Background Effective disease management for people living with human immunodeficiency virus (PLWH) includes the encouragement of physical activity. Physical function capacity in PLWH may be influenced by a variety of factors. Objectives This study describes the physical function capacity as assessed with the 6-minute walk test (6MWT) of an urban cohort of PLWH and determined whether a history of pulmonary tuberculosis (PTB), anthropometric measures, age and gender predicted distance walked. Method Secondary data collected from 84 PLWH on antiretroviral therapy were analysed. Information included 6MWT distance, anthropometric measurements and demographic profiles. Descriptive and inferential statistics were undertaken on the data. A regression analysis determined predictive factors for 6MWT distance achieved. Significance was set at a p-value of ≤ 0.05. Results The study consisted of 66 (78.6%) women and 18 (21.4%) men with a mean age of 39.1 (± 9.2) years. The 6MWT distance of the cohort was 544.3 (± 64.4) m with men walking further (602.8 [± 58.6] m) than women (528.3 [± 56.4] m); however, women experienced greater effort. The majority of the sample did not report a history of PTB (n = 67; 79.8%). Age, gender and anthropometric measures were associated with 6MWT distance, but of low to moderate strength. The regression equation generated included age and gender. This model was statistically significant (p < 0.00) and accounted for 34% of the total variance observed. Conclusion Age and gender were predictive factors of physical function capacity and women experienced greater effort. Clinical implications This study provides information on the physical function capacity of PLWH and a suggested 6MWT reference equation for PLWH in South Africa.
{"title":"Factors associated with physical function capacity in an urban cohort of people living with the human immunodeficiency virus in South Africa","authors":"R. Roos, H. Myezwa, H. van Aswegen","doi":"10.4102/sajp.v75i1.1323","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1323","url":null,"abstract":"Background Effective disease management for people living with human immunodeficiency virus (PLWH) includes the encouragement of physical activity. Physical function capacity in PLWH may be influenced by a variety of factors. Objectives This study describes the physical function capacity as assessed with the 6-minute walk test (6MWT) of an urban cohort of PLWH and determined whether a history of pulmonary tuberculosis (PTB), anthropometric measures, age and gender predicted distance walked. Method Secondary data collected from 84 PLWH on antiretroviral therapy were analysed. Information included 6MWT distance, anthropometric measurements and demographic profiles. Descriptive and inferential statistics were undertaken on the data. A regression analysis determined predictive factors for 6MWT distance achieved. Significance was set at a p-value of ≤ 0.05. Results The study consisted of 66 (78.6%) women and 18 (21.4%) men with a mean age of 39.1 (± 9.2) years. The 6MWT distance of the cohort was 544.3 (± 64.4) m with men walking further (602.8 [± 58.6] m) than women (528.3 [± 56.4] m); however, women experienced greater effort. The majority of the sample did not report a history of PTB (n = 67; 79.8%). Age, gender and anthropometric measures were associated with 6MWT distance, but of low to moderate strength. The regression equation generated included age and gender. This model was statistically significant (p < 0.00) and accounted for 34% of the total variance observed. Conclusion Age and gender were predictive factors of physical function capacity and women experienced greater effort. Clinical implications This study provides information on the physical function capacity of PLWH and a suggested 6MWT reference equation for PLWH in South Africa.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131669735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Knowledge of neurophysiology of pain influences healthcare providers’ attitudes and beliefs about patients with chronic low back pain which affect management choices. Objectives The aim of this study was to determine the level of knowledge of pain and attitudes and beliefs towards patients with chronic low back pain among final year undergraduate students from the School of Therapeutic Sciences at the University of the Witwatersrand. Methods This cross-sectional study included two questionnaires – Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) for measuring attitudes and beliefs about pain and the Neurophysiology of Pain Questionnaire (NPQ) for knowledge of pain. These were distributed to 224 students. An analysis of variance and a two-sided t tests compared data with p ≤ 0.05. Results The study had a 65% response rate (n = 145), of which the majority were female students (n = 115, 79%). Overall, the mean correct NPQ score was 6.01 (± 1.98), with a significant difference among the programmes (p = 0.005). Mean NPQ scores for each programme were as follows: physiotherapy 6.97 (1.77), biokinetics 6.31 (2.43), exercise science 6.25 (2.5), pharmacy and pharmacology 5.69 (1.39), nursing 5.32 (1.39) and occupation therapy 5.21 (2.09). The mean correct scores for HC-PAIRS were 63.1 (8.9), with significantly higher scores in females than males (p = 0.04). Knowledge scores had a low inverse relationship with scores for attitudes and beliefs towards patients with chronic low back pain (r = -0.304; p = 0.0002). Conclusion There is a deficit in knowledge of pain among final year students in the School of Therapeutic Sciences, with a low correlation with attitudes and beliefs towards patients with chronic low back pain. Therefore, improving the knowledge of pain might result in a change in these attitudes and beliefs. Clinical implications The results have shown an association between knowledge of pain and attitudes and beliefs towards patients with chronic low back pain. Therefore, knowledge is one of the factors that could contribute in changing the attitudes.
