Masters of Science - Msc (Physiotherapy)

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Activity limitations and participation restrictions four years after traumatic spinal cord injury in Cape Town, South Africa
(University of the Western Cape, 2018) van Wyk, Vania; Joseph, Conran; Mlenzana, Nondwe
The distressing event of Spinal Cord Injury (SCI) leads to complete or incomplete injury, and results in many complications such as such as neurogenic shock, cardiovascular disease, temperature regulatory problems, respiratory complications, dysphagia, thromboembolism, and pressure ulcers amongst others. These complications limit the individual’s functioning and participation. Participation is fruitful and meaningful when you are actively involved in a specific activity. To understand the lack of participation within a specific setting, it is important to know what the limitations in activities are, and what causes these limitations. The goal of rehabilitation should be to reintegrate patients back into the community so that they can fulfil their roles. Aim: The aim of the study was (1) To determine included participants’ socio-demographic and injury characteristics; (2) To describe healthcare services received by people living with long-term Traumatic Spinal Cord Injury (TCSI) over the past 12 months; (3) To determine the point prevalence of common activity limitations of survivors of TSCI four years after injury; (4) To determine the point prevalence of participation restrictions of survivors of TSCI four years after injury; and (5) To determine factors associated with activity limitations and selected participation restrictions four years after injury.
An analysis of health promoting and risky behaviours of health science students of the University of the Western Cape
(University of the Western Cape, 2007) Steyl, Tania; Phillips, J.S.; Dept. of Physiotherapy; Faculty of Community and Health Sciences
Assessing and understanding the health needs and abilities of university and college students is vital in creating healthy campus communities. Student learning is a central part of the higher education academic mission, and health promotion serves this mission by supporting students and creating healthy learning environments. Findings from various studies suggest that students entering the university setting put themselves at risk through unhealthy behaviours. Health science students are the future health professionals who will teach health promotion and disease prevention. The aim of this study was to determine and analyse health risk behaviours and health promoting behaviours among health science students at the University of the Western Cape. The study further aimed to identify the factors influencing these students' engagement in these risk behaviours.
Assessment and treatment choices of physiotherapists treating non-specific low back pain in Rwanda
(University of the Western Cape, 2005) Twagirayezu, Jacques; Gurie, P Mrs; Dept. of Physiotherapy; Faculty of Community and Health Sciences
The aim of this study was to determine assessment and treatment choices of physiotherapists treating non-specific low back pain in Rwanda. The main objectives were to identify the common types of low back pain treated by physiotherapists, to determine the
Attitudes of health science students towards people with disabilities at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania
(2010) Sheriff, Insiyya Djamil; Rhoda, Anthea
The effects of disability on the individual not only include physical, psychological and emotional adjustments but also negative attitudes of able bodied people towards persons with disabilities. The attitudes of healthcare professionals towards persons with disabilities could affect rehabilitation outcomes as well as the reintegration of these people into society. The aim of the study was to investigate the attitudes of health science students towards persons with disabilities at Kilimanjaro Christian Medical Centre (KCMC), in Tanzania. An explorative quantitative research design using a cross-sectional survey was used. The study sample (182) included all Physiotherapy, Occupational Therapy, Nursing, Medical and Optometry students. Data was collected using the Attitudes Towards Disabled Persons Scale,consisting of 20 items rated on a six-point Likert Type Scale. A demographic questionnaire which included questions relating to the contact of the students with persons with disabilities was also administered. Descriptive and Inferential statistical analysis was conducted using the Statistical Package for the Social Sciences version 15.0. Permission to conduct the study was obtained from the Higher Degrees Committee and the Senate Research Grant and Study Leave Committee of the University of the Western Cape. Further permission was requested from Ministry of Education, Research and Ethics Department in Tanzania and the authorities of the respective Health Sciences programmes to include students in the study. Information obtained was handled with confidentiality and anonymity, and the students had the right to withdraw from the study at anytime.The results revealed that the sample consisted of more females (58%) than males (41.2%).The majority of the participants were between the ages of 20-29 years. The highest response rate was from the medical students (29.1%) followed by the physiotherapy students (27.5%).The Optometry and physiotherapy students had more positive attitudes than the rest of the health science students who participated. The mean score on the ATDP scale was 59.01 (12.3) with scores ranging from 18 to 90. The results therefore revealed that overall the students had a neutral to negative attitude towards persons with disabilities. With regards to the contact of the students with persons with disabilities 26.9% of the participants responded that they had had a long talk with a person with a disability while only 17.6% of the students responded that persons with disabilities visited their homes. The mean contact score was 22.72 indicating that the students had a slightly above average contact with persons with disabilities. No association was found between the attitude and contact mean scores.Information obtained in this study could be used to influence the curriculum of Health Science Students at Kilimanjaro Christian Medical Centre.
