Thesis (MScPhysio)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Ankle sprains are reportedly the most common lower limb injury amongst active individuals. Aim: The aim of this study was to investigate whether treatment interventions employed by physiotherapists during the first week of functional rehabilitation of an ankle sprain, at primary care level, were aligned with evidence-based guidelines for acute ankle sprains. Design: A descriptive cross-sectional study was conducted. Participants: A total of 91 physiotherapists from the Western Cape Metropole (WCM) completed questionnaires. Method: Physiotherapists' treatment interventions were recorded based on a case study of a typical moderately sprained ankle. According to classification of the West Point Ankle Grading System, a moderate sprain is a partial macroscopic tear of the ligaments with moderate pain, swelling and tenderness with some loss of motion and mild to moderate instability of the joint. Anticipated return to sport is two to six weeks. Relative occurrence of selected interventions during the first week of rehabilitation was calculated. Chi-square tests were used to compare differences between physiotherapists' responses and the recommendations of the practice guidelines. Results: Physiotherapists' overall selections of treatment interventions were in alignment with the "Koninklijk Nederlands Genootschap voor Fysiotherapie" (KNGF) guidelines and correlated positively to the recommendations stipulated by KNGF therein. Physiotherapists indicated many interventions for which good evidence exists: compression, cryotherapy, early mobilisation, and neuromuscular exercises. It is of concern that 49% – 91% (n = 91) physiotherapists indicated some form of manual mobilisations for which there is a lack of evidence, and more than two-thirds indicated the application of an electrotherapy intervention, which is not recommended in the guidelines. Conclusion: Physiotherapists should reconsider interventions for which there is no evidence as this may reduce cost of care, without compromising patient outcomes. / AFRIKAANSE OPSOMMING: Verslae dui daarop dat verstuite enkels die mees algemene besering van die onderste ledemaat van aktiewe persone is. Doelwit: Die doel van hierdie ondersoek was om vas te stel of fisioterapeute in primere gesondheidsorg se keuse van rehabilitasie tegnieke gedurende die eerste week van funksionele rehabilitasie na 'n enkel besering, op koers is met bewysgebaseerde kliniese riglyne in die hantering van akute enkel beserings. Ontwerp: 'n Beskrywende deursnit ondersoek is geloods. Deelnemers: 'n Vooraf opgestelde vraelys is deur 91 fisioterapeute in die Weskaapse metropool voltooi. Metodiek: 'n Gevalle studie is aangebied van 'n tipiese matige verstuite enkel. Die respondent moes hulle tegnieke in die hantering van die geval aandui. Volgens die klassifikasie van die “West Point Grading System” word so 'n verstuiting gekenmerk deur makroskopiese gedeeltelike skeur van die enkel ligamente, matige pyn, swelsel en tasteerheid van die area. Dit gaan gepaard met 'n effense verlies van beweging en stabiliteit van die gewrig. Die prognose vir so 'n besering om na sport terug te keer is om en by twee tot ses weke. Die insidensie van aanwending van geselekteerde metodes van behandeling gedurende die eerste week en die verhouding met die vooraf geselekteerde behandelings riglyne opgestel deur die “Koninklijk Nederlands Genootschap voor Fysiotherapie” (KNGF) is bereken en ontleed. Die “Chi-square” toets is gebruik om die verskil te bereken tussen die respons van die Fisioterapeute en die aanbevelings van die kliniese riglyne. Resultate: Oorkoepelend is die keuses van behandelings tegnieke deur die fisioterapeute in lyn met die riglyne van die 'Koninklijk Nederlands Genootschap voor Fysiotherapie' (KNGF). Verskeie sinvolle behandelings is gekies waarvoor daar positiewe aanduidings was, byvoorbeeld: lokale kompressie, ys terapie, en oefeninge. Dit is egter kommerwekkend dat 49 – 91% (n=91) van die deelnemers 'n manuele tegniek ingesluit het waar daar tans gebrekkige aanduidings voor bestaan. Verder, het meer as twee derdes van die fisioterapeute aangedui dat hulle elektroterapie sou gebruik wat nie in riglyne aanbeveel word nie. Gevolgtrekking: Fisioterapeute moet die gebruik van tegnieke waarvoor daar nie duidelike bewyse in die literatuur bestaan nie, heroorweeg, want dit mag die koste van behandeling verminder, sonder om die positiewe resultate van herstel, negatief te beinvloed.

