Research Articles (Physiotherapy)

Permanent URI for this collection

https://hdl.handle.net/10566/47

Browse

Now showing 1 - 20 of 224

Accuracy of clinical neurological examination in diagnosing lumbo-sacral radiculopathy: a systematic literature review
(BMC, 2017) Tawa, Nassib; Rhoda, Anthea; Diener, Ina
BACKGROUND: Lumbar radiculopathy remains a clinical challenge among primary care clinicians in both assessment and diagnosis. This often leads to misdiagnosis and inappropriate treatment of patients resulting in poor health outcomes, exacerbating this already debilitating condition. This review evaluated 12 primary diagnostic accuracy studies that specifically assessed the performance of various individual and grouped clinical neurological tests in detecting nerve root impingement, as established in the current literature. METHODS: Eight electronic data bases were searched for relevant articles from inception until July 2016. All primary diagnostic studies which investigated the accuracy of clinical neurological test (s) in diagnosing lumbar radiculopathy among patients with low back and referred leg symptoms were screened for inclusion. Qualifying studies were retrieved and independently assessed for methodological quality using the ‘Quality Assessment of Diagnostic tests Accuracy Studies’ criteria. RESULTS: A total of 12 studies which investigated standard components of clinical neurological examination of (sensory, motor, tendon reflex and neuro-dynamics) of the lumbo-sacral spine were included. The mean inter-observer agreement on quality assessment by two independent reviewers was fair (k = 0.3 – 0.7). The diagnostic performance of sensory testing using MR imaging as a reference standard demonstrated a sensitivity (confidence interval 95%) 0.61 (0.47-0.73) and a specificity of 0.63 (0.38-0.84). Motor tests sensitivity was poor to moderate, ranging from 0.13 (0.04-0.31) to 0.61 (0.36-0.83). Generally, the diagnostic performance of reflex testing was notably good with specificity ranging from (confidence interval 95%) 0.60 (0.51-0.69) to 0.93 (0.87-0.97) and sensitivity ranging from 0.14 (0.09-0.21) to 0.67 (0.21-0.94). Femoral nerve stretch test had a high sensitivity of (confidence interval 95%) 1.00 (0.40-1.00) and specificity of 0.83 (0.52-0.98) while SLR test recorded a mean sensitivity of 0.84 (0.72-0.92) and specificity of 0.78 (0.67-0.87). CONCLUSION: There is a scarcity of studies on the diagnostic accuracy of clinical neurological examination testing. Furthermore there seem to be a disconnect among researchers regarding the diagnostic utility of lower limb neurodynamic tests which include the Straight Leg Raise and Femoral Nerve tests for sciatic and femoral nerve respectively. Whether these tests are able to detect the presence of disc herniation and subsequent nerve root compression or hyper-sensitivity of the sacral and femoral plexus due to mechanical irritation still remains debatable.
Activity limitations and factors influencing functional outcome of patients with stroke following rehabilitation at a specialised facility in the Western Cape
(African Health Sciences, 2013) Joseph, Conran; Rhoda, Anthea
BACKGROUND: Determining the functional abilities and factors influencing outcome of patients with stroke following rehabilitation are essential for the planning of future interventions and services in order to optimise recovery. OBJECTIVES: To determine the activity limitations and factors influencing functional outcome of patients with stroke managed at a specialised rehabilitation centre. METHODOLOGY: A longitudinal study design was used to determine the functional outcomes of patients admitted to the centre on admission and discharge. A data gathering sheet was developed to collect information pertaining to the demographicand medical profile and process of rehabilitation, whereas the Barthel Index was used to collect data relating to functional abilities. For analysis, descriptive statistics as well as inferential statistics (Student t test) were utilised to determine the paired differences. Six prognostic factors influencing functional outcome were selected and tested using linear (bivariate) regression. RESULTS: The mean Barthel Index scores on admission and at discharge were 58.85 and 81.59 respectively. A significant improvement was noted in the execution of functional task of patients with stroke (p< 0.01) between the data collection points. Despite the significant overall improvement, results show a high prevalence of dependence with walking and stair climbing at discharge. Only functional ability on admission (r=0.49) predicted a favourable functional outcome at discharge. CONCLUSION: This study highlights the limitations of younger stroke survivors and the need for continued rehabilitation following in-patient care. It further underscores the administration of a functional rating scale on admission in order to aggressively manage activity limitations.