{"title":"Level of knowledge, attitudes and beliefs towards patients with chronic low back pain among final year School of Therapeutic Sciences students at the University of the Witwatersrand – A cross-sectional study","authors":"Grace Mukoka, B. Olivier, Sadiya Ravat","doi":"10.4102/sajp.v75i1.683","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.683","url":null,"abstract":"Background Knowledge of neurophysiology of pain influences healthcare providers’ attitudes and beliefs about patients with chronic low back pain which affect management choices. Objectives The aim of this study was to determine the level of knowledge of pain and attitudes and beliefs towards patients with chronic low back pain among final year undergraduate students from the School of Therapeutic Sciences at the University of the Witwatersrand. Methods This cross-sectional study included two questionnaires – Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS) for measuring attitudes and beliefs about pain and the Neurophysiology of Pain Questionnaire (NPQ) for knowledge of pain. These were distributed to 224 students. An analysis of variance and a two-sided t tests compared data with p ≤ 0.05. Results The study had a 65% response rate (n = 145), of which the majority were female students (n = 115, 79%). Overall, the mean correct NPQ score was 6.01 (± 1.98), with a significant difference among the programmes (p = 0.005). Mean NPQ scores for each programme were as follows: physiotherapy 6.97 (1.77), biokinetics 6.31 (2.43), exercise science 6.25 (2.5), pharmacy and pharmacology 5.69 (1.39), nursing 5.32 (1.39) and occupation therapy 5.21 (2.09). The mean correct scores for HC-PAIRS were 63.1 (8.9), with significantly higher scores in females than males (p = 0.04). Knowledge scores had a low inverse relationship with scores for attitudes and beliefs towards patients with chronic low back pain (r = -0.304; p = 0.0002). Conclusion There is a deficit in knowledge of pain among final year students in the School of Therapeutic Sciences, with a low correlation with attitudes and beliefs towards patients with chronic low back pain. Therefore, improving the knowledge of pain might result in a change in these attitudes and beliefs. Clinical implications The results have shown an association between knowledge of pain and attitudes and beliefs towards patients with chronic low back pain. Therefore, knowledge is one of the factors that could contribute in changing the attitudes.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130767592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Loveness A Nkhata, Yolandi Brink, D. Ernstzen, Q. Louw
Background Evidence-based clinical practice guidelines on back pain recommend early management and use of approaches that emphasise self-management, psychological and physical therapies. Lately, mass media campaigns, addressing misconceptions about back pain, have been conducted in developed countries. Objectives This study retrieved and synthesised the contents of back pain messages and described the outcomes and effectiveness of the media campaigns. Method Seventeen key words and 10 electronic databases were used to conduct a search between February and July 2018. Authors screened titles, abstracts and full-text articles independently to identify eligible studies. Data were reported using narratives because of heterogeneity in the outcomes. Results Appraisal of articles was done using the Physiotherapy Evidence Database scale for randomised controlled trials (RCT) (one) or the Joanna Briggs Institute checklist for non-RCT (four). The campaigns were conducted in the general population in Australia, Canada, Norway, the Netherlands and Scotland. The message ‘stay as active as possible’ increased participants’ awareness and influenced their health beliefs and healthcare utilisation behaviours resulting in reductions in sick leave days, work disability, healthcare utilisation and claims. Conclusion The back pain campaign message ‘stay as active as possible’ increased participants’ awareness and influenced their health beliefs and healthcare utilisation behaviours. Even though the campaigns were done in high-income countries, their contents and methods are transferable to developing countries. However, their implementation must be tailored and efficient and cost-effective methods need to be explored. Clinical implications Providing information on back pain can contribute to significant changes in sickness behaviours and beliefs.
