| dc.description.abstract | Musculoskeletal pain is the most cardinal sign of sickle cell disease among children
which occurs due to vaso-occlusion causing disability. Exercise has proven to be
helpful in musculoskeletal pain and should be used like any other therapy. World
Health Organization guidelines recommend all children to be active for 60 minutes
daily for 3 months to achieve health benefits in health and illness. Therefore, the aim
of this study was to analyze the effectiveness of exercise in musculoskeletal pain
among children with sickle cell disease. Specifically, to determine the relationship
between socio demographic characteristics and musculoskeletal pain among children
with sickle cell disease, examine strategies used in management of musculoskeletal
pain, analyze factors that influence management of musculoskeletal pain and assess
the outcome of exercise on musculoskeletal pain. This study was guided by the theory
of Bio-psychosocial theory of Health and Illness. The study adapted a quasi
experimental pre and post design with two arms control and intervention groups.
Intervention group was introduced to a 12 week exercise while the control group
continued with their routine. Both groups were recruited live from sickle cell and
hemophilic clinics. Quantitative data was collected using questionnaire and analyzed
by chisquare test of independence and mixed model anova.Qualitative data was
collected using key informant guides and indepth interviews and analysed by thematic
content analysis.The study had a sample size of 176 children, 22 respondents
participated in indepth interviews.The results found no statistically significant
association between socio demographic characteristics and musculoskeletal pain
among children with sickle cell disease. The majority of the respondents in
intervention group reported mild musculoskeletal pain after the intervention (n=104,
59.1%). The results of the Chi-square test for hemoglobin levels (χ2 (2) = 23.99, p <
.001), hospital visits (χ2 (2) = 22.033 p <0.01), exercise participation p <0.01) and
painful attacks p <0.01 were significant. There was a statistical significant difference
in intervention group on baseline and post intervention pain levels as measured by
Wong Baker Faces Pain Rating Scale self-reported pain p<0.01, unlike in control
group, where there was no significance difference in baseline and post intervention
results. Economic,sociocultural,individual factors influenced musculoskeletal pain
management.Drugs were used as one of the strategies. A mixed model analysis of
variance (ANOVA) with one within-subjects factor and one between-subjects factor
was conducted to determine whether significant differences existed among pain- post
and pain-pre between the levels of group. The main effect for group was significant, F
(1, 174) = 135.02, p < .001, indicating that there were significant differences in painpost
and pain-pre between the levels of group. The main effect for the within-subjects
factor was significant, F (1, 174) = 278.76, p < .001, indicating that there were
significant differences between the values of pain post and pain pre. For the
intervention category of group, pain post was significantly less than pain pre, t (174)
= -28.72, p < .001.Effectiveness of exercise was measured using partial eta
squared(np2) where by above 0.14 indicates a large effect while 0.01 indicate a small
effect. In conclusion, these results suggest that the intervention was effective in
reducing musculoskeletal pain in this population with np2 of 0.44,0.62.0.60 . The study
recommends use of exercise to reduce musculoskeletal pain among children with
sickle cell disease. | en_US |