Actual and perceived substance use of health science students at a university in the Western Cape, South Africa
(Makerere Medical School, Uganda, 2011) Steyl, Tania; Phillips, Julie
Background: Substance use among youth is a worldwide epidemic that impacts negatively on the health sector as well as the family and society. Early student life is a time of tremendously high motivation to conform to the behaviours, values, and attitudes that are valued by the youth culture. They observe their peers’ behavior and alter their own behaviour with their peers’ norms and expectations. This compliance with perceived peer norms can however lead to increased smoking, alcohol and drug use. Objectives: To determine and analyze risky and health promoting behaviour of health science students at a university in the Western Cape, South Africa. In this paper the association between actual risk and perceived risk for substance is discussed. Methods: A self-administered questionnaire containing items from both the NCHRBS and the ACHA-NCHA were administered to 201 health science students at a South African university. Results: When perceptions of typical student behaviour were compared to actual reported behaviour, overestimated consumption patterns for the typical student was found for smoking, alcohol and drug use. Conclusion: The misperceptions of peer norms have important educational or prevention program implications. These findings clearly indicate that educational and awareness programs regarding alcohol and drug use should take perceptions of peer alcohol and drug use into consideration.
Adapting the learning environment of a first year interprofessional module towards collaborative-ready graduates
(Nurse Education Today, 2022) Filies, G.C.; Kock-Africa, L.
Background: There has been a global call for a more collaborative workforce to combat the complex healthcare challenges experienced in societies. As a result, health professions education has amended their curricula to include interprofessional education as a strategy to allow students to learn from, with and about each other across disciplines during their training. It is imperative to review the learning environment of these interprofessional modules. To determine the learning environment for the acquisition of the interprofessional core competencies, there needs to be an understanding of the changes to the module, and the impact it has on student performance over a selected period. Objective: This study aimed to determine how have the changes to the material dimension of the learning environment for first-year students in an IPE curriculum promoted student learning. Methods: A document analysis research design was used to extract data over a two-year period. An adaptation of the Context, Input, Process, Product and Outcomes evaluation model was to determine how changes to the learning environment of students registered for a first year interprofessional module, promoted learning. Results: The findings reveal that curriculum changes made to the location and setting can yield improvements in the development and enhancement of the selected interprofessional education core competencies. Conclusion: This study concludes that in alignment with the learning styles of the 21st century student, curriculum development should include an enhanced form of deeper learning in the light of the fourth industrial revolution.
Alcohol use among black female adolescents in a South African community: A mixed methods investigation
(Faculty of Community and Health Sciences, University of the Western Cape, 2008) Phillips, Julie
Background: According to the World Health Organization global alcohol consumption has increased in recent decades, with most of this increase occurring in developing countries. Added to this is the concern of the increased social acceptability of alcohol use and the widespread experimentation with alcohol during adolescence. Objectives: The purpose of this study was to better understand health risk behaviours, specifically alcohol use, among black female high school learners in a designated research locale of a local community in the Western Cape, South Africa. Study design: The method of inquiry in this study was a mixed methods sequential explanatory strategy. Results: A lifetime prevalence of alcohol use was reported by 57.8% of the study sample. All the participants agreed that drinking has a negative influence on adolescent health. Conclusion: Alcohol use in South Africa is an ever-increasing health problem and the current study provides evidence that the prevalence of this behaviour remains a public health concern.
Another piece to the epidemiological puzzle of traumatic spinal cord injury in Cape Town, South Africa: A population-based study2018
(Health and Medical Publishing Group, 2018) Phillips, J; Braaf, J; Joseph, C
The epidemiology of traumatic spinal cord injury (TSCI) is poorly understood in developing countries. In South Africa (SA) specifically, two healthcare systems (private v. government funded) exist, and it is therefore important to assess patient characteristics in order to plan appropriately.To determine epidemiological characteristics of TSCI in the private healthcare system in Cape Town, SA, and compare findings with previously published data from the government sector.