{"title":"A systematic review on self-management education campaigns for back pain","authors":"Loveness A Nkhata, Yolandi Brink, D. Ernstzen, Q. Louw","doi":"10.4102/sajp.v75i1.1314","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1314","url":null,"abstract":"Background Evidence-based clinical practice guidelines on back pain recommend early management and use of approaches that emphasise self-management, psychological and physical therapies. Lately, mass media campaigns, addressing misconceptions about back pain, have been conducted in developed countries. Objectives This study retrieved and synthesised the contents of back pain messages and described the outcomes and effectiveness of the media campaigns. Method Seventeen key words and 10 electronic databases were used to conduct a search between February and July 2018. Authors screened titles, abstracts and full-text articles independently to identify eligible studies. Data were reported using narratives because of heterogeneity in the outcomes. Results Appraisal of articles was done using the Physiotherapy Evidence Database scale for randomised controlled trials (RCT) (one) or the Joanna Briggs Institute checklist for non-RCT (four). The campaigns were conducted in the general population in Australia, Canada, Norway, the Netherlands and Scotland. The message ‘stay as active as possible’ increased participants’ awareness and influenced their health beliefs and healthcare utilisation behaviours resulting in reductions in sick leave days, work disability, healthcare utilisation and claims. Conclusion The back pain campaign message ‘stay as active as possible’ increased participants’ awareness and influenced their health beliefs and healthcare utilisation behaviours. Even though the campaigns were done in high-income countries, their contents and methods are transferable to developing countries. However, their implementation must be tailored and efficient and cost-effective methods need to be explored. Clinical implications Providing information on back pain can contribute to significant changes in sickness behaviours and beliefs.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116314621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Louw, E. Puentedura, I. Diener, K. Zimney, Terry Cox
Background The use of pain neuroscience education (PNE) has been shown to be effective in reducing pain, improving function and lowering fear and catastrophisation. Pain neuroscience education utilises various stories and metaphors to help patients reconceptualise their pain experience. To date no individualised study has looked at which stories and metaphors may be the most effective in achieving the positive outcomes found with the use of PNE. Objectives This study examined patient responses to the usefulness of the various stories and metaphors used during PNE for patients who underwent surgery for lumbar radiculopathy. Method Twenty-seven participants who received preoperative PNE from a previous randomised control trial (RCT) were surveyed 1-year post-education utilising a 5-point Likert scale (0 – ‘do not remember’, 4 – ‘very helpful’) on the usefulness of the various stories and metaphors used during the PNE session. Participant demographics and outcomes data (pain intensity, function and pain knowledge) were utilised from the previous RCT for analysis and correlations. Results Nineteen surveys were returned for a response rate of 70%. No story or metaphor mean was below 2 – ‘neutral’, lowest mean at 2.53; 6 of the 11 stories or metaphors scored a mean above 3 – ‘helpful’. Conclusion No individual story or metaphor stood out as being predominately important in being helpful in the recovery process through the use of PNE. Clinical implications The overall messages of reconceptualising pain during PNE may be more important than any individual story or metaphor.