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction: In the intensive care unit population, approximately 40% of patients require mechanical ventilation and 20-25% of these patients will encounter difficulties in the discontinuation of mechanical ventilation. As mechanical ventilation affects the diaphragm, a better understanding of the structural and functional changes of the diaphragm is warranted. Method: A scoping review was done to determine whether a relationship between diaphragm thickness, diaphragm strength and diaphragm endurance had been established. Seven databases were searched using a specific search strategy. Papers were identified based on pre-defined inclusion criteria. Data was extracted by the primary investigator (PI) into a self-developed excel spreadsheet. Criteria were developed for a more focused review to inform the planning of a primary study. The primary study investigated the relationship between diaphragm thickness, diaphragm strength and diaphragm endurance in young, healthy individuals. A sample of convenience was used; included healthy individuals (18-24); three activity-levels (sedentary; endurance- and strength related sporting activities); stratified for gender and BMI. Measurements included: Sonographic measurement of diaphragm thickness; mouth pressure manometer measurements for diaphragmatic strength; and fatigue resistance index as a measure of endurance. Participants were instructed to breathe through a pressure threshold device at 60% of PImax until task failure. The fatigue resistance index was calculated as PImax final/PImax initial. Intra-rater reliability was established and testing procedures standardised a priori. Results: 405 full texts were retrieved and assessed for inclusion into the review. Papers identified the evaluation of diaphragm function in a variety of populations. 23 papers were included in the focused review. Six papers were published on diaphragm thickness, six on diaphragm strength and eleven on diaphragm endurance. No papers identified the correlation between diaphragm thickness, diaphragm strength and diaphragm endurance. 55 subjects, males and females, were recruited for the primary study. Groups were similar at baseline with regards to gender, age and BMI. The mean age of the sample was 21.16 years (SD = 1.55), with a mean body mass index (BMI) of 25.43 kg/m2 (SD = 3.70). A moderate positive correlation was established between diaphragm thickness and diaphragm strength measurements (r = 0.52; r2 = 0.27; p < 0.01). Diaphragm thickness was not correlated with diaphragm endurance (r = -0.15; r2 = 0.02; p = 0.29). No relationship was found between the strength of the diaphragm and the endurance of the diaphragm (r= -0.19; r2 = 0.04; p= 0.16). Conclusion: Guidelines for the measurement of diaphragm function do exist, but they are not adhered to by the majority of studies. Study procedures are inconsistently reported and this may affect the reproducibility of techniques in future studies. We further conclude that a correlation exists between diaphragm thickness and diaphragm strength. The use of ultrasound to measure diaphragm thickness proved to be a reliable technology and gave a moderate indication of the strength of the diaphragm. This technology may help clinicians to detect and monitor dysfunction of the diaphragm in the early stages of admission to the acute setting. / AFRIKAANSE OPSOMMING: Inleiding: Ongeveer 40% van pasiente wat in intensiewe sorgeenheid behandel word, benodig intubasie en meganiese ventilasie. Tot 25% van hierdie pasiënte sal probleme ondervind in die staking van meganiese ventilasie. Meganiese ventilasie beïnvloed die diafragma, daarom word n beter begrip van die strukturele en funksionele veranderinge van die diafragma benodig. Metode: 'n Literatuur oorsig is gedoen om te bepaal of daar 'n verhouding bestaan tussen die dikte, krag en uithouvermoë van die diafragma. Sewe databasisse is deurgesoek aan die hand van spesifieke databasis gedefinieerde soektog strategie. Relevante artikels is geïdentifiseer aan die hand van pre-gedefinieerde insluiting