A Painter Falls From His Ladder and Tells You He Has Dislocated His Shoulder Again

• Inquiry article
• Open Access
• Published: 11 Baronial 2017

Causes, trends and severity of musculoskeletal injuries in Republic of ghana

BMC Musculoskeletal Disorders volume 18, Article number:349 (2017) Cite this article

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Background

Musculoskeletal [MSK] injuries are common causes of long-term hurting and physical disability which affect many people worldwide. The economical and social impacts on the individual, society and national health systems are enormous making a matter of public wellness concern. Therefore, this report examined the causes and extent of MSK injuries in a referral infirmary in Ghana.

Methods

A prospective study blueprint with consecutive sampling method was used to recruit patients admitted at Trauma Unit of measurement besides as those receiving orthopaedic reviews at St. Joseph'due south Orthopaedic Hospital over a ten-month catamenia. A structured questionnaire, Visual Analogue Scale (VAS) and Abbreviated Injury Scale (AIS) were used to collect data which were analysed descriptively using SPSS version twenty.

Results

A total of 269 MSK injury patients were identified - of these, 137 (l.9%) males with an average historic period of 38 years (SD = 19.88). Nearly half (49.ane%) of the injuries sustained were fractures, and common causes were vehicular crash 113 (42.0%) and fall 68 (25.3%). Body parts afflicted about were the knee joint (19.62) and the mean levels of pain for all injuries were 6.04 ± 2.44 and iii.25 (±1.50) respectively.

Conclusion

Republic of ghana needs a healthy population to steer its development trajectory. Policy makers in Ghana should pay attention to both preventive besides as direction of MSK injuries, or else, nigh of the land's working class could alive with lasting furnishings of injuries which may take significant impacts on the economy.

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Background

Musculoskeletal [MSK] injuries are the commonest causes of severe long-term hurting and physical disability affecting hundreds of millions of people around the earth [i]. MSK injury is known to lead to morbidity and mortality in Low and Middle-Income Countries [LMICs] [two]. According to the Globe Health Arrangement [WHO] in 2000, various kinds of injuries resulted in the expiry of 5.1 million people and deemed for 12% of the disability-adjusted life years (DALYS) worldwide which is expected to increase to 20% past the year 2020 [3,4,5]. Additionally, one-tertiary of all health-related absence from work in developed countries are attributed to MSK conditions - a situation which is likely to be double in LMICs where a huge number of people suffer from non-fatalities every solar day [v]. This reinforces the need for attention to be given to trends in MSK injuries in LMICs where there seems to be numerous issues facing the healthcare organisation.

MSK injuries are amongst the almost incapacitating in the adult population than any other grouping of disorders [6]. In the developed countries, similar Canada, USA and Western Europe, the prevalence of physical disabilities caused by MSK condition has been estimated at 4–v% of the adult population [7]. The prevalence is higher among women and increases markedly with age [6]. Similarly, MSK injury is associated with 40% of chronic conditions; 54% of all long-term disability and 24% of all restricted activity days [six]. The pain and disability brought near by MSK weather condition affect social operation and mental wellness, farther diminishing the patient's quality of life [6, 8]. Therefore, having baseline information on the prevalence of MSK injury could enable policy makers to channel resource in both prevention and intervention.

The burden of this condition is heavily borne by LMICs, where preventive strategies are often nonexistent, untimely and fifty-fifty difficult to notice [4]. It is important to reiterate the fact that the economic and social impact of MSK injuries on the individual, society, and the national health intendance systems is enormous [1,2,three]. Thus, in the absence of data on mutual trend in MSK injury, it will be difficult for healthcare system to put in place effective preventive and management strategies. Information technology will exist interesting to note that road traffic crashes have been identified as one of the major causes of serious MSK injuries in LMICs [2, 9, ten]. Besides, they are one of the primary causes of years lived with disability in all continents and major economies [6]. As fast cars are existence developed and LMICs lacking the fiscal capacity to expand their roads but continue to utilise single lanes roads, road traffic crashes are spring to increment [4, 5]. These claims are unverifiable in the Ghanaian context; though road traffic crashes appear to be major national business concern because of the number of people lost annually.