Assessment of risk factors for Non-Communicable diseases among a cohort of community health workers in Western Cape, South Africa
(The College of Medicine and the Medical Association of Malawi, 2021-09) Johnson, Levona; Schopp, Laura; Waggie, Firdouza; Frantz, J.M
Community Health Workers (CHWs) have been identified as the key health professionals to drive the agenda of the prevention of health risk behaviours, linked to noncommunicable diseases (NCDs) in South Africa. They are regarded as the agents of change, who will provide impetus to the achievement of the health behaviour goals, set out by the South African National Department of Health1 . However, this cohort, may suffer from an array of NCDs. There are various risk factors that influence the health of individuals and contribute to NCDs, including modifiable and non-modifiable risk factors, which cannot be changed, or altered by an intervention, such as age, family history, gender and ethnicity2,3. Modifiable risk factors have been classified as behavioural, physical, and biological4 . Globally, NCDs are responsible for 80% of premature deaths in LMICs5,6. In response to the NCD pandemic, the World Health Organisation (WHO) set a global target in 2012, which was aimed at reducing premature deaths, caused by NCDs, by 25%, by the year 20257 . However, this goal will require drastic, immediate, and targeted approaches that address the root causes of NCDs. South Africa has followed the global trend, and evidence depicts an increase in NCDs8 , with a 27% probability of dying between the ages of 30 and 70 years, as a result of cardiovascular diseases (CVDs), diabetes, cancers, or chronic respiratory conditions7,9. This is similar to other countries such as India (26%), Philippines (28%), Democratic People’s Republic of Korea (27%), Mali (26%), Russian Federation (30%), Ukraine (28%) , Tajikistan (29%), Fiji (31%), Afghanistan (31%) and Armenia (31%)9 In the Western Cape, the prevalence of chronic diseases of lifestyle raises major concerns about the communities’ health risk behaviour. The Burden of Disease Survey for the Western Cape, which was released on 24 April 2017, reported that NCDs contributed to 61% of deaths in the Western Province10
Barriers and facilitators to utilisation of rehabilitation services amongst persons with lower-limb amputations in a rural community in South Africa
(SAGE Publications, 2018) Naidoo, Ugendrie; Ennion, Liezel
BACKGROUND: Persons with disabilities who reside in rural areas experience challenges accessing and utilising health services and rehabilitation. Due to the high prevalence of diabetes mellitus in rural regions, the risk of having a lower-limb amputation is increasing. Comprehensive rehabilitation is vital to mitigate the negative impact that a lower-limb amputation has on a person. OBJECTIVE: To explore the barriers and facilitators to accessing rehabilitation experienced by persons with lower-limb amputations in a rural setting. STUDY DESIGN: A qualitative descriptive approach was used to collect and analyse data. Methods: Data were collected from 11 conveniently sampled participants from three sub-district hospitals in the rural iLembe district, Kwa-Zulu Natal, South Africa. Data were collected using semi-structured interviews to explore the barriers and facilitators perceived by persons with lower-limb amputations in a rural region. RESULTS: The three main barriers identified in this study were environmental factors, financial constraints and impairments. These barriers negatively impacted the participant’s utilisation of rehabilitation. The two main facilitators identified were environmental facilitators and personal factors which aided participant’s utilisation of rehabilitation. CONCLUSION: Access to rehabilitation was mainly hindered by the challenges utilising transport to the hospital, while self-motivation to improve was the strongest facilitator to utilising rehabilitation.
Barriers experienced by service providers and caregivers in clubfoot management in Kenya
(SAGE Publications, 2015) Kingau, Naomi Wanjiru; Rhoda, Anthea; Mlenzana, Nondwe
Disability in childhood remains a challenge globally. Linked to this disability is an apparent increase in the prevalence of infants born with congenital clubfoot. Clubfoot can, however, be effectively managed but this management faces various challenges. This study aims at exploring the barriers experienced in Kenya.In-depth interviews were conducted with 20 participants. Informed consent was sought. Field notes were taken and the interviews tape-recorded. The interviews took 45 minutes to 1 hour. They were transcribed verbatim and analysed by thematic content.
Barriers to utilisation of physiotherapy services among the elderly in the Livingstone district, Zambia
(University of the Western Cape, 2006) Malambo, Pasmore; Marais, Margaret R.