{"title":"Pain neuroscience education: Which pain neuroscience education metaphor worked best?","authors":"A. Louw, E. Puentedura, I. Diener, K. Zimney, Terry Cox","doi":"10.4102/sajp.v75i1.1329","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1329","url":null,"abstract":"Background The use of pain neuroscience education (PNE) has been shown to be effective in reducing pain, improving function and lowering fear and catastrophisation. Pain neuroscience education utilises various stories and metaphors to help patients reconceptualise their pain experience. To date no individualised study has looked at which stories and metaphors may be the most effective in achieving the positive outcomes found with the use of PNE. Objectives This study examined patient responses to the usefulness of the various stories and metaphors used during PNE for patients who underwent surgery for lumbar radiculopathy. Method Twenty-seven participants who received preoperative PNE from a previous randomised control trial (RCT) were surveyed 1-year post-education utilising a 5-point Likert scale (0 – ‘do not remember’, 4 – ‘very helpful’) on the usefulness of the various stories and metaphors used during the PNE session. Participant demographics and outcomes data (pain intensity, function and pain knowledge) were utilised from the previous RCT for analysis and correlations. Results Nineteen surveys were returned for a response rate of 70%. No story or metaphor mean was below 2 – ‘neutral’, lowest mean at 2.53; 6 of the 11 stories or metaphors scored a mean above 3 – ‘helpful’. Conclusion No individual story or metaphor stood out as being predominately important in being helpful in the recovery process through the use of PNE. Clinical implications The overall messages of reconceptualising pain during PNE may be more important than any individual story or metaphor.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124835984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background HIV-associated peripheral neuropathy (PN) is common in people living with HIV. Its management is mostly symptomatic utilising pharmacological approaches. Objectives This study determined the effects of an exercise intervention on PN among Rwandan people living with HIV receiving antiretroviral therapy (ART). Methods A 12-week single-blinded randomised controlled trial using the Brief Peripheral Neuropathy Screen (BPNS) as the assessment tool tested the effects of an exercise intervention on PN, followed by a 12-week non-intervention period. A total of 120 people with HIV- associated PN on ART were randomised to an exercise or no exercise group. Both groups continued receiving routine care. A bivariate analysis using Pearson’s chi-square test for significant differences in PN symptoms and signs, between groups, at baseline, after the 12 weeks intervention and 12 weeks post-intervention using generalised linear regression models to determine predictors of treatment outcomes was undertaken, utilising an intention-to-treat analysis (alpha p ≤ 0.05). Results At 12 weeks, the intervention group compared to the control: neuropathic pain 70% versus 94% (p < 0.005), PN symptoms severity – mild and/or none in 85% versus 60% (p < 0.001) and radiation of PN symptoms reduced, 80% versus 37% (p < 0.001). There were no differences in PN signs at 12 weeks intervention and at 12 weeks post-intervention. Having changed the antiretroviral (ARV) and having developed PN symptoms after the start on ARVs predicted treatment improvement, while demographic factors did not predict any treatment outcome. Conclusion A physiotherapist-led exercise intervention improved PN symptoms, but with non-significant improvement in PN signs. Factors related to early diagnosis and treatment of PN were facilitators for the improvement of PN symptoms. Clinical implications Physiotherapist-led exercises should be integrated into the routine management of people living with HIV on ART with PN symptoms.
{"title":"The effects of a physiotherapist-led exercise intervention on peripheral neuropathy among people living with HIV on antiretroviral therapy in Kigali, Rwanda","authors":"D. Tumusiime, A. Stewart, F. Venter, E. Musenge","doi":"10.4102/sajp.v75i1.1328","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1328","url":null,"abstract":"Background HIV-associated peripheral neuropathy (PN) is common in people living with HIV. Its management is mostly symptomatic utilising pharmacological approaches. Objectives This study determined the effects of an exercise intervention on PN among Rwandan people living with HIV receiving antiretroviral therapy (ART). Methods A 12-week single-blinded randomised controlled trial using the Brief Peripheral Neuropathy Screen (BPNS) as the assessment tool tested the effects of an exercise intervention on PN, followed by a 12-week non-intervention period. A total of 120 people with HIV- associated PN on ART were randomised to an exercise or no exercise group. Both groups continued receiving routine care. A bivariate analysis using Pearson’s chi-square test for significant differences in PN symptoms and signs, between groups, at baseline, after the 12 weeks intervention and 12 weeks post-intervention using generalised linear regression models to determine predictors of treatment outcomes was undertaken, utilising an intention-to-treat analysis (alpha p ≤ 0.05). Results At 12 weeks, the intervention group compared to the control: neuropathic pain 70% versus 94% (p < 0.005), PN symptoms severity – mild and/or none in 85% versus 60% (p < 0.001) and radiation of PN symptoms reduced, 80% versus 37% (p < 0.001). There were no differences in PN signs at 12 weeks intervention and at 12 weeks post-intervention. Having changed the antiretroviral (ARV) and having developed PN symptoms after the start on ARVs predicted treatment improvement, while demographic factors did not predict any treatment outcome. Conclusion A physiotherapist-led exercise intervention improved PN symptoms, but with non-significant improvement in PN signs. Factors related to early diagnosis and treatment of PN were facilitators for the improvement of PN symptoms. Clinical implications Physiotherapist-led exercises should be integrated into the routine management of people living with HIV on ART with PN symptoms.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115528747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The Department of Physiotherapy at the University of the Western Cape began accepting students with visual impairments (VIs) into the undergraduate physiotherapy programme in 1996. However, until recently, none had received a clinical rotation in any high care setting. Objectives The aim of this study was to explore the experiences of all stakeholders involved in the process of placing a student with VI into the intensive care unit (ICU). Method This case study used interviews with relevant stakeholders to explore their experiences of integrating the ICU placement into the student’s clinical programme. Interviews were recorded and transcribed, and then analysed thematically. Results There was a certain amount of anxiety present, especially among clinical staff, before the placement began. Discussions among stakeholders at each stage of the process served to identify potential problems before they arose, and allowed staff to plan solutions in advance. Challenges were found in both the attitudes of staff, and in the clinical environment, some of which were relatively easy to address, while others will require significant investments of resources to resolve. Conclusion Our findings suggest that it may be possible to successfully place students with VI into intensive care settings, and they can enjoy positive learning experiences, given an appropriate context and adequate support. However, care needs to be taken at every stage of the process to ensure that supporting structures are in place prior to, and during, the placement. Clinical implications All stakeholders, including the students and the relevant clinical and academic staff, need to be actively involved in the process of planning for the clinical placement.