The attitudes of physiotherapists in Gaborone and Ramotswa, Botswana, towards treating people living with HIV/AIDS
(University of the Western Cape, 2007) Kambole, Mercy Mulenga; Struthers, Patricia; Dept. of Physiotherapy; Faculty of Community and Health Sciences
Physiotherapists are increasingly treating peole living with HIV/AIDS. However, there is little information which has been reported on their attitudes in providing treatment to people with HIV/AIDS or what facilitates positive attitudes. The aim of this study was to determine attitudes of physiotherapists towards treating people living with HIV/AIDS in Botswana.
Awareness of physiotherapy interventions among pregnant females in antenatal clinics, Buffalo city municipality, Eastern Cape, South Africa
(2013) Sajan, Merly; Phillips, Julie
Aim: The aim of the study was to to explore women’s awareness and use of antenatal services at Cecilia Makiwane Hospital. Objectives: The specific objectives were to determine the awareness of physiotherapy interventions among pregnant women attending antenatal clinic as well as the health professional’s knowledge about physiotherapy in the antenatal clinic.
Back pain amongst dentistry students at the University of Western Cape
(University of the Western Cape, 2008) Pradeep, Joseph Reejen; Frantz, José; Diener, Ina; Faculty of Science
Back pain has been reported to be the most common type of discomfort in all occupational groups. Studies have shown that dentists experience more neck, shoulder and back pain than practitioners in other occupational groups. This has caused an increase of social and economic costs of healthcare and increased frequency of sickness absenteeism in Western countries. About 72% of dentists experience back pain according to studies done in Western countries thus showing a very high prevalence among dentist. This study aimed to investigate the prevalence of back pain among dentistry undergraduate students. As there have been reports of high prevalence of back pain among dentistry students in Western countries.
Barriers and facilitators regarding patient adherence towards physiotherapy rehabilitation programs in the management of osteoarthritis in Nairobi, Kenya.
(University of Western Cape, 2020) Wanunda, Wendy Ashley; Mlenzana, Nondwe; Tawa, Nassib
Reduced adherence levels have been demonstrated by some patients affected with Osteoarthritis. Therefore, this study aimed at exploring the barriers and facilitators regarding patient adherence towards physiotherapy rehabilitation programs in the management of osteoarthritis in Nairobi, Kenya. The objectives of the study were to determine the clinical profile of patients with osteoarthritis on physiotherapy rehabilitation programs, to explore the patient-reported barriers and facilitators towards physiotherapy rehabilitation programs and exploring physiotherapists’ perceptions of patient adherence towards physiotherapy rehabilitation programs. The study setting was at the Kenyatta National Hospital physiotherapy clinic in Nairobi, Kenya.
Barriers and facilitators therapists experience regarding their support provision in an inclusive education system
(2009) Kotze, Josephine Dianne; Struthers, P.