While in that location is considerable funding for command of communicable diseases, at that place has been piddling attention paid to either the documentation, prevention or the treatment of MSK problems in LMICs [9,ten,11,12]. Despite the increasing burden of MSK disorders in LMICs, enforcement of policies and intervention have just begun to address injury command [13]. This lack of programmatic and policy bulldoze towards the direction of injuries is in role due to a lack of population-based and national research findings of MSK injuries. Apparently, availability of information in this regard may influence wellness decision-makers to allocate enough resource into injury prevention and management [ii, 4, five]. Thus, addressing the burden of injury in LMICs should be a public health priority where basic services that are depression-cost, high-yield and appropriate, accept to be fabricated bachelor in about every health facility.

It is essential to mention that between 2000 and 2010, WHO launched the "Os & Articulation Decade" to raise awareness of the impacts of MSK injuries and disorders [12,13,14]. After more than than half dozen years of the campaign, the causes of MSK injuries affecting Ghanaians are all the same to be documented as the land continue to rely on estimate given past WHO. This seems to suggest that the causes and burden of MSK injuries have not received scholarly attending in Ghana. Therefore, this report aimed to outline the etiological spectrum, injury patterns and short-term outcome of these injuries. The objectives of the current study included: ane) assessing the characteristics of injured patients; two) the type of injury, causes and body parts affected; and 3) the severity of the injuries. It is anticipated that findings from this written report could help raise awareness and then that MSK disorders receive primacy in health strategy, grooming, research and management amidst clinicians and health policy makers.

Methods

Report design and setting

The study was a prospective pattern which involved MSK injury patients receiving orthopaedic intendance at St. Joseph's Orthopaedic Hospital, Koforidua-Ghana, which serves a population of around 250,000. Information technology is a Cosmic Mission Infirmary which aims to provide efficient and affordable speciality care in orthopaedic trauma. With approximately 180 beds, St. Joseph'south is among the few orthopaedic hospitals in Ghana with a catchment area encompassing the entire Due west African Sub-region. Annually, the infirmary attends to over xl,000 cases with at least 11%, coming from exterior the Eastern region where the hospital is located. Specifically, orthopaedic trauma cases constitute over 60% of the patients treated in the facility. The study was conducted from November 2013 to Apr 2014.

Sampling technique

Consecutive sampling technique was used to recruit participants for this study. According to Lunsford and Lunsford, in consecutive sampling, but the available population is studied which makes it possible to accept a good representation of the target population [15]. Patients were included if they presented with a MSK condition that was treated at the hospital. Researchers included all accessible patients with MSK conditions over a 6 month menses who met the inclusion criteria, as and when they arrived at the hospital. The inclusion criteria were; 1) patients admitted at the Trauma Unit and 2) patients receiving orthopaedic reviews at the St. Joseph's Orthopaedic Hospital. Conversely, patients were excluded if they: i) absconded from the hospital, 2) were discharged against medical advice, iii) had other neurological conditions which may require other neurological investigations and direction or 4) died before the cess was completed.

Method and process of information collection

After the necessary approval was granted, health professionals at the departments and wards were informed nigh the study. Because the hospital is a referral centre for orthopaedic trauma, the administrators informed usa to collect data on Thursdays which is the day most patients went for consultation and review. In the discharge of their duties, the health professionals informed patients most the report. They explain the objectives of the written report to patients and those who agreed to take role in the study were referred to the trained research banana who was hired to collect data. Due to proximity of the facility to the researchers, the research assistant who was resident in the surface area was tasked to practise the data drove. Some participants completed the questionnaire themselves while those who were unable to read were helped by the research assistant. Each participant spent an approximate time of 45 min – i h.

The questionnaire used in the data collection was adult from a review of literature. Information collected included demographic characteristics of participants, the diagnosis, injury causes, various parts of the body involved, the length of hospital stay and severity of injuries. Also, pain was measured with Visual Analogue Scale (VAS) while the severity of injury of the patient was assessed with Abbreviated Injury Calibration (AIS). The VAS consists of a horizontal or vertical line exactly 10 cm equal parts with anchors at either end, i.e. 0 and x. On the scale, 0 = no pain, one–3 = balmy pain, iv–6 = moderate and vii–10 = severe hurting [fifteen, 16]. Also, AIS is coded from a score of zero to six with a score of 0 = no injury, 1 = minor, 2 = moderate, 3 = serious, four = severe, 5 = critical and 6 = maximum [sixteen].