kriteria. Data is onttrek en in ‘n self-ontwikkelde datablad opgesom deur die primêre ondersoeker (PI). Hierdie inligting is gebruik in die beplanning van ‘n primêre studie. Die doel van die primêre studie was om die verhouding tussen die diafragma dikte, krag en uithouvermoë in jong, gesonde individue te ondersoek. ‘n Gerieflikheids steekproef is gebruik; insluitend gesonde individue (18-24); drie aktiwiteits vlakke (passief; uithouvermoë- en krag verwante sportaktiwiteite) en breë spektrum vir geslag en ligaamsbou (BMI). Metings ingesluit: sonografiese meting van die diafragma se dikte; monddruk manometer metings vir diafragmatiese krag en ‘n moegheid/weerstand indeks as maatstaf van diafragmatiese uithouvermoë. Deelnemers is opdrag gegee om asem te haal deur toestel met druk maksimum gestel 60% van PImax, tot mislukking. Die moegheid/weerstand indeks is bereken as PImax finale / PImax oorspronlik. Intra-meter betroubaarheid is bepaal en toets prosedures is gestandaardiseer voordat data ingesamel is. Resultate: 405 vol teks artikels is uitgelig vir insluiting in die literatuur oorsig. Diafragmatiese funksie is ge-evalueer in 'n verskeidenheid bevolkings. Drie en twintig artikels is in die finale oorsig ingesluit. Ses artikels wat diafragma dikte evalueer, ses wat diafragmatiese krag evalueer en elf wat die diafragma se uithouvermoë evalueer is ingesluit in die oorsig. Geen van die artikels uitgelig het ‘n ooreenkoms tussen diafragma dikte, diafragma krag en diafragma uithouvermoë geïdentifiseer nie. 55 deelnemers is gewerf vir die primêre studie. Groepe was soortgelyk by basislyn met betrekking tot geslag, ouderdom en BMI. Die gemiddelde ouderdom van die toetsgroep was 21.16 jaar (SD=1.55), met 'n gemiddelde BMI van 25.43 kg/m2 (SD = 3.70). ‘n Middelmatige positiewe verhouding is waargeneem tussen diafragma dikte en krag (r = 0.52; r2 = 0.27; p < 0.01). Geen verhouding is gevind tussen diafragma dikte en uithouvermoë nie (r= -0.15; r2 = 0.02; p = 0.29). Daar is ook geen verhouding waargeneem tussen diafragma krag en diafragma uithouvermoë nie. (r= 0.19; r2 = 0.04; p = 0.16). Gevolgtrekking: Daar bestaan wel riglyne vir die meting van die diafragma se funksie, maar in die meerderheid van studies word dit nie nagekom nie. Studie prosedures is nie konsekwent weergegee nie en dit kan die resultate van tegnieke beinvloed in toekomende studies. ‘n Matige sterk verhouding is waargeneem tussen diafragmatiese dikte en krag. Die gebruik van ultraklank om die diafragma se dikte te meet is betroubare tegnologie en kan n redelike aanduiding gee oor die krag van die diafragma. Hierdie tegnologie kan praktisyne help om enige disfunksie van die diafragma te identifiseer en te monitor in die vroeë stadiums van toelating tot die akute omgewing.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: On average one in three patients following lumbar surgery (LS) for radiculopathy experience persistent pain and disability following surgery. No perioperative treatments have shown any ability to decrease this persistent pain and disability. In another challenging low back pain (LBP) population, chronic LBP, pain education focusing on the neurobiology and neurophysiology of pain, has shown an ability to reduce reported pain and disability. The purpose of this research study was to develop and test a preoperative neuroscience education program for LS and determine its effect on pain and disability following LS. Research Design and Methods: After a series of studies, a newly designed preoperative neuroscience educational tool (PNET) was developed. Eligible patients scheduled for LS for radiculopathy participated in a multi-center study where they were randomized to either receive usual care (preoperative education), or a combination of usual care plus one session covering the content of the PNET, as delivered by a physiotherapist in a one-on-one verbal session. Prior to LS, and one, three and six months after LS, 67 patients completed a series of self-report outcome measures consisting of LBP and leg pain rating (Numeric Rating Scale), function (Oswestry Disability Index), fear