In South Africa, the Education White Paper 6 on Special Needs Education (2001) Building an inclusive education and training system stated that the special schools would be resource centres for ordinary schools that admit learners with disabilities. Occupational therapists,physiotherapists, speech and language therapists (collectively called therapists) had previously been employed in special schools, but under the new structure, would form part of the district-based support teams to provide their support to ordinary and full service schools.Therapists working in an inclusive education system would need to change the focus of their model of support from a medical model of direct support to a health-promoting model of indirect support. The aim of the current study was to determine whether therapists are changing their model of support in building inclusive and health-promoting schools and also to determine the barriers and facilitators they experience in providing their support in an inclusive education system. This study used both qualitative and quantitative methodology.The quantitative component was a non-experimental, descriptive, cross-sectional design,using one questionnaire in a survey. The questionnaire was used to determine the type of support provided to schools. In total, 97 therapists, who worked at special schools in the Western Cape, participated in the study by completing the questionnaire. The test-retest results of the questionnaire indicated that most of questions (63%) showed perfect agreement (Kappa 0.81-1.0). Quantitative data analysis was done by descriptive statistics, using SPSS.The results indicated that therapists were using the medical model of support combined with a more holistic approach using the principles of the health-promoting framework. The qualitative component involved three group interviews, which were held at three different special schools, in three different education districts, with a total of 12 therapists. The group interviews were used to determine the barriers and facilitators that either prevent or promote provision of support. Qualitative data analysis was done by using content analysis with codes and themes to determine barriers and facilitators. The barriers included the following: therapists’ uncertainty about roles; lack of networking, lack of certain competencies and training; delayed response from district; lack of policy;autocratic leadership styles; exclusion from the district-based support team; concern to support learners at special school; therapists being based at the special school; lack of human resources; insufficient time; cost of therapists’ training; education department circuit boundaries affecting communication;negative attitudes of principals and educators; and parents’ non-involvement. The facilitators included therapists’ competencies to fulfil roles; educators’ positive attitude; meetings; training to improve therapists’ skills; the co-ordinating role of the district-based support team;and the supportive role of learner support educator and the principal. This study provides evidence concerning therapists’ roles and the barriers and facilitators which therapists experience regarding their support provision in an inclusive education system.
Barriers and facilitators to utilisation of rehabilitation services amongst persons with lower-limb amputations in a rural community in Kwa-Zulu Natal
(University of the Western Cape, 2017) Naidoo, Ugendrie; Ennion, L.; Rhoda, Anthea
An estimated 387 million people worldwide already have diabetes mellitus (DM), with those numbers rising to an estimated 592 million people by the year 2035. The prevalence of diabetes mellitus continues to increase with the largest increase seen in low- and middleincome countries, such as South Africa (Shaw, Sicree,& Zimmet, 2010; Peer et al., 2012; International Diabetes Federation, 2014; Bertram et al., 2013; Mayosi et al., 2009). Lowerlimb amputation is a common complication of uncontrolled diabetes mellitus (Moxey et al., 2011) and there is a marked increase in the incidence of diabetes mellitus in rural areas in South Africa. The impact that the amputation has on the individual's life can be devastating since the amputation of the limb is likely to be accompanied by a profound sense of loss. Rehabilitation can assist to retrain physical and functional abilities, psychological and emotional adjustment issues, as well as social and community reintegration (Manderson & Warren, 2010). Therefore, comprehensive rehabilitation is vital to mitigate the negative impact that a lower-limb amputation has on a person. Persons with disabilities who live in rural areas experience challenges accessing health services and rehabilitation (Harris et al., 2011). Even though challenges with accessing healthcare in rural settings are well documented, there is no literature specifically pertaining to persons with lower-limb amputations in a rural South African context.
Barriers experienced by parents/caregivers of children with clubfoot deformity attending specific clinics in Uganda
(University of the Western Cape, 2006) Herman, Kazibwe; Struthers, Patricia; Dept. of Physiotherapy; Faculty of Science
Clubfoot is the most common congenital structural deformity that leads to physical impairments in children in many poor developing countries. Inadequately treated or neglected clubfoot has been found to be a common cause of ohysical disability globally among children and young growing adults. Many children are referred to the clinics for treatment but some parents do not comply with the treatment regimen whcih requires attending for consecutive treatment sessions. The purpose of this study was to investigate barriers to treatment attendance parents/caregivers of children with clubfoot encounter in complying with clubfoot treatment during the plaster csting phase in Uganda.
