Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007. / Study Aim: To describe the profile and selected outcomes of CABG patients admitted in the Cape metropolitan area. Design: A prospective descriptive study design with a multicentre observational approach was followed. Method: All patients undergoing isolated CABG surgery, whether elective or emergency, during a three-month period (15 August–15 November 2005) were included in the study. Demographic data, pre-operative medical status, intra-operative, as well as post-operative information were collected using a self-designed structured initial assessment form (SIA). Means and standard deviations were calculated where applicable. Relationships between different variables were analyzed by means of: ANOVA, correlations, linear and logistic regressions. Where it appeared that the ANOVA assumptions were violated, non-parametric bootstrap techniques were employed. Results: Two hundred and forty five patients were admitted to the seven hospitals which provide CABG surgery in the Cape metropolitan area in the allotted period. The profile of patients admitted to private and state institutions were similar. The mean age of the sample was 60 (±10). The mean LOS of the total cohort was 12 (±5.5) days, with patients in the state hospitals staying longer 13.4 days (± 7.1). Patients who were older than 60 were twice as likely to have a LOS >12days (odds ratio = 2.49; 95% confidence interval = 1.33 to 4.65). The development of a pleural effusion or pneumothorax was associated with an increased LOS (p<0.01). At least one PPC was reported in 65% of the population. A mortality rate of only 3% was reported. Conclusion: Patients in this cohort were younger than in developed countries. An age greater than 60 years was a predictor of an LOS >12days in the current cohort. Patients were most likely to develop a PPC on day three after CABG surgery. Physiotherapeutic intervention, if any, would be well aimed at those patients older than 60 years of age. Screening of patients in the first three post-operative days for the development of PPCs is also advised.

Thesis (MScPhysio)--Stellenbosch University, 2004 / ENGLISH ABSTRACT: Background: Children with Attention Deficit Hyperactivity Disorder (ADHD) have been reported to have motor proficiency problems. Few studies have established the extent of these motor problems and few studies investigate both gross and fine motor proficiency. The studies which do investigate motor proficiency, often also include other aspects, for example physical fitness, grip strength or kinaesthesia. It is important to be able to identify motor proficiency deficit in this population group early for appropriate intervention to be as effective as possible. The first step in this process is to identify the areas of motor proficiency deficits experienced by these children. Study Design: A cross-sectional descriptive study was done. Objective: The main aim of this study was to establish if children with ADHD demonstrate motor proficiency problems. A second aim was to identify in which areas of motor proficiency they have the most problems. Method: A sample of 28 boys and 9 girls (n = 37) children with ADHD, between the ages of six and ten, were identified by the medical practitioners at four school clinics in the Cape Metropole. The Bruininks-Oseretsky Test of Motor Proficiency was used to test the children. The demographic and other factors that could have affected the motor proficiency in these children were recorded. Results: The range, mean and standard deviation were calculated for all the subtests and the three composite scores. Eighty-one percent of children scored below the expected norm on the Battery Composite Score (20th percentile) with the difference in age equivalent scores being significantly different (p < 0.01), the Gross Motor Composite Score (20th percentile and p < 0.01) and on the Running Speed and Agility Subtest (p < 0.01), the Balance Subtest (p < 0.01), Strength Subtest (p < 0.01) and the Upper Limb Coordination Subtest (p < 0.01). No significant motor proficiency problems were identified in the Fine Motor Composite Score (35th percentile), the Bilateral Coordination Subtest, the Response Speed Subtest, the Visual motor Subtest or the Visual Motor Control Subtest. Conclusions: These results support the literature in so far as motor proficiency deficits are present in children with ADHD, which in turn supports the need for early identification of these problems. / AFRIKAANSE OPSOMMING: Agergrond: Kinders met Aandag Afleibaarheid Hiperaktiwiteit Sindroom (ADHD) demonstreer probleme met motoriese vaardighede. 