Data management and analysis

Data collected were entered into a reckoner and analysed using SPSS software version 20.0 with the aid of a medical statistician. Data were summarised in the form of proportions and frequency tables for chiselled variables. Ways, median, mode and standard difference were likewise used to summarise continuous variables. Ways and standard deviations were illustrated using tables to nowadays the causes of MSK injuries, pain levels and severity.

Ethical consideration

The study was reviewed and canonical past the Kwame Nkrumah University of Scientific discipline and Technology (KNUST) /Komfo Anokye Educational activity Infirmary (KATH) Committee on Human Inquiry, Publications and Ethics (CHRPE). Administrative approval was obtained from St. Joseph's Orthopaedic Infirmary, Koforidua. The confidentiality of the information provided by patients was assured. Patients were assured that refusal to participate in the study would not touch on their treatment in the hospital. The study included only participants who gave their consent past signing the consent class and were informed that participation was voluntary. An data leaflet was given to the patients to read before consenting. The participants were informed that they could opt out of the study at any time and would non be required to give whatsoever reason for doing so.

Results

Demographic characteristics of participants

The demographic characteristics of the participants are summarized in Tabular array 1. A full of 320 questionnaires were administered by the enquiry assistant to the participants, of which 269 were fully completed and deemed valid for analyses of the study. Male person participants constituted 137 (50.9%) while female patients were 132 (49.1%). The ages of the respondents ranged betwixt 1 and 82 years with a mean of 38.0 years (SD 19.9 years). The majority of the participants were between the ages of 40 and 60 years (36.8%) while less than v% were below the age of v. The majority of participants were married (51.7%), with 37.ii% who were never married.

Table 1 Demographic characteristics of injury patients

Full size table

Distribution of diagnoses

Table 2 shows per centum distribution of participants regarding historic period, gender and marital status based on their respective diagnoses. Ane hundred and thirty-two (49.1%) of participants presented fracture cases, 32 (11.9%) were arthritis, 27 (10.0%) had dislocation, 40 (fourteen.9%) had back pain, eighteen (6.7%) were of ligament injury, 6 (2.2%) were amputation while 14 (5.two%) were tendon injury. Lxx-nine out of the 132 participants diagnosed with fracture were male while simply 4 were amputees. On the other hand, 53 of the 132 fracture patients were females compared to only two who were amputees Regarding historic period, over 30% were between 40 and 60 years while less than five% were less than 5 years. Out of the 132 fracture patients, 51 were betwixt twoscore and 60 years while just ii in the aforementioned age bracket were amputated. Of those less than 5 years of age, 12 were diagnosed with ligament injuries while only one was having a tendon injury. On marital status, over 50% of participants were married compared to less than 2% who were separated. Out of the total number of participants diagnosed with fracture (132), 53% were married while less than ii% each were separated and widowed. Of those who were amputated, all were married.

Table 2 Percentage distribution of characteristics of participants reporting hurting or discomfort due to injury or crash with diverse diagnoses

Total size tabular array

Body parts affected, causes and severity of injury

Nearly injuries were related to the articulatio genus (xix.6%), followed by the low back (14.6%), thigh (eleven.iv%), talocrural joint (10.viii%) and shoulder (10.1%). The neck recorded the least injuries (0.half dozen%). Few injuries occurred at the foot, upper back and the thumb/finger regions. Table 3 presents the distribution of causes of injuries amid participants. Vehicular crash was found to be the highest cause of MSK injuries, representing 42.0% of injury causes, while attack was 0.vii%. Out of 132 participants diagnosed of fracture, xc were due to vehicular crash while just 2 indicated others. About arthritis (32), 22(68.8%) indicated other while simply ii mentioned assail. In relation to dislocation (27), 15(55.6%) indicated vehicular crashes while 12 mentioned fall. For back hurting (40), 26(65%) indicated other causes while but ii indicated gunshot as cause of their status. For amputation, four indicated other while two indicated vehicular crash as a cause of their status.