avoidance (Fear Avoidance Beliefs Questionnaire), pain catastrophization (Pain Catastrophization Scale), pain knowledge (Pain Neurophysiology Questionnaire), various beliefs and experiences related to LS (Likert Scale), and post-operative utilization of healthcare (Utilization of Healthcare Questionnaire). Results: At six month follow up there were no statistical difference (p <0.05) between the experimental and control groups in regards to the primary outcome measures of function (p = 0.296), LBP (p = 0.077) and leg pain (p = 0.074). The experimental group scored significantly better on various questions regarding beliefs and experiences having undergone LS, compared to the control group indicating a more positive surgical experience. Analysis of healthcare utilization showed that patients who received the preoperative neuroscience educational program had dramatically less health care utilization (medical tests and treatments) in the six months following LS (p = 0.001), resulting in a 38% savings in healthcare cost. Conclusion: The addition of a preoperative neuroscience educational program to usual care for LS for radiculopathy resulted in a profound behavioral change leading to a more positive surgical experience, decreased healthcare utilization and resultant savings, despite persistent pain and disability. / AFRIKAANSE OPSOMMING: Agtergrond: Gemiddeld een uit elke drie pasiënte ervaar volgehoue pyn en gestremdheid na lumbale chirurgie (LC) vir radikulopatie. Geen peri-operatiewe behandeling het al getoon dat dit die vermoe het om hierdie volgehoue pyn en gestremdheid te verminder nie. In nog 'n uitdagende lae rug pynbevolking, naamlik chroniese lae rugpyn, het pyn-onderrig, wat fokus op die neurobiologie en neurofisiologie van pyn, getoon dat dit kan lei tot verminderde rapportering van pyn en gestremdheid. Die doel van hierdie navorsingstudie was om 'n preoperatiewe neuro-onderrig program vir lumbale chirurgie te ontwikkel en te toets, en die uitwerking daarvan op pyn en gestremdheid na LC te bepaal. Navorsingsontwerp en Metodiek: Na 'n reeks studies is 'n nuwe preoperatiewe neuroonderrig hulpmiddel (PNET) ontwikkel. Geskikte pasiënte wat geskeduleer was vir LC weens radikulopatie, het deelgeneem aan 'n veelvuldige- sentrum studie. Deelnemers is lukraak in een van twee groepe ingedeel om of gewone sorg (preoperatiewe onderrig), of 'n kombinasie van gewone sorg met een sessie wat die inhoud van die PNET gedek het. Laasgenoemde sessie is aangebied deur 'n fisioterapeut in 'n een-tot-een verbale sessie. Voor die LC, en een, drie en ses maande na LC, het 67 pasiënte 'n reeks van selfverslaggewende uitkoms metings voltooi, wat insluit: Lae Rug- en beenpyn gradering („Numeric Pain Rating Scale‟), Funksie („Oswestry Disability Index‟), Vrees-vermyding („Fear Avoidance Beliefs Questionnaire‟), Pyn-katastrofering („Pain Catastrophization Scale‟), Pynkennis („Pain Neurophysiology Questionnaire‟), verskeie oortuigings en ervarings wat verband hou met LC („Likert Scale‟), en postoperatiewe Gesondheidsorg-benutting („Utilization of Healthcare Questionnaire‟). Resultate: Tydens die ses-maande-opvolg was daar geen statistiese verskil (p <0,05) tussen die eksperimentele- en kontrolegroepe met betrekking tot die primêre uitkoms metings van Funksie (p = 0,296), Lae rug Pyn (p = 0.077) en beenpyn (p = 0,074), nie. Die eksperimentele-groep het betekenisvol beter gevaar met verskeie vrae oor oortuiging en ervarings na afloop van LC. Ontleding van gesondheidsorg benutting, het getoon dat pasiënte wie die preoperatiewe neuro-onderrig program ontvang het, dramaties minder Gesondheidsorg (mediese toetse en behandelings) in die ses maande na LC benodig het, (p = 0,001), wat gelei het tot 'n 38% besparing in gesondheidsorgkoste. Gevolgtrekking: Die byvoeging van 'n preoperatiewe neuro-onderrig program, tot die gewone-sorg vir LC weens radikulopatie, het „n noemenswaardige gedragsverandering veroorsaak wat tot n meer positiewe chirurgiese ervaring, verminderde gesondheidsorg benutting en finansiele besparing gelei het, ten spyte van volgehoue pyn en gestremdheid.

Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2006. / Postoperative rehabilitation programs have shown little efficacy in decreasing pain and disability in short and long term outcomes for lumbar discectomy. Preoperative education in other disciplines of medicine and physiotherapy has shown to decrease pain and disability postoperatively. No studies to date have been published on preoperative education for spinal lumbar surgery patients with radiculopathy. Objective: The objective of this study was to contribute towards further understanding of the preoperative educational requirements of patients undergoing lumbar surgery for lumbar radiculopthy. Method Two surveys were conducted. A new questionnaire was developed for patients to determine their preoperative educational needs regarding spinal surgery due to radiculopathy. These questionnaires were administered at 4-weeks postoperatively to patients from four spinal surgeons in the Greater Kansas City metropolitan area of the US. A second physiotherapist survey was developed and distributed to physiotherapists registered with the Kansas and Missouri State Boards who were actively involved in treating spinal surgery patients in Kansas and Missouri. The data collected from completed questionnaires were analyzed using descriptive and inferential statistical tests....

Thesis (MScPhysio(Interdisciplinary Health Sciences. Physiotherapy))--University of Stellenbosch, 2005. / Objectives: This study forms part of a baseline study conducted on patients admitted to an adult surgical ICU between June and October 2003. The survival rate and health related quality of life (HRQoL) of patients 12months following ICU discharge was determined. The correlation of selected demographic and ICU variables to survival and HRQoL was determined. Design: Prospective observational cohort study. Setting: Tenbed closed public tertiary adult surgical ICU. Patients: 180 subjects obtained from a previous baseline study. Measurements: The baseline study provided the demographic data and ICU variables. Survival rate was determined from a Kaplan Meier survival curve. A self-developed questionnaire was used to obtain other selected variables for comparison. A modified Short-Form 36 version 2 (SF-36v2) was use to measure HRQoL perceptions of patients. Results: The survival rate was 62% at 12 months following ICU admission. None of the selected variables were significantly correlated to the long-term survival outcome except for APACHE II which was negatively correlated to this outcome (p<0.01). Forty-six subjects took part in the HRQoL study. The mean HRQoL scores ranged between 43% and 53% for each of the SF-36 HRQoL domains. The physical functioning (43.5%), role play (44.5%) and role emotion (43.1%) domains had the lowest scores. APACHE II had a significantly negative correlation to the physical functioning domain of HRQoL (p=0.02). Age was positively correlated to social functioning (p<0.01) and role emotion (p=0.03). Patients employed after ICU had significantly higher scores for general health (p<0.01) than those who were not. Patients unsure of their TB status and HIV status had significantly lower scores in general health (p=0.02) and role emotion (p=0.05) respectively. ICU length of stay was negatively correlated to role play (p=0.05) and role emotion (p<0.01). Intubation period was negatively correlated to general health (p=0.04). Conclusion: APACHE II was the only variable significantly correlated to both long-term survival and the physical functioning domain of HRQoL. Although the long-term survival was comparable to that of international ICU populations the HRQoL outcomes were slightly lower. Similar to international studies and a South African study evaluating the HRQoL of aids sufferers and police, the current ICU population presented more limitation in the physical functioning, role play and role emotion domains of HRQoL.

Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008. / The Western Cape Education Department initiated a project that aims to provide all the learners from the province with computer access and to promote computer use in schools. Prolonged sitting in front of computers and psychosocial factors have been associated with musculoskeletal symptoms internationally. However, the impact of computer use on musculoskeletal pain among South African high school learners is yet to be determined. Objective The objective of the study was to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain in grade ten high school learners working on desktop computers. Study design An observational analytical study was performed on a sample of 104 asymptomatic high school learners. Methodology Six high schools in the Western Cape metropole were randomly selected 322 grade ten learners who are using desktop computers, were screened for upper quadrant musculoskeletal pain. Measurements at baseline were taken of the 104 asymptomatic learners, 49 girls and 55 boys. The sitting postural alignment was measured by using the Portable Posture Analysis Method (PPAM), which measured head tilt; cervical angle; shoulder pro- and retraction angle and thoracic angle in the sagittal plane. Depression and anxiety were described by using the Beck Depression Inventory (BDI) and the Multidimensional Anxiety Scale for Children (MASC) respectively. The exposure to computer use was described in terms of duration and frequency of daily and weekly computer use. At three and six months post baseline, the onset and area of upper quadrant musculoskeletal pain was determined by using the Computer Usage Questionnaire. Results After six months, 27 of the 104 learners developed upper quadrant musculoskeletal pain due to seated or computer-related activities. There was no difference in computer exposure between the learners who developed upper quadrant musculoskeletal pain symptoms and the learners who remained asymptomatic. An extreme cervical angle (<34.75° or >43.95°; OR 2.6; 95% CI: 1.0-6.7) and a combination of extreme cervical and thoracic angle (<63.1° or >71.1°; OR 2.19; 95% CI: 1.0-5.6) were significant postural risk factors for the development of upper quadrant musculoskeletal pain. There was a tendency for boys to be at a greater risk for upper quadrant musculoskeletal pain than the girls (OR 1.94; 95% CI: 0.9-4.9). Weight greater than 54.15kg and a depression score greater than 11 was found to be significantly associated with a poor posture (OR 3.1; 95% CI: 1.0-9.7; OR 1.02; 95% CI: 1.0-1.1). Discussion and conclusion The study concluded that poor posture, relating to extreme cervical and thoracic angles, is a risk factor for the development of upper quadrant musculoskeletal pain in high school learners working on desktop computers. South African boys were at a greater risk of developing upper quadrant musculoskeletal pain than the girls. However the study found no causal relationship between depression, anxiety and upper quadrant musculoskeletal pain among South African high school learners and computer usage.

Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007. / Objective The objective of this study was to establish the reliability and validity of a Portable Posture Analysis Method (PPAM). Design The design for the reliability section was a repeated measures observational study and the design for the validity section was a correlation study. Background The prevalence of spinal pain among high school learners is high (Murphy et al, 2002). It is also notable that the prevalence of back pain increases across the teenage years (Grimmer & Williams 2000, Burton et al 1996). In South Africa, the preliminary findings of a study conducted by a Physiotherapy masters candidate (Ms L Smith: ethics nr. N05/09/164) indicates that about 74% of high school learners in Cape Town complained of musculoskeletal pain. Posture has been identified by some researchers to be a primary predictor of the development of spinal, particularly upper quadrant pain among computer users (NIOSH 1997, Vieira et al 2004). Measurement of posture poses a real challenge to researchers wanting to accurately evaluate posture in research projects. Considering the practical implications in measuring posture, the validity and reliability of posture measurement are often reported to be poor. Many of these methods of indirect assessment of working posture have been reported on in the literature. These measures include; the goniometer, inclinometer, flexible electrogoniometer, flexicurve and photography (Harrison et al 2005, Christensen 1999, Nitschke et al 1999, Chen & Lee 1997). ...

Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007. / AIM: The aim of this study was threefold. Firstly to determine the effect of passive thoracic flexion-rotation (PTFR) movement on the total static compliance of the respiratory system, tidal volume, respiratory rate and plateau pressure. Secondly, to identify the interventions used by physiotherapists to influence compliance and thirdly to compare the effects of these interventions. DESIGN: A one group, pre-test-post-test physiological study and a systematic review of the literature were performed. METHOD: A randomised sample consisting of 18 intubated and ventilated subjects of varying periods of ventilation and various conditions was obtained. The interventions used included tactile stimulation and PTFR movements. Subjects acted as their own controls. Objective variables namely tidal volume, respiratory rate and plateau pressure were recorded by a research assistant. These measurements were taken immediately following the intervention and repeated again three times in an interval of 20 minutes after the movement was discontinued. Total static compliance of the respiratory system was calculated as tidal volume divided by the difference between plateau pressure and positive end-expiratory pressure. The search strategy for the systematic review included the searching of five databases, a secondary search (pearling) and a hand search. Two independent reviewers agreed on the inclusion of articles and their methodological quality. A critical review form (Law et al 1998) was used for scoring methodological quality and a hierarchy of evidence for allocating the level of evidence of each study. Inclusion criteria were experimental studies, written in English and published after January 1995. Participants were intubated, ventilated humans, over the age of 18.

Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008. / The prevalence of low back pain (LBP) in United Arab Emirates (UAE) is estimated to be about 57% in males and 64% in females. Low back pain is commonly treated by primary care physicians and physiotherapists in the UAE. are increasingly used for clinical assessment, to demonstrate and reflect on the effectiveness of an intervention. Oswestry Disability Index (ODI) is Self-reported outcome measure that widely used and recommended for LBP. ODI Arabic version was developed and validated in women population. To date no UAE Arabic version of the ODI exists which has been cross-culturally adapted, validated and published in the peer-reviewed literature. . Objective The objectives are, to cross-culturally adapt the Arabic version of the ODI developed in Tunisia to devise a pre-final ODI-UAE Arabic version; to pre-test the pre-final ODI-UAE Arabic version in a target group of patients to devise the final ODI-UAE Arabic version; and to determine the reliability and construct validity of the final ODI-UAE Arabic version. Study design Culture adaptation, reliability and validity testing. Methodology The cross culture adaptation of the ODI Arabic version developed in Tunisia was performed in accordance with the published guidelines. For reliability 108 clients of UAE nationals with LBP were consecutively selected and completed the final ODI-UAE Arabic version, at baseline and 48 hours, and test–retest reliability and internal consistency were calculated. For validity 108 completed the final ODI-UAE Arabic version, VAS, and the Squat test at baseline and 4 weeks follow up; construct validity, items frequency response, response to change and floor and ceiling were evaluated. Results The ODI-UAE (9 questions) had high level of test–retest with ICC of 0.99; the mean at baseline and 48 hours was (0.68); Cronbach's alpha was 0.99. Strong positive correlation with VAS r =>0.70 (p = <0.01), and moderate inverse correlation between ODI and Squat r =>0.65 (p = <0.01).The results of the maximum frequency response were less than 80% for the entire 9 question. The effect size and the SRM of ODI-UAE, VAS and Squat test at baseline and 4 weeks were identical comparable the effect size, were 1.66, 1.85, and 1.59 respectively. ODI-UAE demonstrated absence of floor and ceiling effect; less than 15% of the respondents achieved the lowest or highest possible score respectively (0 -11.5) or (87-100%). Conclusion The ODI-UAE Arabic version is an easy to understand, reliable and valid condition-specific outcome measure for the measurement of the limitation of functional ability cause by LBP in the United Arab Emirates national population.