Barriers to reintegration experienced by stroke clients post discharge from a rehabilitation center in Malawi
(University of the Western Cape, 2012) Chimatiro, George Lameck; Rhoda, Anthea
Stroke is a worldwide medical emergency, and the trend in its incidence is rising. Stroke leads to activity limitation and participation restriction among stroke clients. However rehabilitation of stroke disability has been found as lacking emphasis on reintegration issues, resulting into stroke clients facing different barriers to reintegration in the community after discharge. There is limited information about experiences of stroke clients in the communities after discharge from rehabilitation centers in Malawi. The current study was conducted to explore the barriers to reintegration experienced by the clients post discharge from a rehabilitation center in Malawi. A qualitative research was adopted to explore the perceived barriers to reintegration at Malawi Against Physical Disabilities (MAP) Kachere rehabilitation centre in Blantyre. In-depth interviews were utilized to capture data from perspectives of eight stroke clients, eight caregivers and seven service providers. The data was analyzed by means of content analysis. The findings of this study show key barriers that challenge community reintegration at two levels: individual and environmental. At individual level the barriers include impairments mainly depression and anxiety and physical weakness; and personal characteristics such as denial, gender and comorbidity. At the environmental level stroke clients experience attitudinal barriers by people in different settings of the community, poor terrain, long distance to places of interest, inaccessible structures and poverty. From the findings, therefore, stroke client experience wide range of barriers in both the activity and participation domains of community reintegration.Based on the key findings, recommendations have been made along three broad lines. To decrease barriers to reintegration, service providers could use the findings to consider equally addressing the potential negative contextual factors to reintegration when managing stroke clients, a shift from purely medical model approach to management of stroke. To increase rehabilitation services the government of Malawi could address the problem of limited funding to rehabilitation organizations and put measures to increase number of rehabilitation personnel at community, district and national levels. Further research in the area of community reintegration and development of a model of stroke care and rehabilitation in the country has also been recommended with view to improving stroke care and enhanced community reintegration post stroke in the country.
Barriers to school attendance among children with disabilities in Rwanda
(University of the Western Cape, 2008) Sagahutu, Jean Baptiste; Struthers, Patricia; Faculty of Community and Health Sciences
The number of children with disabilities under the age of 18 years around the world varies from 120 to 150 million. In many countries, throughout the world, the majority of children with disabilities either do not receive any form of education or, if they receive any, it is often inappropriate. UNESCO estimates that more than 90% of children with disabilities in developing countries do not attend schools. Rwanda has recently started inclusive education in a number of schools around the country for ensuring that children with disabilities have access to education. Despite this, in Rwanda, many children with disabilities do not attend school and this number is not known. This study aimed to identify the barriers to school attendance by children with disabilities in Rwanda.
Challenges experienced by mothers of children with cerebral palsy in Ndola, Zambia.
(University of the Western Cape, 2012) Singogo, Carol; Rhoda, Anthea
About 10% of children world-wide experience developmental disorders and require access to the health care system. These disorders also require extensive care giving, often throughout childhood and into the adult years. Cerebral palsy (CP) is one such chronic condition, and can serve as a major cause of childhood disability. It is the commonest cause of neurological impairment in childhood and is associated with functional limitations and lifelong disability. Providing the high level of care required by a child with long-term functional limitations can become burdensome and may impact on both the physical and psychological health of the care giver. To prevent problems suffered by mothers of children with CP, it is important to explore the challenges experienced. All studies conducted previously on cerebral palsy in Zambia focus on impairments and difficulties experienced by children with CP and none of the mothers’ challenges have been explored. The aim of this study therefore was to explore the challenges that mothers of children with cerebral palsy experience in Ndola, Zambia. The study was conducted at two rehabilitation centers (Twapia and Mushili) under the Community Based Rehabilitation (CBR) catchment area in Ndola. A qualitative research design was employed. The mothers were stratified and purposefully selected and interviews were stopped once theoretical saturation was reached. Permission to conduct the research was obtained from relevant bodies and ethical issues were observed throughout the study. Sixteen (16) mothers of children with CP were interviewed. In-depth interviews were done using an interview guide which was designed after extensive review of literature. The interviews were audio recorded. The recorded data was transcribed verbatim and thematic analysis was used to analyze the data. The results showed that the mothers faced many challenges which included emotional, physical health, socio-economic, environmental, misdiagnosis of the condition of their children, marital problems and lack of implementation of policies regarding children with CP by the Zambian government
The challenges experienced by persons with physical disabilities who live in Chifubu Township in Zambia.