{"title":"Supporting a student with visual impairment in the intensive care unit","authors":"M. Rowe, T. Steyl, Joliana Phillips, A. Rhoda","doi":"10.4102/sajp.v75i1.1324","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1324","url":null,"abstract":"Background The Department of Physiotherapy at the University of the Western Cape began accepting students with visual impairments (VIs) into the undergraduate physiotherapy programme in 1996. However, until recently, none had received a clinical rotation in any high care setting. Objectives The aim of this study was to explore the experiences of all stakeholders involved in the process of placing a student with VI into the intensive care unit (ICU). Method This case study used interviews with relevant stakeholders to explore their experiences of integrating the ICU placement into the student’s clinical programme. Interviews were recorded and transcribed, and then analysed thematically. Results There was a certain amount of anxiety present, especially among clinical staff, before the placement began. Discussions among stakeholders at each stage of the process served to identify potential problems before they arose, and allowed staff to plan solutions in advance. Challenges were found in both the attitudes of staff, and in the clinical environment, some of which were relatively easy to address, while others will require significant investments of resources to resolve. Conclusion Our findings suggest that it may be possible to successfully place students with VI into intensive care settings, and they can enjoy positive learning experiences, given an appropriate context and adequate support. However, care needs to be taken at every stage of the process to ensure that supporting structures are in place prior to, and during, the placement. Clinical implications All stakeholders, including the students and the relevant clinical and academic staff, need to be actively involved in the process of planning for the clinical placement.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133734506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Des Scott, C. Scott, J. Jelsma, D. Abraham, J. Verstraete
Background Health-Related Quality of Life (HRQoL) data together with clinical findings allow for monitoring of intervention efficacy and the effect on HRQoL. Children with Juvenile Idiopathic Arthritis (JIA) experience symptoms often persisting into adulthood, emphasising the need to track HRQoL. Objectives The aim of this study was to investigate psychometric properties of the EuroQol five-dimensional youth questionnaire (EQ-5D-Y) in children with JIA. Methods A cross-sectional, analytical study design was used. Children 8 to 15 years were recruited, completing the self-report EQ-5D-Y and two other HRQoL questionnaires. Known group validity was established by comparing the effect size between children with different disease severities. Concurrent validity was tested using Kruskal–Wallis to compare the ranking of scores on different questionnaires. Feasibility was assessed by number of missing responses and time to complete each questionnaire. Results All questionnaires were able to distinguish between children with different JIA severity. There was a significant difference in ranking of most Juvenile Arthritis Multidimensional Assessment Report dimension scores across EQ-5D-Y levels, (p < 0.05), indicating concurrent validity. There was poor concurrent validity with the PedsQL dimensions tested with EQ-5D-Y, except for ‘pain’ (p = 0.001). The EQ-5D-Y was the quickest to complete with no missing values. Conclusion This study showed that the EQ-5D-Y is valid and feasible in measuring HRQoL in JIA children and adequately responsive to detect change over time. Clinical implications It is quick and easy to use in a busy clinical setting, allowing for effective JIA management monitoring.