AIM: The purpose of this study was to identify the barriers to utilisation of physiotherapy services among elderly people in Zambia. METHODS: By means of a convenience sampling technique, 200 elderly people, both males and females aged 60 years and above, were recruited from the Livingstone District in Zambia. A structured questionnaire, developed from literature, was used for collecting data. The Excel software programme and Statistical Package for Social Science (SPSS) were used for the capturing and analyses of the data, using descriptive and inferential statistical analyses. RESULTS: The factors that influenced the utilization of physiotherapy services by the participants were: non-referral to the service, long distances, transport, unavailability of the service in the communities and lack of awareness of physiotherapy. Income was significantly associated (p<0.05) with their inability to go for physiotherapy services. DISCUSSION: The results of this study show that physiotherapy services are not meeting the needs of the elderly in the Livingstone District in Zambia there is a need for the physiotherapy profession to raise awareness of their role in the elderly and become promoters of healthy and active aging by providing services at primary health care level through outreach programmes. CONCLUSION: Well-coordinated health services that integrate social, economical and physical services for the elderly in the district are recommended in order to achieve active and healthy ageing.
Bayesian jackknife tests with a small number of subsets: application to HERA 21 cm power spectrum upper limits
(Monthly Notices of the Royal Astronomical Society, 2023) Wilensky, M.J; Kennedy, F; Bull, P
We present a Bayesian jackknife test for assessing the probability that a data set contains biased subsets, and, if so, which of the subsets are likely to be biased. The test can be used to assess the presence and likely source of statistical tension between different measurements of the same quantities in an automated manner. Under certain broadly applicable assumptions, the test is analytically tractable. We also provide an open-source code, CHIBORG, that performs both analytic and numerical computations of the test on general Gaussian-distributed data. After exploring the information theoretical aspects of the test and its performance with an array of simulations, we apply it to data from the Hydrogen Epoch of Reionization Array (HERA) to assess whether different sub-seasons of observing can justifiably be combined to produce a deeper 21 cm power spectrum upper limit. We find that, with a handful of exceptions, the HERA data in question are statistically consistent and this decision is justified. We conclude by pointing out the wide applicability of this test, including to CMB experiments and the H0 tension.
Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy
(BioMed Central, 2013) Rowe, Michael; Frantz, Jose M.; Bozalek, Vivienne
Background: While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond “having” knowledge and skills, but there is limited evidence for how to integrate technology into these innovative teaching approaches. Methods: This study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed. Results: Clinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the integration of technology into teaching practice, rather than the features of the technology. Conclusions: There is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able to navigate the complexity of health systems and patient management in ways that go beyond the application of knowledge and skills.
Beyond the lecture: Teaching for professional development
(Health and Medical Publishing Group, 2016) Rowe, Michael
BACKGROUND. Clinical educators are being challenged to graduate students who can adapt to complex situations. Evidence suggests that one must go beyond teaching students what to know and what to do, and help them learn how to be. OBJECTIVE. To identify teaching strategies that could be used to help develop students beyond technical proficiency. METHODS. This study used a nominal group technique to gather input from clinical educators, requesting them to identify teaching strategies for developing lifelong learning, emphasising the development of students’ knowledge and skills, and taking into account students’ emotional responses to the clinical context. Participant responses were transcribed and analysed thematically. RESULTS. Participants reported that clinical educators should be role-models to students in a process of lifelong learning, including demonstrating the vulnerability of ‘not knowing’. They also suggested integrating a variety of different teaching methods that aim at achieving the same goal. Finally, participants emphasised the importance of intentionally incorporating personal values into reflective learning activities. By creating space for the shared learning experiences of teachers and students, participants highlighted the possibility of helping students to develop the mindset necessary to adapt to complex health systems. CONCLUSION. Clinical educators emphasised the developmental nature of the teaching and learning process, highlighting the importance of an authentic interaction between students and teachers.
Challenges and opportunities related to postgraduate evidence-based practice module using blended learning
(Health and Medical Publishing Group, 2011) Frantz, Jose M.; Himalowa, S.; Karuguti, W.; Kumurenzi, A.; Mulenga, D.; Sakala, M.
