs. I will say being the president of Nigeria does not translate to development in Yoruba land. This is because Nigeria as a broken nation has gone beyond repair and cannot be mended. Not especially with the disoriented system of government that it currently practices.

Just like Slovenia and Croatia left Yugoslavia before they started reaping the benefits of nationhood. Yoruba, Igbo, Hausa, or any other nationality in Nigeria cannot enjoy the goodness of a nation unless the people come together to decide their future. It would be better if this were to happen sooner rather than later to avoid the impeding danger the country may face.

We all know that Nigeria is living on borrowed time and those still behaving like they have a country to call home are just living in fools’ paradise. The only solution for Nigeria is complete dissolution, and any outcome short of this is just applying a sticking plaster to a gushing wound.

As we celebrate the peace we enjoy in Yorubaland today, may I use this opportunity to appreciate those who have kept the flames of peace burning bright. I also want to thank those individuals who have organised this year’s celebration and those who have volunteered their time and resources to see that the event is celebrated in style.

I also thank many of our diasporan Yoruba who are visiting Yorubaland, especially for the first time from places like South and Latin American countries, and elsewhere around the world. We appreciate your efforts in coming down to the homeland to celebrate this year’s event. May the peace of God be with us all and deliver the total freedom and liberty we all desire and grant to us our independent Yoruba nation sooner rather than later.

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Soliloquy: Between Big Brother Naija and Tastee Spelling Bee Competition




By Michael Effiong

This past Thursday, I was privileged and honoured to attend the Tastee Spelling Bee Competition organized to commemorate the 10th Remembrance anniversary of Mr Oluwabunmi Adedayo, who we used to fondly called gentle giant.

Oluwabunmi who was the Executive Director of the famous quick service restaurant, Tastee Fired Chicken (TFC) made quite an impact while on earth. He was warm and humble, and always willing to help others, little wonder that his dear parents: Pamela and Kunle Adedayo decided to turn their personal tragedy to a force for good by establishing the Bunmi Adedayo Foundation.

As I sat down to watch the primary school pupils wow us with their knowledge of English pronunciation and spelling, my mind wondered to my days as member of the St Joseph’s Boys High School, Surulere Literary and Debating Society, and a smile spread across my face.

Then my mind again meandered to the video of the quiz competition that occurred at the Big Brother Naija House which has since gone viral, my reaction this time was that of disgust.

In case you missed it, in the said video, the contestants were asked a pot pourri of questions ranging from mathematics to current affairs. What really caught many people’s attention was the scandalous answers that emanated from theses “celebrity” contestants.

One was asked who was Nigeria’s first president, the contestant did not know! How embarrassing was that.

Another was asked what was the meaning of CAC. She went : ” CAC (she pronounced it kak), CAC”, she looked so shocked as if she had been asked to climb Mount Everest and then blurted some gibberish as answer. All they wanted her to say was CAC is the acronym of Corporate Affairs Commission. How difficult can that be?

It was, therefore, a huge paradox and heart-warming to see these pupils, including a contestant from Pacelli School for the Blind, show their proficiency in the English language.

They lapped up their questions with effortless ease, in fact, some of them were spelling words that I, with my over 30 years’ experience in journalism, was encountering for the first time.I was really impressed.

When one juxtaposes the wondrous performance of these kids to the woeful performance of the Big Brother Naija Housemates, it is not hard to see why our country is where we are at the moment.

When I expressed my angst to an older friend on the Big Brother Housemates show of shame, he laughed and asked me what I had expected

He went on to explain to me that the criteria to be a housemate and win over 100 million naira, juicy prices and endorsement deals did not require any intellectual rigor.You are not expected to be intelligent or take any aptitude test. Just fill out a form, upload a video saying something about yourself and a photo!

Then, you must be articulate, interesting and willing to share your must private thoughts in an open forum to strangers and also be ready to cavort ceaselessly! That’s all!

He therefore affirmed that expecting any seriousness from the Big Brother Naija housemates was like Waiting for Godot.

I believe it is time for us to begin to change our mindset for the betterment of our country. What exactly is our priority as a nation? What are the things that interest us? What are the things that we spend our money on and what are the things that we spend our time on?

In contrast to the huge advertising and sponsorship that is poured on big brother naija, knowledge-based shows like the Spelling Bee, debate shows and quiz compettions never get any traction or attention by Nigerians. Winners hardly are appreciated with the kind of cool cash and media frenzy associated with big brother.

This kind of mentality has to change. If we are to turnaround the fortunes of our country, we have to change our attitude to knowledge and education in general.

It is time for corporate Nigeria to stop paying lip service to talent shows that are intellectually-focused, yes, not everyone has to be educated, but the large number of a country should rank up on that index especially even if to just showcase your talent, if Nigeria wants to take its rightful place at the top table of world prominence.

It is said that “Ideas rule the world” and that soft power is the new gold. How can we compete if we do not invest in our kids and youths like the Bunmi Adedayo Foundation.