{"title":"Validity and feasibility of the self-report EQ-5D-Y as a generic Health-Related Quality of Life outcome measure in children and adolescents with Juvenile Idiopathic Arthritis in Western Cape, South Africa","authors":"Des Scott, C. Scott, J. Jelsma, D. Abraham, J. Verstraete","doi":"10.4102/sajp.v75i1.1335","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1335","url":null,"abstract":"Background Health-Related Quality of Life (HRQoL) data together with clinical findings allow for monitoring of intervention efficacy and the effect on HRQoL. Children with Juvenile Idiopathic Arthritis (JIA) experience symptoms often persisting into adulthood, emphasising the need to track HRQoL. Objectives The aim of this study was to investigate psychometric properties of the EuroQol five-dimensional youth questionnaire (EQ-5D-Y) in children with JIA. Methods A cross-sectional, analytical study design was used. Children 8 to 15 years were recruited, completing the self-report EQ-5D-Y and two other HRQoL questionnaires. Known group validity was established by comparing the effect size between children with different disease severities. Concurrent validity was tested using Kruskal–Wallis to compare the ranking of scores on different questionnaires. Feasibility was assessed by number of missing responses and time to complete each questionnaire. Results All questionnaires were able to distinguish between children with different JIA severity. There was a significant difference in ranking of most Juvenile Arthritis Multidimensional Assessment Report dimension scores across EQ-5D-Y levels, (p < 0.05), indicating concurrent validity. There was poor concurrent validity with the PedsQL dimensions tested with EQ-5D-Y, except for ‘pain’ (p = 0.001). The EQ-5D-Y was the quickest to complete with no missing values. Conclusion This study showed that the EQ-5D-Y is valid and feasible in measuring HRQoL in JIA children and adequately responsive to detect change over time. Clinical implications It is quick and easy to use in a busy clinical setting, allowing for effective JIA management monitoring.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121933672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Physiotherapists know the depth of gross anatomical knowledge required for safe and effective clinical practice. They can offer insightful opinions on inclusions for and teaching of an anatomy curriculum for physiotherapy students. Objectives The aim of this study was to gather opinions of physiotherapists as to what they perceive as necessary anatomy curricular content for undergraduate physiotherapy students and identify pedagogy that should be used. Method A qualitative methodology using a grounded theory approach incorporating semi-structured interviews was utilised in this study. Theoretical sampling was used to identify representative South African physiotherapists. An inductive process, using continuous manual analysis of data by two independent coders, was undertaken. Data were collapsed until themes were identified. Triangulation and other strategies for trustworthiness of data were instituted. Results Theoretical saturation was reached after five focus groups (n = 32). Demographical information indicated physiotherapists of all age groups and both genders working in diversified clinical areas. Seven themes were identified and incorporated information from ‘structure’, ‘content’ and ‘pedagogy’ for anatomy programmes to the psychological impact of course aspects on a student’s psyche. Vertical integration of anatomy into later preclinical years, incorporation of physiotherapists to teach anatomy, a ‘physiotherapist personality’ and ‘anatomy know how’ for clinical practice were included. Conclusion Opinions of physiotherapists are important in identifying curricular and teaching considerations that can be incorporated into an anatomy programme designed for physiotherapy students. Clinical implications Targeted anatomy education for physiotherapy students can aid learning and retention of anatomical knowledge necessary for effective and safe clinical practice.