Table 3 A distribution of the causes of the various musculoskeletal injuries equally diagnosed

Full size tabular array

Level of pain and injury severity

Table 4 presents the distribution of injury severity recorded on the AIS. Participants were asked to circle the number that best explain their condition. In all, information technology was found that 74 participants (27.v%) indicated that their weather condition were serious while only two (0.7%) were in critical conditions. When information technology comes to individual diagnoses, out of 132 participants diagnosed with a fracture, over 90 had serious and astringent conditions. On arthritis, 18 had no injury while only two participants indicated moderate injuries. On dislocation, out of 27 participants, 16 (21.6%) reported serious conditions compared to three (ix.7%) indicated moderate weather condition. On dorsum hurting, out of 40 participants diagnosed, twenty (37.0%) were without injury while merely 2 were in disquisitional condition. In terms of ligament injury (xviii), eight each indicated no injury and serious injury respectively (see Table 4 for details).

Table 4 Distribution of injury severity indicate on the AIS

Full size table

The mean score of both pain and injury severity were calculated (see Tabular array v for details). The overall mean level of pain equally reported by the participants was 6.04 ± 2.44. Dislocation recorded the highest mean of 6.85(±2.05) while tendon injury recorded the lowest mean of iv.00(±3.37). In addition, fracture and amputation recorded a mean of six.38(±2.18) and 6.00(±ii.37) respectively. The overall mean injury severity level reported past participants using the AIS was 3.25(±one.50). Amputation recorded the highest mean severity level of 4.33 (±0.52) while tendon injury recorded the least hateful of 3.25 (±one.50). In the same way, fracture and dislocation recorded an average of at least three on the calibration.

Table 5 Distribution of the mean levels of pain

Full size table

Discussion

This study aimed to document the extent and causes of MSK injuries in a major referral hospital in Republic of ghana. As found by the study, the leading cause of MSK injury in this study was vehicular crash. This finding is non different from studies in other countries where the vehicular crash was reported every bit a main cause of MSK injuries [4, 9, 12, 17, 18]. The contributing ascent of vehicular crash in Republic of ghana may be due to 2nd-paw vehicles, bad roads and weak enforcement of traffic laws (v). Possibly, both drivers and pedestrians lack agreement and interpretation of road signs which could exist responsible for the increasing number of vehicular crashes. Also, falls were recorded as the 2d leading cause of MSK injuries amidst participants in this study. This finding corroborates a written report by Onwudike, Olaloye and Oni [19] who identified falls, assaults and gunshots as among the leading causes of injuries. This opens the fence on the extent of consideration given to the needs of diverse individuals during building and infrastructural development. Notwithstanding, the power of individuals who suffered injuries to adapt to the already built physical environments is an issue which is gaining gradual discussions in Republic of ghana as existing empirical inquiry has found the physical environments to exist unfriendly [20]. In the interest of all persons, it is vital for builders to make provision that could guarantee the rubber of users of the facilities.

The study identified fracture, arthritis, dislocation, dorsum pain, amputation, ligament and tendon injuries every bit the primary MSK injuries presented by participants. Fracture cases were the virtually reported injury by the participants in this study. It was confirmed past the findings by Lee & Porter [1] that fractures were the commonest condition reported in their written report. This might have had impact on the daily living weather condition of individuals as they may be unable to perform their duties every bit expected. For example, Järvinen, Järvinen and Kaariainen [21] identified MSK injuries to be common in professional and amateur athletes. Payne, Kinmont and Moalypour [22] mentioned that whatsoever injury to a body office besides causes traumatic injury to both bone and surrounding soft tissue. Their report also revealed that 90% of muscle and tendon injuries are usually caused by excessive strain which may result in disability of the individual to railroad train or compete for several weeks. These injuries have high tendencies to recur which might account for many chronic MSK conditions. Thus, the difficulty in tackling such injuries presents an urgent concern for LMIC where not much investment are provided for the development of healthcare organisation.

Back hurting was likewise one of the leading weather participants reported. Participants who reported having back hurting attributed the condition to other causes rather than vehicular crash, falls, assaults and gunshot in this study. This confirmed the findings by Waddell et al. [23] that information technology is often difficult to associate back pain with some of the causes of MSK injuries. Although the prevalence of back pain varied from population to population, a study by Brage and Laerum [24] revealed that 60–80% of world's population experience recurring back pain and hence, it was non surprising that participants indicated other causes. Potentially, there are daily habits such every bit sitting, conveying or other tasks that could crusade dorsum pain. Perchance, individuals do not get education in some daily life activities which might take impact on their lives.