The use of information and communications technology (ICT) has become integral to health professions education worldwide. The incorporation of online facilities and maintaining of the face-to-face element make blended learning the ‘best of both worlds’. Blogs can be used to create a relatively learner-centred environment that allows students to learn at their own pace. Though blended learning has been proved to be appropriate in higher learning institutions, it comes with challenges and opportunities. Our study intended to highlight the challenges and identify opportunities encountered by an evidencebased practice (EBP) postgraduate class who used the blended learning model of learning. An action-based research methodology was utilised in this study. This involved data gathering, action planning, action taking and action evaluation. Data were gathered through the use of a blog that was accessed by all participants. They made comments which were reflecting their perceptions on the model that was used for the course. The students gave consent to participate while permission from the physiotherapy head of department was also acquired. Deductive analysis was used for data analysis. The information from the blog was extracted and converted into text files. Coding and analysis into opportunities and challenges as expressed by the participants was performed. Theoretical saturation through every reviewer’s agreement and satisfaction about the information was included. The data consisted of 94 postings made of primary postings (22) and responses (72). All the authors acted as reviewers. Certainty was achieved by discussing any ambiguity in coding. Any necessary amendments were made. The participants reported to have experienced some challenges pertaining to blended learning. The blog that was used as a media between students and the facilitator was inefficient in some way. Some students could not access it when required and some resources in the blog were inaccessible. The wireless internet connection mainly used in this model was not reliable. However, there were opportunities experienced by the learners. These included easy interaction between the learners and the facilitator at any time. The model also reduced instructor dependence and made the learners more responsible of their work. The blog appeared as a resource base for skills development. Timely feedback involving solving the problems students encountered during the course improved the communication skills between the students and the facilitator. However, technology constraints involving the blog and the internet connection were overwhelming among the students while writing up the tasks allocated to them. Despite the fact that students faced some challenges, facilitators of blended learning such as the interaction between the students and the facilitator of the course were motivating to keep the course interesting. While students experienced some opportunities about blended learning, its future rests on averting the challenges associated with it more, especially in developing countries. If the challenges reported would be addressed in developing countries, blended learning can be effective in building students’ engagement and relieving of overcrowded classrooms in higher learning institutions.
Challenges experienced by community health workers and their motivation to attend a self-management programme
(AOSIS, 2022) Johnson, Levona J.; Schopp, Laura H.; Waggie, Firdouza
Community health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. However, they themselves have health risk behaviours, which predispose them to non-communicable diseases and thus need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours.: This study aimed to explore the challenges experienced by CHWs in carrying out their daily duties and the motivating factors to join a self-management programme.
Challenges facing physiotherapy education in Africa
(Nova Southeastern University, 2007) Frantz, Jose M.
Health care is changing and the demands put on health professionals are increasing. Physiotherapy education should reflect the health and social priorities of the nation. The World Confederation of Physical Therapy (WCPT) is committed to assisting physiotherapy associations in developing educational standards. Physiotherapy education in Africa however, seems to have a real need for assistance from the WCPT. The aim of this paper is to highlight the challenges facing physiotherapy education in Africa. The Delphi methodology was used to obtain information from key informants involved in the area of physiotherapy education from a variety of African countries. The majority of the participants were people who have experienced physiotherapy education in Africa either as graduates or current teachers. Data were analyzed into themes and sent back to respondents for confirmation. The most important challenges highlighted were: lack of undergraduate training opportunities, limited number of therapists, upgrading of physiotherapy educators, research as a major component of physiotherapy education, and recognition of physiotherapy as an essential service. It is concluded that assistance is needed for physiotherapists from Africa to take their rightful place in the health team and higher education institutions should look at improving diploma qualifications of physiotherapists in African countries.
Changes in activity limitations and predictors of functional outcome of patients with spinal cord injury following in-patient rehabilitation
(AOSIS, 2013) Joseph, Conran; Mji, Gubela; Mlenzana, Nondwe; Rhoda, Anthea; Statham, S.; De Wet, C.