{"title":"Opinions of South African physiotherapists on gross anatomy education for physiotherapy students","authors":"Dorothy Shead, R. Roos, B. Olivier, A. Ihunwo","doi":"10.4102/sajp.v75i1.1318","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1318","url":null,"abstract":"Background Physiotherapists know the depth of gross anatomical knowledge required for safe and effective clinical practice. They can offer insightful opinions on inclusions for and teaching of an anatomy curriculum for physiotherapy students. Objectives The aim of this study was to gather opinions of physiotherapists as to what they perceive as necessary anatomy curricular content for undergraduate physiotherapy students and identify pedagogy that should be used. Method A qualitative methodology using a grounded theory approach incorporating semi-structured interviews was utilised in this study. Theoretical sampling was used to identify representative South African physiotherapists. An inductive process, using continuous manual analysis of data by two independent coders, was undertaken. Data were collapsed until themes were identified. Triangulation and other strategies for trustworthiness of data were instituted. Results Theoretical saturation was reached after five focus groups (n = 32). Demographical information indicated physiotherapists of all age groups and both genders working in diversified clinical areas. Seven themes were identified and incorporated information from ‘structure’, ‘content’ and ‘pedagogy’ for anatomy programmes to the psychological impact of course aspects on a student’s psyche. Vertical integration of anatomy into later preclinical years, incorporation of physiotherapists to teach anatomy, a ‘physiotherapist personality’ and ‘anatomy know how’ for clinical practice were included. Conclusion Opinions of physiotherapists are important in identifying curricular and teaching considerations that can be incorporated into an anatomy programme designed for physiotherapy students. Clinical implications Targeted anatomy education for physiotherapy students can aid learning and retention of anatomical knowledge necessary for effective and safe clinical practice.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122081419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Diabetes mellitus (DM) and its related sensory peripheral neuropathy (SPN) are the biggest risk factors for foot ulcer formation and lower limb amputation. Reduced vibration perception results in less sensitivity to pressure and is a known risk factor for diabetic foot ulcers. Improving vibration perception in the feet of people with SPN could be protective against foot ulcers. The aim of this study was to determine if a therapeutic vibrating insole, used for 35 consecutive days, could improve vibration perception in a patient with type 2 DM. Patient presentation The patient was a 63 year-old male with a medical history of peripheral vascular disease, controlled hypertension, hyperlipidaemia, artherosclerosis and SPN secondary to controlled type 2 diabetes. Management and outcome The patient used the insoles for 20 min a day for 35 consecutive days. Vibration perception thresholds were measured four times in total: once at baseline, immediately post intervention, 1 month and 10 months later. Vibration perception threshold decreased with an average of 22 V (range 6 V–34 V) dependant on the tested location and time after intervention. The improvement remained after 1 and 10 months. Conclusion The use of a vibrating insole as a therapeutic device improved this patient’s perception of vibration in his feet. Clinically, vibrating insoles potentially might reduce the risk for ulcer formation and subsequent lower limb amputation in patients with DM and SPN. Clinical implications Using a vibrating insole therapeutically, can potentially improve the perception of vibration and pressure in patients with sensory peripheral neuropathy secondary to type 2 diabetes mellitus. Improved vibration perception might reduce the risk for diabetic ulcer formation and subsequent lower limb amputation.
糖尿病(DM)及其相关感觉周围神经病变(SPN)是足部溃疡形成和下肢截肢的最大危险因素。振动感知减少导致对压力的敏感性降低，这是糖尿病足溃疡的已知危险因素。改善患有SPN的人的足部振动感知能力可以防止足部溃疡。本研究的目的是确定治疗性振动鞋垫，连续使用35天，是否可以改善2型糖尿病患者的振动感知。患者介绍患者为63岁男性，有外周血管疾病病史，控制性高血压、高脂血症、动脉硬化和继发于控制性2型糖尿病的SPN。处理和结果患者每天使用鞋垫20分钟，连续使用35天。总共测量了四次振动感知阈值:基线时一次，干预后立即一次，1个月后一次和10个月后一次。根据干预后的测试位置和时间，振动感知阈值平均降低了22 V(范围为6 V - 34 V)。1个月和10个月后仍有改善。结论使用振动鞋垫作为治疗手段，改善了患者对足部振动的感知。在临床上，振动鞋垫可能会降低糖尿病和SPN患者溃疡形成和随后下肢截肢的风险。在治疗中使用振动鞋垫可以潜在地改善2型糖尿病继发感觉周围神经病变患者对振动和压力的感知。改善振动感知可能降低糖尿病溃疡形成和随后下肢截肢的风险。
{"title":"Improving vibration perception in a patient with type 2 diabetes and sensory peripheral neuropathy","authors":"Liezel Ennion, J. Hijmans","doi":"10.4102/sajp.v75i1.602","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.602","url":null,"abstract":"Introduction Diabetes mellitus (DM) and its related sensory peripheral neuropathy (SPN) are the biggest risk factors for foot ulcer formation and lower limb amputation. Reduced vibration perception results in less sensitivity to pressure and is a known risk factor for diabetic foot ulcers. Improving vibration perception in the feet of people with SPN could be protective against foot ulcers. The aim of this study was to determine if a therapeutic vibrating insole, used for 35 consecutive days, could improve vibration perception in a patient with type 2 DM. Patient presentation The patient was a 63 year-old male with a medical history of peripheral vascular disease, controlled hypertension, hyperlipidaemia, artherosclerosis and SPN secondary