(University of the Western Cape, 2010) Sakala, Mary Seliya; Rhoda, Anthea
People with physical disability experience various challenges which include physical, social and attitudinal challenges. These challenges which limit the inclusion of persons with physical disabilities in society are a result of barriers and the physical impairment itself. These factors also cause activity limitations and participation restrictions. Despite the United Nations declaration of 1993 for equalization of opportunities for people with disabilities, not much has changed. It is with this background that the researcher aimed to explore the challenges experienced by people with physical disabilities living in a low cost location of Zambia. Qualitative research methods were employed using a phenomenological approach to gain an in-depth insight of these challenges from participants' Iived experiences. Twenty participants were purposively selected for three focus group discussions, and eight of the twenty participants took part in the in depth interviews. The data was organised and analysed using the thematic method. Results of the study showed that participants in this study were challenged with architectural barriers due to designs, they lacked formal education, specialised skills, and most of them were unemployed and financially dependent on others. The negative attitudes of families, service providers, and the community in general resulted in discrimination and limited the participation and involvement of people with disabilities in the mainstream activities. The cultural beliefs of the participants in the research influence the manner in which society perceives persons with disability and treat them. Limited access to information about HIV/AIDS and the myths about the cure of the pandemic makes people with disabilities more vulnerable and at risk of being infected. The information regarding challenges experienced by people with disabilities gained in the study could be used by the policy makers for implementation of the UN declaration of equalization of opportunities for people with disabilities.
The challenges experienced by persons with physical disabilities who live in Chifubu Township in Zambia.
(University of the Western Cape, 2010) Sakala, Mary Seliya; Rhoda, Anthea
People with physical disability experience various challenges which include physical, social and attitudinal challenges. These challenges which limit the inclusion of persons with physical disabilities in society are a result of barriers and the physical impairment itself. These factors also cause activity limitations and participation restrictions. Despite the United Nations declaration of 1993 for equalization of opportunities for people with disabilities, not much has changed. It is with this background that the researcher aimed to explore the challenges experienced by people with physical disabilities living in a low cost location of Zambia. Qualitative research methods were employed using a henomenological approach to gain an in-depth insight of these challenges from participants' Iived experiences. Twenty participants were purposively selected for three focus group discussions, and eight of the twenty participants took part in the in depth interviews. The data was organised and analysed using the thematic method. Results of the study showed that participants in this study were challenged with architectural barriers due to designs, they lacked formal education, specialised skills, and most of them were unemployed and financially dependent on others. The negative attitudes of families, service providers, and the community in general resulted in discrimination and limited the participation and involvement of people with disabilities in the mainstream activities. The cultural beliefs of the participants in the research influence the manner in which society perceives persons with disability and treat them. Limited access to information about HIV/AIDS and the myths about the cure of the pandemic makes people with disabilities more venerable and at risk of being infected. The information regarding challenges experienced by people with disabilities gained in the study could be used by the policy makers for implementation of the UN declaration of equalisation of opportunities for people with disabilities.
Clinical reasoning of clinicians and undergraduate physiotherapy students during the intensive care unit rotation
(University of the Western Cape, 2024) Kariem, Hudaa; Hess, Danelle
Clinical reasoning (CR) is an important element of clinical practice and is considered essential for decision making. Physiotherapists need to make decisions daily, irrespective of their area of physiotherapy practice. Due to the complexity and intensity of the decision-making process, when it comes to critically ill patients in the Intensive Care Unit (ICU), the reasoning process in this particular setting may be different. The aim of the study was to explore the process of CR in both Clinicians working in ICU and undergraduate student physiotherapists training in the ICU. The objectives of the study were to explore the understanding of CR in undergraduate physiotherapy students and clinicians, to explore the process of CR and clinical decision-making (CDM) in clinicians working in the acute ICU setting and to explore the process of CR and CDM in undergraduate physiotherapy students following their rotation on the ICU placement. This study employed a qualitative approach with an exploratory research design. The population for the study included final year physiotherapy students on their ICU clinical rotation and clinicians working in the ICU. A purposive sampling method was employed to identify the participants. Data for the study was collected by means of semi-structured interviews. The data was analysed using Braun and Clarke’s six-phase thematic analysis approach where various themes and sub-themes emerged from the data.
