Department of Physiotherapy

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Browsing by Subject "Activity limitation"

Now showing 1 - 4 of 4
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    Determining the process of rehabilitation and the outcomes of patients at a specialised in-patient centre in the Western Cape
    (University of the Western Cape, 2012) Conran, Joseph; Rhoda, Anthea; Dept. of Physiotherapy
    The World Health Organisation estimates that the majority of the disabled population resides in the developing world, but most of the research on outcomes of patients originates from the developed world. In the light of the differences in healthcare structures and function, especially rehabilitation between settings and countries, it is imperative to have an understanding of the functioning of patients at discharge with the objective of measuring the level at which outcomes are met. The aim of this study was therefore to determine the process of rehabilitation and the outcome of patients following in-patient rehabilitation at a facility in the Western Cape. A quantitative research design was employed to address the objectives. Self-administered questionnaires were developed to collate information pertaining to the demographic-, socioeconomic- and medical profile of patients and data extraction sheets collected information relating to the process of rehabilitation and the impairment status of patients on admission. With regards to activity and participation, a longitudinal study design was used, which utilised standardised outcomes measures. The sample consisted of all patients with stroke and spinal cord injury admitted within a three-month period, and all ethical principles relating to research on human subjects, as stipulated in the Helsinki Declaration were adhered to during data collection, with ethical clearance obtained from relevant authorities. The SAS and the Microsoft Excel Package 2007 were used to analyse the quantitative data elements. Descriptive statistics using frequencies, percentages, ranges, means, and standard deviations and inferential statistics using chi-square, student T-tests and correlation tests, for determining the predictors of functional outcome, were calculated. There were 175 patients, whereof 82 were patients with stroke and 93 with spinal cord injury, with 143 (76 presenting with spinal cord injury and 67 with stroke) meeting the inclusion criteria on admission. The mean age of those with spinal cord injury and stroke was 34.14 and 52.95 years. Most of the patients with spinal cord injuries were single (73.68%), whereas the majority (53.73%) of patients with strokes were married at the time of injury. All patients were managed by the doctor and the nurse, with most of the patients receiving physiotherapy, occupational therapy and social assistance from the social worker. With regards to recreational activities, 46.87% of patients with spinal cord injury and 39.39% of those with stroke attended the learn to swim programme, and 29.68% of patients with spinal cord injury attended the wheelchair basketball sessions. The mean length of hospital stay for patients with spinal cord injury and stroke was 73.11 and 51. 62 days, with most of the spinal cord injured patients (80.26%) and stroke patients (82.08%) discharged home without follow-up rehabilitation. The most prevalent impairments on admission of the spinal cord injury cohort were muscle weakness (75.0%), bladder incontinence (71.1%) and reduced sensation (69.7%), whereas patients with stroke presented mostly with muscle paralysis (80.6%), abnormal tone (76.1%) and aphasia (50.8%). Functional limitations experienced by the participants included, mobility, stair climbing and transfers. The participants experienced participation restrictions in the following domains, leisure activities and employment. A clinical significant improvement was noted in execution of functional task of patients with spinal cord injury (p< 0.0001) and stroke (p< 0.0001) between admission and discharge. A significant statistical change was also detected for the participation elements of both stroke and spinal cord injury cohorts. Functional ability on admission was found to be a predictor of functional outcome of the stroke diagnostic group at discharge, whereas the multiple redictor model of functional outcome of the spinal cord injured cohort at discharge was significant with remaining variables of functional outcome score on admission (p<0.0001) and bladder -and bowel impairment(s) (p=0.0247). The study findings suggest that despite the significant change in activity and participation, most of the patients were discharged home without further follow-up for rehabilitation, irrespective of the activity limitations and participation restrictions still experienced at the time of discharge. The latter finding questions the duration of the length of hospital stay, which does not allow patients to be independent in all meaningful activities and participatory actions and roles by the end of inpatient rehabilitation. The study findings could assist authorities to adapt the existing rehabilitation programme and referral process .
