South African Journal of Physiotherapy最新文献

Background: As patients with hemiplegia have a high risk of falling, it is important to develop a fall rehabilitation plan and/or apply personalised treatment when necessary.

Objectives: We aimed to evaluate the effects of individualised treatment with Computerised Dynamic Posturography (CDP) on balance in patients with and without a history of chronic hemiplegic falls.

Method: Forty patients with hemiplegia (time post-stroke: 8-18 months) between 40 and 70 years of age in the Istanbul Yeniyüzyıl University, Gaziosmanpaşa Hospital participated in our study. The patients were divided into two groups: Group 1, falling history (n = 20) and Group 2, no falling history (n = 20). The patients in both groups were included in a traditional rehabilitation programme for 5 weeks, 5 days a week, for 1 h. The group with a history of falls also received individualised CDP treatment for 20 min, 3 days a week, for 5 weeks. Patients were evaluated with a Sensory Organisation Test (SOT) and a Berg Balance Scale (BBS).

Results: In Group 1, a significant improvement was determined in the after-treatment SOT 5 values compared with the before treatment SOT 5 values (p = 0.022). Significant improvement was found in BBS (p = 0.003) and SOT 6 (p = 0.022) values in Group 2. There was no statistically significant difference in improvement between the two groups (p ≥ 0.05).

Conclusion: Larger samples and longer duration of individualised CDP therapy studies may be required to improve balance with chronic hemiplegia and a history of falls.

Clinical implications: In addition to traditional therapy, individualised CDP treatment may be beneficial for patients with a history of post-stroke falls.

Background: Work-related musculoskeletal disorders (WRMSDs) are a major health issue for low-income countries because of their high prevalence among workers and on account of the scarcity of ergonomic preventative measures in the workplace.

Objectives: To determine the prevalence of WRMSDs among weavers, assess their consequences, and analyse the associated occupational risk factors.

Method: A cross-sectional survey was carried out among 257 handloom weavers using the Nordic questionnaireand the working conditions were assessed through a descriptive analysis using the key indicator method.

Results: The WRMSDs annual prevalence was 85% in all parts of the body, 71% for the low back region, 41% for the shoulders, and 37% for the knees. One quarter of the weavers indicated having stopped work for 1-30 days because of their low back pain (LBP). The prevalence of WRMSDs was associated with the number of hours worked per day, the years of experience, and age. Long working hours, load carrying (> 20 kg - 25 kg), awkward postures, repetitive limb movements, and unfavourable environmental conditions were identified as occupational risk factors.

Conclusion: Work-related musculoskeletal disorders are common among weavers and LBP is the most frequently cited disorder and the primary reason for work interruptions and a decrease of activities. The prevalence of WRMSDs is associated with professional and personal factors. Actions based on ergonomic rules are necessary to prevent WRMSDs.

Clinical implications: Our study highlights the issue of WRMSDs and the need for prevention in the informal sector, which constitutes the major part of economic activity in low-income countries.

[This corrects the article DOI: 10.4102/sajp.v79i1.1847.].

Background: The extension of medicine prescription rights to other healthcare providers was proposed to reduce pharmacotherapeutic service delivery challenges in the South African healthcare sector. The scope of practice of physiotherapists is being reviewed to possibly include prescription rights to promote service delivery.

Objectives: Our study assessed the attitudes of registered South African physiotherapists to the inclusion of prescription rights in their scope of practice, including enablers and challenges, and the drug classes they believe to be most relevant.

Method: A cross-sectional descriptive survey of South African registered physiotherapists was completed using an online questionnaire.

Results: A total of 359 participants completed the questionnaire, where 88.2% agreed that prescribing rights should be introduced, and 87.64% would want to be trained to prescribe. Participants identified several benefits: improved service delivery (91.3%); reduced healthcare delivery costs (89.8%); decreased need for multiple healthcare practitioner consultations (93.2%). Concerns included: inadequate training (55%); increased workload (18.7%); increased insurance premiums against medical liability claims (46.2%). Drugs of relevance included analgesics (95.6%) and bronchodilators (96.0%), while low preference was placed on drugs unrelated to physiotherapy. Chi-square analysis revealed associations between specific drug classes and fields of expertise.

Conclusion: South African physiotherapists agree that prescribing and a limited formulary would benefit their scope of practice; however, educational concerns are evident.

Clinical implications: Findings support the drive to extend the South African physiotherapy scope of practice, however, investigation will be needed to determine the most appropriate way to capacitate future physiotherapists and current graduates should the extension be approved.

Background: Public-private partnership (PPP) for the delivery of health services is known to improve access to healthcare, yet little is known about its utilisation for rehabilitation services, particularly in sub-Saharan Africa (SSA).