The results of this study revealed that weather presented at the hospital were of different severity scores. For instance, participants diagnosed of back pain and tendon injuries reported low scores on the injury scale. Although this report did not measure disability levels, it somehow contradicts a study by Borenstein [17] who establish back pain every bit a leading cause of inability and activity limitation. Still, this report found it to be 1 of the most reported complaints of participants and hence, farther study could establish its relationship with disability. Additionally, participants with fractures, dislocation, amputation and ligament injuries recorded the highest severity score which means that they might be experiencing, or be at adventure of, disability. Specifically, participants who had fractures recorded ane of the highest scores on the severity calibration. They also class the majority of participants recruited in this study. It is possible that there is either lack of trained personnel or lack of infrastructure to properly handle fracture conditions. Information technology is worth mentioning that fractures may recur if not properly managed which might negatively affect patients. Hence, all-time intervention strategies may be needed to enable individuals to go back to the society. Unsurprisingly, amputation was institute to record the highest severity. This is likely to leave individuals with permanent disability and participants who had amputation would need other help to be physically functional again. This study is likewise in agreement with Woolf and Pfleger's [8] findings that amputation is the commonest cause of severe long-term and physical disability.

It is imperative to mention that most of the participants diagnosed were plant to be between the ages of 40–threescore years which seems to be disquisitional period where people are mainly engaged in productive activities. Within this period, people are expected to stay good for you to be able to meet the demands of life. Nevertheless, with intense working conditions and possibly the desire to excel in one's field of attempt, it is possible that individuals may be unable to regularly exercise or eat healthy diets making them susceptible to injuries that might keep them out of the world of work. A healthy population is a wealthy population [25] and therefore, injuries need to be handled well in order not to burden society with individuals who would keep to depend on others for survival. This finding is consistent with studies by Chang et al. [26] and Rubenstein [27] who mentioned the take a chance of injuries amidst older people. Although these studies were conducted with participants anile lx years and over, it could somehow exist compared to the Ghanaian context where the boilerplate life expectancy is a little over 50 years. Good for you living appears to be an important public health business for countries with depression mortality rate. Ghana needs to work on this area in order to mayhap, prolong the life expectancy of its citizens.

The levels of pain indicated that participants diagnosed with fracture, dislocation and amputation experienced the near hurting on the VAS. This is possibly a major wake-up call for health professionals, especially those involved in rehabilitation, to critically evaluate their approach to disabling atmospheric condition and adopt mechanisms which they could use to handle patients. There is the need for individuals to get back into the community to go along working or live independently like whatsoever other person within the society. Therefore, it is essential for wellness professionals to learn the best preparation as well as resourced to rehabilitate patients back into the gild.

Implication for policymaking

The report has implications for policy making in Ghana. The report revealed that a major crusade of MSK injuries is vehicular crash. This calls for intensified campaigns, workshops and seminars geared towards defensive driving skills and the apply of road signs which could assist reduce the number of vehicular crashes on the roads. Elvik et al., [4] in a written report in Europe reports that the loftier rate of route crashes and traffic injuries, especially among company drivers, led the companies to adopt campaigns such equally educating their employees against the use of attending-enervating activities such every bit using mobile phones while driving as well as organizing workshops to brainwash them on the need to drive responsibly. In Ghana, road traffic controllers must ensure that devil-may-care drivers are dealt with according to the traffic rules and regulations. Law enforcement agencies such equally the Motor Traffic and Transport Unit [MTTU] of the Ghana Police Service as well every bit National Route Safety Commission [NRSC] must intensify rules and regulations pertaining especially to our roads to reduce the increasing number of vehicular crashes in the land.

Secondly, apart from route crashes, at that place were other factors found to cause injuries amid participants. It is recommended that educative, interventionist programmes geared towards prevention and direction of injuries are emphasised. For instance, Chang et al., [26] and Rubenstein [27] suggested the essence of regular exercises which could help reduce the high rate of injuries acquired past falls among older persons. Ghana Health Service and Republic of ghana Physiotherapy Association [GPA] could lead this campaign. Likewise, Mock and Cheridan [ix] mentioned that the increase in the number of ambulance units across United mexican states enabled rapid response to victims of vehicular crashes and shooting incidents. This could exist adopted in Ghana to enable early response to road crashes. Also, information technology is prudent that more health workers, particularly nurses and emergency attendants, should be trained in management and emergency treatment of MSK injuries. Furthermore, rehabilitation centres should be instituted, or the existing facilities should be resourced to assistance individuals who get victims of MSK injuries. This will assistance with the management of most of the chronic injuries and the rehabilitation of the disabling weather condition.

