phd
PhD students:
Bimika Kadgi, KUSMS: Women’s health
Supervision: Ann-Katrin Stensdotter (NTNU)
Co-Supervision: Britt Stuge (UiO), Corlia Brandt (Wits), Daily leader in Nepal Ranjeeta Acharya (KUSMS)
The effect of Pelvic Floor Muscle Training for Urinary Incontinence in Nepalese women
This project investigates in a cross-sectional study the knowledge on Urinary Incontinence (UI) among women in Nepal. The reported prevalence in Nepal is 50%, which is above the international average. The condition has severely negative impact on quality of life, but a common misconception is the belief that UI is normal with childbirth and ageing. There is therefore a great need in Nepal for information about UI, education, and intervention to prevent or treat UI. Pelvic floor muscle training (PFMT) is recommended as a first line conservative treatment showing that exercises over 3 months duration has proven effect on UI. An RCT will be conducted to compare the effect of a 12-week supervised PFMT program to information only where the control group is followed up by phone calls. The RCT is evaluated at 6 months. A one-year follow-up of the intervention group investigates self-efficacy the effect on UI one year later.
Govinda Nepal, KUSMS: Stroke rehab
Supervision: Ann-Katrin Stensdotter (NTNU)
Co-Supervision: Ole Petter Norvang (NTNU), Veronica Ntsiea (Wits), Daily leader in Nepal Ranjeeta Acharya (KUSMS)
Mobile health technologies and its application in rehabilitation of stroke survivors in Nepal
This main objective of this project is to improve rehabilitation after stroke in Nepal by 1) developing, implementing, and investigating the feasibility of a cost-effective and comprehensive mobile application for home based rehabilitation of stroke survivors, 2) describe guidelines for standard care of home-based physiotherapy after stroke, and 3) translate and cross culturally adapt the Barthel Index for ADL function after stroke into Nepali language. In Nepal the mean length of hospital stay after stroke is 7 - 10 days, while rehabilitation afterwards is left unaddressed as an effect of shortage of rehabilitation professionals including physiotherapists (1 physiotherapist per 25000 population), difficult geographical terrain, and affordability (31% living below the poverty line). Most patients are bound to be cared for at home, however, guidelines describing standard home care for these patients does not exist. The development of a mobile application for home rehabilitation after stroke is thus expected to contribute to overcome these challenges. In Nepal, the incidence of stroke is 64 per 1000 admissions to the hospital and prevalence of 23.7 per 1000 population. Stroke has been identified as one of the priorities for WHO and the UN in their actions to reduce the burden of non-communicable diseases.
Prakash Matho, KMC: Musculoskeletal
Supervision: Ann-Katrin Stensdotter (NTNU)
Co-Supervision: Monica Unsgaard-Tøndel (NTNU), Vaneshveri Naidoo (Wits), Daily leader in Nepal Dr. Sunil Kumar Joshi (KMC)
CHRONIC NONSPECIFIC LOW BACK PAIN IN RURAL AND URBAN NEPALESE POPULATION
The main objective of this study is to establish the psychosocial risk factors for non-specific lower back pain (LBP) in people living in urban and rural areas in Nepal by investigating pain perception, believes, and coping strategies. LBP is internationally recognized as a leading musculoskeletal problem often accompanied by socioeconomic burden. Non-specific LBP in particular is a substantial cause for disability additionally oftentimes bringing functional limitations and reduced quality of life, as well as psychosocial and economic problems. Globally, 60.1 million disability-adjusted life-years were in 2015 due to LBP, and is according to Global Burden of Disease data, the number one cause of disability in Nepal. Since 2005 the number of years lived with disability due to LBP in Nepal has increased by 16.9%. LBP-related disability is however reported lower in rural areas, perhaps due to the very low socioeconomic status of individuals living in these areas forcing them to keep working despite the presence of pain. Interestingly, rural households report higher subjective well-being than do their economically better off urban counterparts. The great difference between urban and rural populations suggests that studies should not generalize findings across these populations but should consider several determinants using a biopsychosocial approach. This describes pain and disability as a multidimensional, dynamic integration among several factors that reciprocally influence one another, shifting emphasis from exclusive reliance on pathophysiology to involvement of the patient’s cognitive and emotional state, pain experiences, and subsequent behaviour. Management of non-specific LBP should consequentially include components across the biopsychosocial spectra. We expect that the results of this study will contribute to shed light upon beliefs and coping of pain which will impact and improve individualized clinical management of LBP for the unique patient’s needs and ultimately help reduce the burden of this condition in Nepal.