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    The effect of occupational-related low back pain on the functional activities among manual workers in construction companies
    (University of the Western Cape, 2010) Himalowa, S.; Frantz, Jose M.
    INTRODUCTION: Low back pain is the most prevalent musculoskeletal condition and one of the most common causes of disability in the world. The disability resulting from low back pain continues to plague the construction industry leading to absenteeism and early retirement among construction manual workers. PURPOSE: The aim of the review was to explore global literature concerning the effect of occupational-related low back pain on the functional activities among manual workers in construction companies. METHOD: A retrospective search of articles published from January 2000 to April 2010. The following electronic data bases, Google Scholar, Academic search premier, CINAHL, ERIC, Health source-consumer Edition, Health source: Nursing/Academic Edition, Master FILE Premier, MEDLINE, MLA Directory of Periodicals, Science direct, MLA International Bibliography, Pre-CiNAHL and PubMed were individually searched using specifically developed search strategies. Methodological quality was evaluated using the Critical Appraisal Skills Programme (CASP) tool and was done by two independent reviewers. RESULTS: The search yielded eleven articles of sound quality. There is evidence that a high percentage of construction workers suffer permanent disability and fail to return to work forcing them to go into early retirement due to occupational related low back pain. The cohort studies have shown that poor performance, reduction in productivity, restrictions on usual activity and participation and incurring high medical costs all pose a challenge to construction manual workers and their employers as a result of occupational related low back. CONCLUSION: The findings support that occupational related low back pain is a challenge among construction manual workers causing serious disability. Further well designed research in Africa into the most effective strategies to prevent and manage occupational related low back pain among construction manual workers is needed.
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    Health status and functioning after traumatic spinal cord injury in South Africa: Comparison between a private and a public health care funded cohort
    (University of the Western Cape, 2018) Jeftha, Tarryn Kim; Joseph, Conran
    Introduction: A spinal cord injury is the damage to the spinal cord that alters functional independence. Two different systems of care for the management of health conditions are available in private and public care in South Africa. A better understanding of health and functioning of individuals in the two systems is crucial to help address inequality between the two systems. The aim of the study was to describe the health status and functioning of persons with traumatic spinal cord injury (TSCI) in the Western Cape province who received public-funded care compared with those in the Gauteng province who received private care. Methodology: The study entailed a cross-section comparison between a government-funded cohort in the Western Cape and a private cohort in Gauteng, two of the provinces of South Africa. Self-administered questionnaires and standardised outcome measures were used to collect the data and to ensure validity and reliability. Data were captured on Excel and then transferred to SPSS (Statistical Package for Social Sciences) for analysis. Ethical clearance to conduct the study was obtained from the Biomedical Research Ethics Committee of the University of the Western Cape.
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    Outcome measures used to assess disability post stroke within the framework of the ICF: a literature review
    (University of the Western Cape, 2011) Joseph, Conran; Rhoda, Anthea
    BACKGROUND: The use of outcome measures has been associated with good practice among clinicians and as a research instrument. These measures can be utilized to assess- and manage patients, observe progress, determine the effects of certain intervention and for research purposes. This scholarly paper investigates the most commonly used outcome measures along the continuum of care, and further provides additional information that will assist researchers and clinicians to decide on the most appropriate outcome measure in a South African Healthcare. METHODS: Literature of the past 10 years dealing with outcome measures was reviewed for this study. The types of papers in this review were systematic reviews, narrative reviews, scholarly papers, longitudinal and cross sectional. RESULTS AND DISCUSSION: Included in this review are four impairment, five activity/disability, two participation restriction and four quality of life outcome measures. Although a number of these measures have been used in the South African setting, it is not clear whether they have been validated for the local context. Few translated versions relevant to South Africa are available and not all measures are freely available, which could limit the use thereof. CONCLUSION: This paper successfully describes the commonly used outcome measures and aspects that should be taken into account when deciding on the appropriate measure.