Conclusion

The study aimed to draw the trends, causes and severity of MSK injuries in Ghana. The study establish the knee as the most reported body function with the neck beingness the least. Vehicular crashes and falls were the most prevalent causes of MSK injuries. Fractures, Arthritis and dislocation were the major conditions seen across age groups among the study participants. Participants with dislocation reported the highest mean pain levels which were closely followed by participants diagnosed with fracture. Individuals who suffered back pain reported the everyman hurting thresholds. Ghana needs a salubrious population to steer its development trajectory. Policy makers in Ghana should pay attention to both preventive as well as management of MSK injuries, or else, about of the state's working course could live with lasting effects of injuries which may have significant impacts on the economy. In club for the country to help manage MSK injuries, it is of import that measures such as investment in resources and quality of preparation of specialists be implemented to help address this menace. As well, rehabilitation centres need to be established to help in restoring victims of MSK injuries to their productive lives.

The results take to be interpreted with caution due to the limited scope of the study. Participants were merely recruited from one major hospital in Republic of ghana which means that the results may not be representative of all patients who have been diagnosed with MSK injuries. Too, it is important to mention that participants who absconded from handling were not included in the final reporting of the report. Thus, information technology is important that future studies be conducted in other hospitals and rehabilitation centres so as to have a holistic understanding of MSK injuries. Despite these limitations, the study has provided a descriptive movie of the causes and severity of MSK conditions that has received lilliputian scholarly attention in Ghana.

Abbreviations

AIS:

Abbreviated Injury Calibration

DALYS:

Disability-adjusted life years

GPA:

Ghana Physiotherapy Association

HIV:

Human Immunodeficiency Virus

LMIC:

Low and Middle Income countries

MSK:

Musculoskeletal

MTTU:

Motor Traffic and Transport Unit

NRSC:

National Road Safety Commission

SD:

Standard departure

VAS:

Visual Counterpart Calibration

WHO:

World Health Organisation

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Acknowledgements

This report was supported by St. Joseph's Orthopaedic Hospital, Koforidua-Ghana. We also appreciate the contribution of the staff of Ghana Health Service, Eastern Region, for their incalculable help during the data collection. The content of this manuscript is the sole responsibility of the authors and does not necessarily correspond the official views of the St. Joseph'due south Orthopaedic Hospital, Koforidua-Ghana. The authors thank all data collectors for their assistance. In improver, we admit the time and attempt contributed by the participants.

Funding

We did non receive any funding for this study.

Availability of data and materials

The datasets used and/or analysed during the electric current study are bachelor from the respective author on reasonable request.

Authors' information

Mr. Eric Lawer Torgbenu is an Banana Lecturer and Senior Physiotherapist at the Department of Physiotherapy and Rehabilitation Sciences of the University of Health and Allied Sciences, Ho-Republic of ghana. He served as the Head of Physiotherapy Department of East Akim Municipal Infirmary, Kibi until his date as an Assistant Lecturer in 2016. He is a member of the Ghana Physiotherapy Association (GPA) and as well, the University Teachers Association of Republic of ghana (UTAG). While employed by the Ghana Health Service, he had the opportunity to read his Principal of Science Caste in Disability and Rehabilitation from Kwame Nkrumah University of Science and Technology, Kumasi. He has rich working feel having been involved in health teaching and promotion exercises across religious bodies in the East-Akim Municipality and beyond. He was too appointed in 2015 every bit a Lecturer at Greenhills School of Wellness Sciences, Accra and lectures in the field of Cardiopulmonary Physiotherapy, Massage Therapy and Practice Therapy.

Mr. Emmanuel Kwaku Nakua is a Senior Lecturer and Biostatistician at the KNUST-School of Public Health. He is currently the Head of Department at Department of Population, Family and Reproductive Wellness. He is engaged in teaching, research and service to the customs and offers lectures in various areas of public health to both undergraduate and graduate students. His research involvement include; Reproductive Health-Child Survival, Maternal health, Malaria and Human Resource for Health. He is currently pursuing his PhD.