Indeed, BAF has taken education as its focus. It has been in the forefront of training teachers and improving the learning experience of pupils.

According to the Foundation “It’s not about building schools, it’s also about building teaching and learning. That’s how communities flourish. They’re agent of change”

The Foundation is devoted to changing lives of children, by innovatively improving the quality of teaching and learning in Nigerian public primary schools.

The Foundation has so far organized 103 trainings, intervened in 1300 plus schools, built one state-of-the-art library, upgraded 5,200 plus teachers, donated one 40-seat ICT laboratory, worked in 56 plus Local Government Education Areas and impacted 15,000 plus pupils.

There is no doubt that we have to catch them young, feed them with the right ideals and ideas that will build them into worthy citizens.

On the day of the spelling Bee, which was won by my name sake, Michael Ofiemum, with Toluwani Toluwani and Janet Oseni taking second and third respectively, the Adedayo’s again showed that their milk of human kindness never runs dry when they extended full scholarship to six pupils of Navy Primary School.

Just like the Spelling Bee winners, contestants and their teachers went home with many prizes, gifts and loads of joy, the smile on the faces of the parents and relations of the scholarship recipients was indescribable.

There is no doubt that the impact of the Spelling Bee Competition and Scholarships by the Bunmi Adedayo Foundation will be etched on the hearts of these pupils and many years later, they will grow up to discuss how this rare opportunity shaped their lives and trust me, at that time, no one will be talking about who won Big Brother Naija 2023.

Let us all decide to invest wisely today by touching lives one child at a time!

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The Mastery of Strategic Alignment




By Tolulope A. Adegoke

“You need a plan to reach your goals. It is your plans that take or get you to a place, not just your dreams. Dreams without an active plan will take you to nowhere. It is a plan that empowers and exposes you to the discipline and responsibilities required to achieve your dreams or set goals. A plan teaches you “HOW” to get there, it is your blueprint. This is your time to set in place some plans that lead you to an ‘expected end’. By the time you get to the ‘end’, you shouldn’t be surprised, because success is intentional; it is deliberate. It is plans that takes you to success, and it is planning that helps you succeed for greatness. Therefore, set it up and step it up!”

– Tolulope A. Adegoke, PhD., FIMC, CMC, CMS, MNIM, CIV

 There should be synergy between your actions and ambitions. You should be able to look at your actions and tell your ambitions. From your ambitions, I will be able to tell where you are going by what you are doing. If what you are doing doesn’t tell or prophesy where you are going, then you are doing the wrong things. Since you are a limited resource, then you are not enough to go round; that means, you have to choose where you have to expend your energy. You cannot tackle everything at the same time. What you are doing must reveal or prophesy where you are going.

A plan is important, not just a dream. A lot of institutions teaches about dreams and vision, but they tend to dish the real deal in parts or halves. You need to understand that getting your plan lined up (to align) with where you are going is far more important. You need a plan to reach your goals. It is your plans that take or get you to a place, not just your dreams. Dreams without an active plan will take you to nowhere. It is a plan that empowers and exposes you to the discipline and responsibilities required to achieve your dreams or set goals. A plan teaches you “HOW” to get there, it is your blueprint.

This is your time to set in place some plans that would lead you to an ‘expected end’. By the time you get to the ‘end’, you shouldn’t be surprised, because success is intentional; it is deliberate. It is a plan that takes you to success, and it is planning that helps you succeed.

The Book of Life says: “write the vision, make it plain, so that whosoever that reads it may run with it.” Somewhere in your life, there ought to be a perfectly Mission Statement: your Vision, Purpose and Goals. That’s what is done in business, and you are in a business to earn a living. What’s your vision? What’s your purpose? What are your goals? With the aforementioned, you are able to choose what is yours wisely. Such that when people offer you things that are not in your Mission Statement, you can say NO because that’s not what you do. A lot of things can be very good, but if they are not in alignment with where you are going, you just have to let them go because you are a limited resource, which is specifically wired for a purpose or calling.

The Book of Exodus 25:1-9 unveils so much: “And the Lord spoke unto Moses, saying, speak unto the children of Israel, that they may bring me an offering: of every man that giveth it willingly with his heart ye shall take my offering. And this is the offering which ye shall take of them; gold, and silver, and brass, and blue, and purple, and scarlet, and fine linen, and goats’ hair, and rams’ skins dyed, red and badgers’ skins, and shittim wood, Oil for the light, spices for the anointing oil, and for sweet incense, Onyx stones, and stones to be set in the ephod, and in the breastplate. And let them make me a sanctuary; that I may dwell among them. According to all that I shew thee, after the pattern of the tabernacle, and the patterns of all the instruments thereof, even so shall ye make it.”

Could God have designed a tabernacle? He is a Master-planner, but He invited His people into the process and planning, and gathering the raw materials. You can quickly tell or deduce by what they are gathering that they are getting ready to build something. Also, one of the most profound statements spoken by God to Moses in the above verses is “Build according to pattern”. In other words, you should have a pattern for living. What God meant by the above is that: “I want you to build according to what I have showed you, do not build outside my plan.”

