Background: Given the limited healthcare resources in low and middle income countries (LMICs), effective rehabilitation strategies that can be realistically adopted in such settings are required. Objective: A systematic review of literature was conducted to identify pragmatic solutions and outcomes capable of enhancing stroke recovery and quality of life of stroke survivors for low- and middle- income countries. Methods: PubMed, HINARI, and Directory of Open Access Journals databases were searched for published Randomized Controlled Trials (RCTs) till November 2018. Only completed trials published in English with non-pharmacological interventions on adult stroke survivors were included in the review while published protocols, pilot studies and feasibility analysis of trials were excluded. Obtained data were synthesized thematically and descriptively analyzed. Results: One thousand nine hundred and ninety six studies were identified while 347 (65.22% high quality) RCTs were found to be eligible for the review. The most commonly assessed variables (and outcome measure utility) were activities of daily living [75.79% of the studies, with Barthel Index (37.02%)], motor function [66.57%; with Fugl Meyer scale (71.88%)], and gait [31.12%; with 6 min walk test (38.67%)]. Majority of the innovatively high technology interventions such as robot therapy (95.24%), virtual reality (94.44%), transcranial direct current stimulation (78.95%), transcranial magnetic stimulation (88.0%) and functional electrical stimulation (85.00%) were conducted in high income countries. Several traditional and low-cost interventions such as constraint-induced movement therapy (CIMT), resistant and aerobic exercises (R&AE), task oriented therapy (TOT), body weight supported treadmill training (BWSTT) were reported to significantly contribute to the recovery of motor function, activity, participation, and improvement of quality of life after stroke. Conclusion: Several pragmatic, in terms of affordability, accessibility and utility, stroke rehabilitation solutions, and outcome measures that can be used in resource-limited settings were found to be effective in facilitating and enhancing post-stroke recovery and quality of life.

BackgroundOlder individuals (over 60 years) with hypertension, diabetes, cardiovascular disease, chronic respiratory disease, and cancer are at the highest risk of contracting and dying from Coronavirus (COVID-19). Compromised immunity (both innate and adaptive) and increased inflammatory response (cytokine-storm syndrome) are predictors for high mortality among this population group. Exercise/physical activity seems to be a plausible way to decrease both the risk of transmission and mortality, and improve health outcomes among this population since there is no available treatment for COVID-19. The study will investigate the effectiveness of physical activity/exercise in improving the immune parameters and reducing the inflammatory biomarkers in proxy conditions that make individuals susceptible to COVID-19.MethodsThe Preferred Reporting Items for systematic reviews and Meta-Analyses Protocol (PRISMA-P) 2015 will guide this review. We will search ten databases (until August 2020) to include randomized control trials articles that explored the effectiveness of physical activity/exercise in improving immune parameters and reducing inflammatory biomarkers in proxy conditions (hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer). Two review authors will independently screen citations (title and abstract), extract data (using standardized forms), assess the risk of bias (using Cochrane risks of bias) and quality of data (using GRADE). Homogenous studies will be analyzed using the fixed-effect model of meta-analysis, while a narrative synthesis will be conducted for heterogeneous studies.DiscussionThere are no specific physical activity/exercise parameters (frequency, intensity, type of exercise and time- FITT) for interventionists to use when developing high-quality RCT for individuals vulnerable to COVID-19. Therefore, it is important to review the literature to identify and highlight the exercise FITT parameters that increase the immune outcomes and reduce inflammatory biomarkers for proxy conditions that make individuals susceptible to COVID-19. It is also important to identify the specific exercise regimen suitable and beneficial for each proxy group.Systematic review registrationPROSPERO CRD42020196907

Objective To analyse the state of behavioural oncology research in Africa and outline key considerations for future research. Methods Five bibliographic databases were searched to identify original English‐language articles published between January 2000 and August 2020. The Behavioural Epidemiology Framework was applied to studies with data/findings from Africa to delineate their current state. Research gaps/opportunities available for behavioural oncology research in Africa were further highlighted. Results Two hundred eighty‐seven original research with findings from Africa has been published over the last two decades, with the highest contribution arising from Nigeria, Kenya, Ethiopia and South Africa. Cervical and breast cancers were the most widely investigated. Prominently studied behaviours relate to cancer screening, health literacy, lifestyle, and vaccination. Behavioural oncology literature in Africa is generally in Phases I and III and lacks in measurement studies (<2%) and studies that seek to evaluate behaviour change/health promotion interventions (<6%) or translate them into practice (13.2%). Conclusion Embracing new and progressive approaches, including methodological/analytical paradigms and implementation science is imperative to advance the frontiers of behavioural oncology research in Africa. This calls for a responsive research approach that can mobilise multidisciplinary/multilevel coalitions, ensuring a research structure that effectively integrates behavioural research and cancer prevention/control in the region.