Mr. Eric Badu is a Ghanaian, with involvement in Disability and Health Research, Wellness Systems Research, Evaluation, Social inclusion, Inclusive Education, Human rights issues and Quantitative and Qualitative data analysis. He has experience in diverse fields including teaching and consulting in disability and wellness enquiry, field mentoring and supervision' in research projects equally well every bit other bookish works. He holds MSc Disability, Rehabilitation and Evolution. From 2013 to 2014, he worked as Graduate Research Assistant, Centre for Disability and Rehabilitation Studies, Kwame Nkrumah Academy of Science and Technology. Currently, he works every bit Regional Research Counselor for Sightsavers West Africa Programmes.

Mr. Henry Kyei is a Clinical Physiotherapy Assistant by profession and currently works at Kibi Government Infirmary. He had his secondary education at the Kumasi Senior High Schoolhouse and further to the St. John of God Physiotherapy and Orthotic Training School, Duayaw-Nkwanta where he obtained a Diploma in Physiotherapy and Orthotics. He did his clinical attachment with several referral hospitals in Republic of ghana including, The Volta Regional Hospital, Ho, and Kumfo-Anokye Teaching Infirmary, Kumasi. He was the Head of Department of the Living Waters Infirmary, Kumasi until his engagement into the Ghana Wellness Service in 2015. He is involved in the rehabilitation of children with congenital clubfoot. He is as well the Information Managing director of Lerick Physiotherapy and Rehab Services, Kibi.

Mr. Maxwell Peprah Opoku is a Ghanaian by birth who started his early education at Mampong-Ashanti - before moving to Kumasi for his first degree in Political Science from Kwame Nkrumah Academy of Science and Engineering. After serving a year equally Teaching and Research Banana, he developed involvement in inability which influenced his decision to enroll in Disability, Rehabilitation and Development for his second degree from this aforementioned Academy. He was appointed as Graduate Teaching Assistant at the Middle of Inability Studies, Department of Community Health while pursuing his Principal degree. He has a second masters in Governance and Regional Integration from Pan African University- Cameroon. His expanse of specialty is disability, special education, community based rehabilitation, Inclusive education, health research, management of natural resource, human rights, social policies and public policy. He is currently a tutor and PhD Candidate in Commonwealth of australia.

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Affiliations

1. Section of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, School of Centrolineal Health Sciences, Ho, Republic of ghana

   Eric Lawer Torgbenu

2. Department of Community Health, Kwame Nkrumah University of Scientific discipline and Technology, School of Medical Sciences, Kumasi, Republic of ghana

   Emmanuel K. Nakua & Eric Badu

3. Department of Physiotherapy, Kibi Government Hospital, Kibi, Ghana

   Henry Kyei

4. Faculty of Education, University of Tasmania, Tasmania, Australia

   Maxwell Peprah Opoku

Contributions

ELT, EKN, MPO and EB were involved in the blueprint and implementation of the study, field piece of work, data direction, analysis, interpretation of the data, and writing of the manuscript. ELT and EB performed the statistical analysis with the guide of EKN. MPO and HK provided significant input to the manuscript, revised information technology critically for important intellectual content, and gave their final approving for the version to be published. All authors accept read and approved of the final manuscript.

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Correspondence to Maxwell Peprah Opoku.

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The Ideals review lath of Kwame Nkrumah University of Science and Applied science (KNUST) /Komfo Anokye Instruction Infirmary (KATH) Commission on Human Research, Publications and Ethics (CHRPE) scrutinized and approved the study protocol. All participants signed a written informed consent before they participated in the study.

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Torgbenu, E.L., Nakua, E.Yard., Kyei, H. et al. Causes, trends and severity of musculoskeletal injuries in Republic of ghana. BMC Musculoskelet Disord 18, 349 (2017). https://doi.org/10.1186/s12891-017-1709-8

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• Received: eleven May 2016

• Accepted: 04 Baronial 2017

• Published: 11 August 2017

• DOI : https://doi.org/x.1186/s12891-017-1709-viii

Keywords

• Musculoskeletal injury
• Rehabilitation
• Hospital
• Orthopaedic
• Republic of ghana

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