What you need is that you should get your vision from the Lord; this is simply the vision of where you are going, and this is “WHY” I put you on Earth; this is the purpose I have for you to do. Your job or duty on Earth is to build on Earth what God has already shown you. So what has God shown you? whatever God has shown you is your purpose and vision. A plan simplifies the process of tasks for an easy accomplishment of set targets. Pattern helps you grow; it builds you and gives you a niche. You are here to build on Earth as Man according to purpose and pattern which has been revealed by God.

Most people have no pattern. This is where mentoring comes in to lead you to act according to a designed pattern or system. Mentoring is about giving somebody a pattern to operate with; it is about giving or revealing and availing to somebody what they can see: walk the way I walk, step the way I step. Ask yourself, genuinely, “do you have a pattern?” Do you have a pattern for a successful career, marriage, business or ministry? Have you ever been around someone who is succeeding? You cannot imitate what you have not seen! People who don’t just hear the word, but do the word prospers and keep going up, challenges notwithstanding, but they continue to succeed because they are obedient and attentive to a laid out pattern of success.

A plan is a clear strategy which is usually documented for the purpose of succeeding, leading, conquering and achieving set-targets or goals in any facet of human endeavours. If you must prosper, then you must not fail to plan!

You must understand that success is always intentional, though many people act as if it isn’t, but it really is. You do not graduate from College and be surprised how it happened; you don’t lose weight by accident; you don’t run a marathon and say you do not know how you did it! The authentic truth is that nobody succeeds by accident.

The next thing you must not fail to understand here is that, you need to forgive yourself for making mistakes. You may have done something so foolish. Success isn’t a magic pill, but an intentional act for a change to occur via the renewing of your mindset, it is a process, it is going to take a little time, but it will work if you work it.

Invest Extra Income

Any unexpected income that is beyond your budget is the kind of money you should invest. Stop engaging in lavish spending. Understand that you do not need to buy what you do not need at all! Other people are investing in the idea that you will spend; that’s why they built a mall; that was their investment, expecting you to spend your money in it so that they can save it. You open up streams of income by investing your extra income, and you don’t start spending like the prodigal son (a fool). Don’t spend beyond your limits again. Now, you have understood that there is need for added investment pockets. In the Book of Matthew 25:14-30, Jesus Christ taught the same concept about investment. Even if He didn’t teach it, you still need to know these concepts of investment because you need to do it for your own good!

One of the biggest errors or mistakes we make is that whenever we a get a lump-sum of money, the first thing we try to do is to pay off all our bills, and what you do not realize is that when you are trying to pay off all your bills, you have bills again. You need to maximize opportunities. Gradually continue to pay your way out of debts by using the measure called DISCIPLINE. Keep the money by saving it; Grow the money by investing the money!

The Book of Life says, “you should bring forth fruits, so that your fruits may abide.” God implies that: “I am interested in getting you to a place that you stop losing everything I am giving you. What you know now will change the next five years of your life.

How can you love somebody and not have a life insurance? So you leave them struggling, evicted and uncared for? It isn’t about the luxuries or the expensive gifts or items. I charge you to convert them into assets, and get an insurance! Set your priorities straight in-line with what makes sense!

Stop accepting what keeps depreciating, and stop ignoring what keeps appreciating. Stop paying for your emotions! Even if you love a thing or luxury or property, don’t buy it if it is beyond your financial means or budget. Quit the emotion, where motion is required for your legs to step back. Stop spending too much on what is not necessarily important for you. Buy the basic needs and invest the rest so that as you rest, the profit yields!

A plan makes you a planter (sower). The idea is the seed; the plan makes you the planter. Every planter (sower) is eligible for the harvest of whatever he or she sows or plants! Ensure that you update your plan on a regular basis, because things change, so that you can make this year your year of effective and sufficient productivity. You must have things in order. Every of your steps must count! Are you positioning yourself in the line of your dream? You need to get ready to do it before you do it! You need to look like it before you are it! Remember, God anointed David to be king while he was still a shepherd boy. God was gradually positioning David into Royalty. God told Samuel in the Book of 1Samuel 16:13 (paraphrased), “I have got a Man in the House of Jesse, find him, I want you to anoint him to be king.” At first, after David was anointed to be king, he was still a shepherd boy, but rumour heard it all across the territories in his time that David was going to be king. You need to realize and understand that God is much more interested and focused on “WHERE” you are going than where you are, at the moment; and He is committed to plan and ride with you, if you will be reasonable enough to take responsibilities and endure the processes required to arrive at the successes that leads to greatness through a PLAN or pattern (strategy) that is well detailed for shifts and positioning to prosper and prevail in your areas of calling or purpose.

…to be continued.

Dr. Tolulope A. Adegoke is an accredited ISO 20700 Effective Leadership Trainer

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