Importance: Some of the symptoms of COVID-19 are fever, cough, and breathing difficulty. However, the mechanism of the disease, including some of the symptoms such as the neurological and musculoskeletal symptoms, is still poorly understood. Objective: The aim of this review is to summarize the evidence on the neurological and musculoskeletal symptoms of the disease. This may help with early diagnosis, prevention of disease spread, and treatment planning. Data Sources: MEDLINE, EMBASE, Web of Science, and Google Scholar (first 100 hits) were searched until April 17, 2020. The key search terms used were "coronavirus" and "signs and symptoms." Only studies written in English were included. Study Selection: The selection was performed by two independent reviewers using EndNote and Rayyan software. Any disagreement was resolved by consensus or by a third reviewer. 3-19%; I 2 86.74%), 3% for acute cerebrovascular disease (95% CI 1-5%; I 2 0%), and 2% for impaired consciousness (95% CI 1-2%; I 2 0%). Conclusion and Relevance: Patients with COVID-19 present with neurological and musculoskeletal symptoms. Therefore, clinicians need to be vigilant in the diagnosis and treatment of these patients.

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Background. Constraint-induced movement therapy (CIMT) is used for the rehabilitation of motor function after stroke. Objectives. The aim of this study was to compare the effects of lower limb CIMT that uses number of repetition of tasks with the one that uses number of hours of practice. Method. The study was a randomized clinical trial approved by the Ethics Committee of Kano State Ministry of Health. Fifty-eight people with stroke participated in the study. Groups 1 and 2 performed daily 600 repetitions and 3 hours of task practice, respectively, 5 times weekly for 4 weeks. Motor impairment (primary outcome), balance, functional mobility, knee extensor spasticity, walking speed and endurance, and exertion before and after commencement of activities were assessed at baseline and postintervention. The data was analyzed using Friedmann and Mann-Whitney U tests. Result. The results showed that there was only significant difference ( p < 0.05 ) in knee extensor spasticity (group 1 ( median = 0 0 , mean   rank = 27.50 ); group 2 ( median = 0 0 , mean   rank = 31.64 )), exertion before commencement of activities (group 1 ( median = 0 0.5 , mean   rank = 21.90 ); group 2 ( median = 1 0.5 , mean   rank = 37.64 )), and exertion after commencement of activities (group 1 ( median = 1 1 , mean   rank = 20.07 ); group 2 ( median = 1 0 , mean   rank = 39.61 ) postintervention in favour of the experimental group (group 1)). Conclusion. The group 1 protocol is more effective at improving outcomes after stroke.

Introduction. Stroke is a leading cause of morbidity and mortality globally. The aim of this study was to compare the effect of constraint-induced movement therapy (CiMT) and proprioceptive neuromuscular facilitation (PNF) on upper limb function of chronic stroke survivors. Methods. overall, 30 stroke survivors were recruited via convenient sampling and consecutively assigned into 2 groups (15 participants each). Group A received CiMT while group B received PNF techniques. All treatments were administered on the affected upper limb, 3 times a week for 6 weeks. Fugl-Meyer assessment (FMA) scale was used to evaluate upper limb function. descriptive statistics served to summarize the demographic characteristics of the participants and inferential statistics of t-test was used to determine the effect of the interventions within the groups and between the groups on the basis of FMA. All statistical analysis was performed with the Statistical Package for the Social Sciences (version 16.0) at the alpha level of 0.05. Results. The participants' mean age was 59.53 ± 9.92 and 63.00 ± 7.27 years for group A and B, respectively. No significant baseline difference was observed between the groups in the upper limb FMA (p > 0.05). A statistically significant post-intervention effect was noted for both treatment approaches; however, when the groups were compared, CiMT resulted in a better improvement than PNF. Conclusions. CiMT and PNF interventions are both beneficial in improving upper limb function, with CiMT being more advantageous. CiMT may be the preferred approach for the management of chronic upper limb post-stroke impairments.

Background Central poststroke pain (CPSP) caused by sensory dysfunction of central origin is a disabling condition that significantly affects the quality of life of stroke patients. Aim The aim of this study is to determine the clinical profiles and pattern of CPSP among stroke patients in Kano, Nigeria. Methods The study was a cross-sectional design involving stroke survivors who were ≥18 years old and with no significant cognitive impairment approved by the Research Ethics Committee of Aminu Kano Teaching Hospital. Participants were assessed using diagnostic criteria form, the douleur neuropathique 4 questions (DN4 questionnaire), and Leeds assessment of neuropathic symptoms and signs (LANNS). Results A total of 120 stroke patients participated in the study, in which 6 (5%) were diagnosed with CPSP occurring within the first 3 months in 50% of the participants. The pain characteristics were mainly moderate (83.3%), burning (62.5%), and continuously experienced (66.7%). The frequently affected parts were extremities or occurring as hemisyndrome. Conclusion Prevalence of CPSP following stroke is low. The clinical features are variable and can occur at a varied time and different intensities and locations. However, it majorly occurs within the first few months post stroke.

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Background/Aims Literature suggests that aerobic exercise improves cognitive impairments post stroke. This systematic review was conducted to analyse evidence on the effectiveness of aerobic exercise in improving post-stroke cognitive impairments. Methods Online databases (PubMed, EMBASE and Web of Science) were systematically searched from inception until 13 July 2017 using the keywords stroke/exercise/cognition. Clinical trials that met the inclusion criteria were assessed for methodological quality using the PEDro scale. Extracted data were synthesised for evidence. Results A total of seven studies met the inclusion criteria. Participants in most of the studies were aged over 60 years and the majority had ischaemic stroke. The most commonly used measure for assessing cognition was the Mini Mental State Examination. The majority of studies included moderate to high intensity exercise (50–70% of VO2max) for 30–60 minutes three to five times per week. There is moderate evidence that aerobic exercise enhances global cognitive function, attention and working memory. Evidence that aerobic exercise improves memory, levels of brain-derived neurotrophic factor and executive function is conflicting and limited. Conclusions Aerobic exercise is moderately effective in improving post-stroke cognitive impairments. More clinical trials are needed in view of the methodological limitations and paucity of existing studies.

Background: Management of patients with covid-19 needing hospitalisation is challenging worldwide. However, little or no information has been gathered regarding the experiences of healthcare workers (hcw s) involved in the care of patients with covid-19 in poorly resourced settings. This study explored the experiences of hcw s managing hospitalised patients with covid-19 in a treatment centre in Kano, Nigeria. Methods: hcw s directly or indirectly involved in managing patients with covid-19 in one of the two treatment centres in Kano, Nigeria, were sampled based on being information-rich cases. The study participants were interviewed individually via telephone using a semi-structured interview guide. Data collection was stopped when content saturation was attained. Data was analysed using thematic synthesis. Results: Eleven hcw s, comprising two medical doctors, five nurses, a laboratory staff member, a community health extension worker, an environmental health officer and a cleaner, participated in this study. Four major themes were generated: (i) the profile and readiness of hcw s prior to being engaged to work in a covid-19 treatment centre, (ii) the experience of hcw s while working in the covid-19 treatment wards, (iii) challenges with working in covid-19 treatment wards, and (iv) post-treatment support for covid-19 patients. The participants had variable prior experience in managing patients with infectious diseases. Interventions offered were mainly antiviral therapy, nursing care, counselling, nutritional interventions and toilet hygiene. Challenges encountered included insufficient cooperation from patients, poor personnel welfare, lack of human resources/equipment and issues interfering with wellbeing (stigma). Conclusion: The studied population exhibited professional competence and success in managing hospitalised patients with covid-19 during hospitalisation, despite existing challenges.