A combination of a physiotherapy and cognitive behavioural therapy in the treatment of non-specific chronic lower back pain: A systematic review
(University of the Western Cape, 2019) Pretorius, Tammy-Lee; Phillips, Julie
Evidence indicates that the current physiotherapy management of patients with chronic non-specific LBP only offers moderate benefit. Combined treatment programmes, addressing body as well as the mind, shows promising results in developed countries with adequate resources but low evidence in poorly-resourced countries and contexts. This is another gap in the existing knowledge. The study aimed to evaluate the effectiveness of a combined physiotherapy and cognitive-behavioral therapy treatment, compared to physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behavior, in adults with non-specific low back pain. The systematic review included articles published, in English only, between 1985-2018 (July) in the following databases available at the University of The Western Cape: EbscoHost, BioMedCentral, Cambridge Journals Online, CINAHL, Cochrane Library, Medline (EbscoHost), Medline (Pubmed), Sabinet Reference, SAGE Journals Online, ScienceDirect,SciFinder Scholar, SCOPUS, Wiley Online Library, Springerlink and PubMed.Two reviewers independently evaluated the methodological quality of full text articles, using a critical appraisal tool. Fourteen (14) articles were included based on methodological rigour. Five (5) articles were included in the narrative synthesis and nine (9) articles were included in the meta-analyses. Statistically significant improvements in pain, disability and mental health, in favour of combination therapy for patients with chronic lower back pain were found. A small but statistically significant cumulative effect size for mental health (g = -0.26, Z = -4.49, p <.01) , physical disability (g = -0.27, Z = -5.09, p <.01) and pain (g = -.27, Z = -5.05, p <.01) , in favour of a combination of cognitive behavioural therapy and physiotherapy in patients with chronic lower back pain was found. In addition, a medium but statistically significant cumulative effect size (g = -0.50, Z = -6.95, p <.01), in terms of fear avoidance, was found in favour of the combination therapy. In conclusion, physiotherapy in combination with cognitivebehavioral therapy was more effective than physiotherapy alone, in reducing pain, disability, mental health and fear-avoidance behaviour, in adults with non-specific low back pain. Ethics: Permission for the study was obtained from the university’s Biomedical Research Ethics Committee.
Community experiences of persons with lower limb amputations in Malawi
(University of the Western Cape, 2018) Mpezeni, Stella; Ennion, Liezel
Persons with lower limb amputations (LLA) experience different challenges in the community. These challenges include the physical, psychological and social function of an individual. Little is known in Malawi on what persons with lower limb amputations go through in the communities where they live. Therefore, the study aimed at exploring and determining community experiences of persons with LLA in Malawi. The study sought to address the following objectives: 1) To determine the functional and psychological status of persons with LLA in the community; 2) To explore and describe experiences on social participation of persons with LLA in the community; 3). To explore experiences on community re-integration following LLA. A mixed method approach was applied where quantitative and qualitative data were collected simultaneously to provide a more holistic overview of the experiences of persons with LLA at one point in time. The study setting was Queen Elizabeth Central Hospital (QECH) and Kamuzu Central Hospitals (KCH) (500 miles), located in Malawi. A sample of 180 participants was recruited to participate in the study. Three self-administered questionnaires (socio-demographic questionnaire, OPUS module of lower extremity functional status, and a Beck’s depression inventory scale) and a semi-structured interview guide were used for data collection. Thematic data analysis was used to analyze qualitative data, while quantitative data was analyzed using descriptive and inferential statistics. Ethical clearance was obtained from the University of the Western Cape Biomedical Research Ethics Committee (BMREC) and College of Medicine Research Ethics Committee (COMREC). Permission to conduct the study was obtained from KCH (500 miles) and QECH. Privacy andconfidentiality was strictly observed such that data obtained was anonymous. It was kept in a secure place, and electronic data was secured using a password.
Cumulative incidence of musculoskeletal injuries among student dancers at Tshwane University of Technology
(University of the Western Cape, 2009) Magida; Phillips, Julie
Dance movements requires explosive power, sustained effort and both local and general endurance. Musculoskeletal injuries (MSI) are the most frequent medical problems among dancers in ballet, which is partly owing to inadequate training and dancers not being properly prepared for the dernands of the dance performance. The study involved a prospective, cohort design. A population of 49 student dancers at Tshwane University of Technology (TUT) were studied over 16 weeks academic year in 2007.The purpose of the present study was to determine the cumulative incidence of musculoskeletal injuries amongst student dancers at TUT. The student dancers filled on a questionnaire about previous injuries, their study schedules and factors they believed increased the risk of injuries. Of the 49 student dancers, 4l (83 o/o) consent to participate. There were 10 cumulative injuries incurred by 41 student dancers over 16 weeks period i.e.7.l yo,0.06 injuries incurred per student month at risk. The main limitations to this study were small sample size and misclassification, recall, and reporting biases. Further research should aim to standardize injury definitions and classifications.

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