Objectives: As a first step to generating evidence to develop a PPP model for physiotherapy service delivery in South Africa, our study mapped and described available research evidence on PPP models for rehabilitation services in the global literature.

Method: The Arksey and O'Malley framework guided our scoping review. Published research on rehabilitation and PPP was searched in five databases from 2000 to August 2022 using keywords, Medical Subject Headings (MeSH) and Boolean terms. Two reviewers independently completed the titles, abstracts and full-text screening of the articles and data extraction from the included articles. A narrative synthesis was conducted, and summaries of the findings are reported.

Results: Nine articles were included from a total of 137 obtained from the evidence searches. Of these, five were from Australia and the others from Hong Kong, Denmark, Bangladesh and the Netherlands. All the included articles showed evidence of PPP models for physiotherapy service delivery.

Conclusion: Our study suggests that PPP models for physiotherapy service delivery exist, particularly in high-income countries (HICs). It also highlights limited research in low- and middle-income countries (LMICs).

Clinical implications: There is a need for primary studies to generate further evidence and develop innovative PPP models for rehabilitation services for the populations who need them most as part of efforts towards improving access to healthcare in LMICs.

Background: Stroke care requires a patient-centred, evidence-based and culturally appropriate approach for better patient clinical outcomes. Quality of life necessitates precise measuring using health-related quality measures that are self-reported and language appropriate. However, most of the self-reported measures were devised in Europe and therefore not considered contextually appropriate in other settings, more so in Africa.

Objectives: Our study aimed to produce a Swahili version by translating and adapting the stroke-specific quality of life (SSQOL) scale among people with stroke in Kenya.

Method: We used a questionnaire translation and cross-cultural adaptation. The pre-validation sample of 36 adult participants was drawn from 40 registered people with stroke, from the Stroke Association of Kenya (SAoK). Quantitative data were collected using both English and Swahili versions of the SSQOL scale. The mean, standard deviation (s.d.) and overall scores were calculated and are presented in tables.

Results: The back translation revealed a few inconsistencies. Minor semantic and equivalence alterations were done in the vision, mood, self-care, upper extremity function and mobility domains by the expert review committee. Respondents indicated that all questions were well-understood and captured. The stroke onset mean age was 53.69 years and the standard deviation was 14.05.

Conclusion: The translated version of the Swahili SSQOL questionnaire is comprehensible and well-adapted to the Swahili-speaking population.

Clinical implication: The SSQOL has the potential to be a useful outcome measure for use in Swahili-speaking patients with stroke.

Background: Osteoarthritis (OA) ranks fifth among all forms of disability worldwide and primary replacement arthroplasty is the treatment of choice in late-stage OA. The current situation in South Africa is that the waiting lists for arthroplasty are extensive with steep costs. According to many studies, physiotherapists can have an impact on this situation by implementing prehabilitation.

Objectives: The aim of our study is to identify the trends in the literature regarding the content of prehabilitation programmes as well as the gaps.

Method: The methodology will involve a literature search and the methodology as proposed by the Joanna Briggs Institute guidelines. The literature searches will be conducted in electronic databases and peer-reviewed journal studies will be included based on predetermined inclusion criteria. Two reviewers will screen all citations and full-text articles and the first author will abstract the data.

Results: The results will be organised into themes and sub-themes, summarised, and reported as a narrative synthesis.

Conclusion: The proposed scoping review will map the breadth of knowledge available on the topic of prehabilitation in terms of exercise prescription principles, pre-operative optimisation and gaps.

Clinical implications: This scoping review is the first part of a study that aims to design a prehabilitation programme suitable for the South African public health user as the demographic and physical characteristics of its health users are unique and dependent on the context.

Background: Community reintegration is one of the ultimate goals of stroke rehabilitation. The increasing burden of stroke morbidity by other non-communicable diseases in Nigeria indicated the need for our study.

Objectives: The authors explored the factors contributing to successful community reintegration among Nigerian stroke survivors.

Method: We conducted an explorative qualitative study design to achieve this aim using in-depth semi-structured interviews with 12-purposively sampled stroke survivors.

Results: Three overarching themes emerged: restriction of participation experienced by stroke survivors, activity limitation as pointers to the quality-of-life experience of stroke survivors and enablers or barriers to community reintegration for stroke survivors. Among the core, sub-themes included incapability of returning to work, difficulty performing domestic activities, social isolation or separation, recreation and leisure time. Enablers of community reintegration included creating a positive mindset, encouragement and social support, while barriers included mobility and speech or language challenges.

Conclusion: Stroke survivors have challenges in returning to work and experience varying levels of activity limitation, which affects their quality of life with identifiable enablers or barriers to community reintegration.

Clinical implications: Stroke survivors with severe functional deficits should be monitored closely and given further rehabilitative assistance to aid functional recovery, thereby facilitating community reintegration.