The purpose of this study was to investigate the changes in the activity limitations of patients following in-patient rehabilitation and the factors influencing functional ability as measured by the Spinal Cord Independence Measure III (SCIM III). A longitudinal study design was utilised to study the change in functional abilities of patients with spinal cord injury between admission and discharge. A convenient sampling strategy was employed, in which every consecutive patient admitted to the rehabilitation centre within a three month period was eligible for the study. Demographic-, medical, and process of rehabilitation data were collected and collated from the patients' medical records using a data gathering sheet that was validated and tested for reliability. Functional abilities were measured by the SCIM III. Seventy-six patients met the inclusion criteria, consisting of 58 paraplegics and 18 tetraplegics. The mean age of this cohort was 34.14 years. A significant difference (p<0.001) in functional ability was detected for the total sample, with only12.5% of patients independent in walking ability and 28.12% in stair management. Four (4) factors were found to be predictors of functional outcomes on bivariate analysis, but when considered together in a multiple regression model, only functional status on admission remained correlated to functional outcomes. Conclusion and implication for practice: Significant improvement in functional abilities of persons with spinal cord injury following in-patient rehabilitation was observed. However, mobility and stair-management limitations were the most prevalent at discharge. Lastly, a lower functional status should be better targeted to optimise functional ability in the future. Future research should be directed towards illuminating whether personal factors or rehabilitation inefficiencies are responsible for the limitations observed at discharge.
Changing the game — can a sport-based youth development programme generate a positive social return on investment?
(UNISA Press, 2017) Sanders, Ben; Raptis, Emanuel
This study examines a sport for development and peace intervention initiated by grassroot Soccer South Africa that promotes youth employability and leadership. A results-based management approach and a social return on investment methodology were used to track the young people during and after the intervention. Preliminary results offer encouraging evidence of progress into employment, education and training with positive social returns for the youth and external stakeholders, suggesting that this investment is cost-effective and impactful. The results indicate that structured sport-based programmes can put young people to work and get them to study in a constructive manner, thereby stimulating economic growth and development. It is concluded that initiatives using sport to promote youth work merit greater investment, recognition and research.
Characteristics and outcomes of gunshot-acquired spinal cord injury in South Africa
(South African Medical Association, 2017) Joseph, C
Spinal cord injuries (SCIs) caused by assault present a unique challenge facing the healthcare system, in that very little is known about how these injuries manifest compared with other causes of injury. Understanding the nuances of gunshot SCIs could contribute towards better care provision. To determine the characteristics of gunshot SCI and compare both injury characteristics and outcomes between gunshot SCI and all other traumatic causes taken together. The gunshot SCI sub-cohort was derived from a 1-year prospective, population-based study, including both tertiary-level hospitals providing SCI care in the Cape Metropolitan area of South Africa (SA). All consenting 145 survivors, after a window period of 7 days, were included, and their demographic and injury characteristics were captured according to the International SCI Core Basic Data Set. Further, selected secondary medical complications (outcomes) were prospectively and routinely assessed throughout acute care. Both descriptive and inferential statistics were used to describe and compare characteristics and outcomes, respectively.
Client perspectives on reclaiming participation after a traumatic spinal cord injury in South Africa
(Oxford University Press, 2016) Joseph, Conran; Wahman, Kerstin; Phillips, Julie; Wikmar, Lena Nilsson
BACKGROUND. The development of rehabilitation services promoting participation in people living with a traumatic spinal cord injury (TSCI) is of major concern for physical therapists. What the client sees as effective participation, barriers, and facilitators might be different due to their particular context. This study was conducted to gain insight into the experiences of attaining an important outcome in a developing context. OBJECTIVE. The aim of this study was to explore the experiences of reclaiming participation in community-dwelling people with TSCI in South Africa. DESIGN. This was an explorative, qualitative study with inductive content analysis. METHODS. Individual semistructured interviews were conducted with 17 adults living with a TSCI in order to explore their experience of participation. The verbatim transcripts were analyzed, and the end result was an overall theme that included 4 emerging categories. RESULTS. The theme “participation possibility” denotes the eventual involvement in life situations. Within this theme, there were 4 categories that emerged as a representation of essential aspects along the continuum of reclaiming participation: (1) dealing with the new self, (2) a journey dominated by obstacles, (3) the catalyst of participation, and (4) becoming an agent. Dealing with and recognizing these intervening conditions seem critical for clients to reconstruct the meaning that is necessary for a broader conception of participation. Limitations. The transferability of these findings to dissimilar contexts may be limited. CONCLUSION. Client perspectives on reclaiming participation after injury affirm the notion of eventual participation, with each person finding strategies to succeed. In order to help clients reclaim participation, health professionals should develop contextually sensitive programs that include peer mentoring and reduce the influence of hindering factors.

Browse

Browsing by Title

Results Per Page

Sort Options