Thesis (MScPhysio (Interdisciplinary Health Sciences. Physiotherapy))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Background: Children who lack the motor coordination to perform the tasks that have usually been acquired at their age, given normal intellectual ability and the absence of other neurological disorders, are classified as having Developmental Coordination Disorder (DCD) according to DSMIV. Limited professional resources prohibit individual therapy and these children are being treated in “gross motor groups” regardless of the fact that this has limited proven efficacy. This study aims to investigate whether group exercise physiotherapy does improve the gross motor function of children with DCD aged six to ten years old. Methods: Thirty-nine children were assessed at pre and post intervention on the Movement Assessment Battery for Children (M-ABC) as well as the Perceived Efficacy and Goal Setting (PEGS) questionnaire by a blinded research assistant. They were randomly allocated to either a control (N=19) or an intervention group (N=20). The intervention group was then further subdivided into groups of four to six per group to attend group exercise sessions of 30 – 45 minutes three times per week. Group exercises were aimed at improving manual dexterity, ball skills and balance by incorporating aerobic exercises, strengthening exercises, coordination as well as task specific activities. Results: There was a significant increase (p=.028) in the total scores tested by the experimental group on the M-ABC after the eight week intervention. Manual dexterity skills had improved significantly (p=.035). There was a trend for ball skills to improve (p=.088) but no improvement was recorded for static or dynamic balance post intervention. PEGS results indicated that subjects considered themselves as very competent regardless of their abilities. Conclusions: The results of this study support the hypothesis that an eight week group exercise program can improve the gross motor skills of children with DCD. It would seem that implementing such an intervention is a viable option, especially where resources limit the availability of one to one therapy. / AFRIKAANSE OPSOMMING: Agtergrond: Kinders wat „n gebrek aan motoriese koördinasie het om ouderdoms verwante take te verrig, gegewe dat hulle normale intellektuele vermoëns het en die afwesigheid van ander neorologiese abnormaliteite, word geklassifiseer as “Developmental Coordination Disorder” (DCD) volgens die DSM IV. Beperkte professionele menslike hulpbronne voorkom individele terapie en hierdie kinders word gewoonlik behandel in grofmotoriese groepe, ongeag dat daar min bewyse is dat dit „n effektiewe behandelings metode is. Die doel van hierdie studie is om vas te stel of „n fisioterapie groepsoefenprogram „n effektiewe behandelingsvorm is om die grofmotoriese vaardighede in ses tot tienjarige primêre skool kinders, met „n diagnose van DCD, verbeter. Metodes: Nege-en-dertig kinders was geassesseer met die “Movement Assessment Battery for Children” (M-ABC) en die “Perceived Efficacy and Goal Setting” (PEGS) vraelys deur „n geblinde navorsingsassistent. Hulle is in twee groepe nl kontrole groep wat nie intervensie gekry het nie (N=19) en „n eksperimentele groep (N=20)verdeel deur eenvoudige ewekansige toewysing. Die eksperimentele groep was verder onderverdeel in groepe van vier tot ses om groepsoefeningsessies by te woon drie keer „n week vir 30 tot 45 minute. Die doel van die groepsoefeninge was om die volgende areas te verbeter: handvaardigheid, balvaardigheid en balans deur die inkorporasie van balansaktiwiteite, spierversterkingsoefeninge, koördinasie sowel as taak spesifieke aktiwiteite. Die deelnemers was weer geassesseer met die Movement-ABC en die PEGS na die agt weke lange intervensie program. Resultate: Daar was 'n beduidende toename (p=.028) in die algehele telling deur die eksperimentele groep op die M-ABC na die agt weke deelname. Handvaardigheid het beduidend verbeter (p=.035). Daar was „n tendens vir balvaardighede om te verbeter (p=0.88), maar geen verbetering was aangedui vir balans na die ingryping nie. Die PEGS resultate was moeilik om te interpreteer aangesien die deelnemers hulself as baie vaardig gesien het ten spyte van hulle vermoëns. Gevolgtrekking: Die resultate van hierdie studie ondersteun die hipotese dat 'n doelgerigte groepsoefeningsprogram wel die grofmotoriese vaardighede van kinders met „n diagnose van DCD verbeter. Fisioterapeute kan 'n groepsofeningsprogram met vertroue implementeer waar 'n tekort aan menslike hulpbronne een tot een terapie beperk.