to controlled type 2 diabetes. Management and outcome The patient used the insoles for 20 min a day for 35 consecutive days. Vibration perception thresholds were measured four times in total: once at baseline, immediately post intervention, 1 month and 10 months later. Vibration perception threshold decreased with an average of 22 V (range 6 V–34 V) dependant on the tested location and time after intervention. The improvement remained after 1 and 10 months. Conclusion The use of a vibrating insole as a therapeutic device improved this patient’s perception of vibration in his feet. Clinically, vibrating insoles potentially might reduce the risk for ulcer formation and subsequent lower limb amputation in patients with DM and SPN. Clinical implications Using a vibrating insole therapeutically, can potentially improve the perception of vibration and pressure in patients with sensory peripheral neuropathy secondary to type 2 diabetes mellitus. Improved vibration perception might reduce the risk for diabetic ulcer formation and subsequent lower limb amputation.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131494160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Patellofemoral pain (PFP) is a common and complex condition. The diagnosis and causal mechanisms are not well understood and therefore the long-term prognosis tends to be poor. Exercise is currently the only evidence-based treatment strategy suggested to improve pain and function in the long term. However, no qualitative studies have been conducted to establish patients’ perceptions of recovery in the long term following an exercise intervention. Objectives To measure self-reported recovery on a 7-point Likert scale in 31 participants with PFP 6 months after a 6-week physiotherapy intervention. To explore the subjective accounts of patients who received a physiotherapy intervention for PFP, regarding their expectations and perceptions of recovery. Method Semi-structured exit interviews were conducted electronically 6 months after intervention to ascertain the patients’ perspectives on whether expectations of treatment were met, and factors that influenced their recovery experience. Results Quantitative analysis of self-reported recovery on a 7-point Likert scale showed that 48.4% of participants felt that they were ‘recovered’. Qualitative analysis showed three main categories: expectations of treatment, perceptions of recovery and changes in functional abilities. Conclusion Clinicians should address patients’ expectations of treatment and include the patients in decision-making regarding their treatment. Long-term follow-up is essential to ensure that treatment effects have been maintained, and this should include information about patients’ self-reported recovery. Clinical implications This study suggests that patients’ expectations of treatment and perceptions of recovery from PFP may influence prognosis. Clinicians need to collaborate with patients and involve them in decision-making to achieve their goals. An individualised treatment approach is essential to adequately address patients’ experiences, priorities and beliefs.
{"title":"Patients’ perceptions of recovery following a 6-week exercise intervention for the treatment of patellofemoral pain: A mixed methods study","authors":"Dominique C. Leibbrandt, Q. Louw","doi":"10.4102/sajp.v75i1.684","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.684","url":null,"abstract":"Background Patellofemoral pain (PFP) is a common and complex condition. The diagnosis and causal mechanisms are not well understood and therefore the long-term prognosis tends to be poor. Exercise is currently the only evidence-based treatment strategy suggested to improve pain and function in the long term. However, no qualitative studies have been conducted to establish patients’ perceptions of recovery in the long term following an exercise intervention. Objectives To measure self-reported recovery on a 7-point Likert scale in 31 participants with PFP 6 months after a 6-week physiotherapy intervention. To explore the subjective accounts of patients who received a physiotherapy intervention for PFP, regarding their expectations and perceptions of recovery. Method Semi-structured exit interviews were conducted electronically 6 months after intervention to ascertain the patients’ perspectives on whether expectations of treatment were met, and factors that influenced their recovery experience. Results Quantitative analysis of self-reported recovery on a 7-point Likert scale showed that 48.4% of participants felt that they were ‘recovered’. Qualitative analysis showed three main categories: expectations of treatment, perceptions of recovery and changes in functional abilities. Conclusion Clinicians should address patients’ expectations of treatment and include the patients in decision-making regarding their treatment. Long-term follow-up is essential to ensure that treatment effects have been maintained, and this should include information about patients’ self-reported recovery. Clinical implications This study suggests that patients’ expectations of treatment and perceptions of recovery from PFP may influence prognosis. Clinicians need to collaborate with patients and involve them in decision-making to achieve their goals. An individualised treatment approach is essential to adequately address patients’ experiences, priorities and beliefs.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117019129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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