'n Paar studies is gedoen om dié bepaalde motoriese vaardighede te bepaal en sommige studies kombineer die ondersoek met ander aspekte van motoriese vaardigheid soos, fiksheid, greep sterkte of kinestesie. Dit is belangrik om die tekortkominge vroeg te identifiseer om effektiewe intervensie so vroeg moontlik te inisieer. Die eerste stap is om die spesifieke vaardighede waarmee hierdie groep kinders probleme ondervind, te identifiseer. Studie: 'n Dwarssnit beskrywende studie is uitgevoer. Doel: Die doel van die studie was om te bepaal of kinders met ADHD motoriese probleme het en of daar spesifieke aspekte van motoriese vaardigheid is waar hulle tekortkominge toon. Metodiek: 'n Steekproef van 28 seuns en 9 dogters (n = 37) tussen die ouderdomme van ses tot tien jaar, met ADHD is deur die mediese praktisyns geïdentifiseer, en getoets. Die Bruininks- Oseretsky Toets vir Motoriese Vaardigheid is gebruik. Enige faktore wat motoriese vaardigheid kon beïnvloed is gedokumenteer. Resultate: Die reikwydte, gemiddelde en standaard afwyking is bereken vir al die sub-toetse en die drie saamgestelde tellings. Een en tagtig persent van die kinders het tellings onder die verwagte norm behaal vir die Saamgestelde Telling van die Battery van toetse (20ste persentiel) met die verskil in ouderdomtelling beduidend verskillend (p<O.01).Die Growwe Motoriese Saamgesteldetelling was (20ste persentiel en p<O.01), die Hardloopspoed- en Ratsheidsubtoets (p<O.01), die Balanssubtoets (p<O.01), Kragsubtoets (p<O.01) en die Boonste Ledemaat Koordinasie-subtoets (p<O.01). Geen beduidende tekorte is deur middel van die Saamgestelde Fyn Motoriese Vaardigheidstoetse (3Sste persentiel), die Bilaterale Koordinasiesubtoets, die Reaksiespoed-subtoets, die Visuele Motoriese subtoets of die Visuele Motoriese Beheer-subtoets gevind nie. Gevolgtrekkings: Die resultate ondersteun die bevindinge uit die literatuur rakende die probleme wat kinders met ADHD met motoriese vaadigheid ervaar en ondersteun die behoefte vir vroeë identifisering om effektiewe intervensie so vroeg moontlik te begin.

Thesis (MSc) -- University of Stellenbosch, 2002. / ENGLISH ABSTRACT: South Africa is a multicultural, multiracial and multilingual nation ("the rainbow nation") with different traditions, values and cultural practices. Due to this diversity there are different belief systems, which give rise to different attitudes and practices towards various health issues such as disability, which in turn, have an impact on the rehabilitation of people with disability. The purpose of this study is to investigate the knowledge, attitudes and cultural beliefs towards disability and to identify the commonalities and differences of three broad cultural groups of South Africa (Blacks, Coloureds and Whites), and to determine their influence on the rehabilitation of disabled people in the Cape Town area. Sixty respondents (20 Blacks, 20 Coloureds and 20 Whites) were interviewed utilizing the knowledge, attitude and belief (KAB) survey in the form of a structured interview. Both probability and non-probability (systematic and purposive) sampling were used. The study was carried out using both quantitative and qualitative methods. The results showed that Whites and Colored generally had a fairly good knowledge of disability and its causes, acquired while they were young, whereas Blacks had a more superficial knowledge of disability, which was only acquired after the birth of a disabled child. The results also revealed that quantitatively all the cultural groups held positive attitudes towards the rehabilitation, education, marriage, childbearing and employment of people with disability. Attitudes towards the stigma attached to being disabled were also encouraging. In contrast, the qualitative data showed disparities between the three cultural groups in attitudes towards rehabilitation, education and marriage. Although rehabilitation is considered an important aspect to disabled people and their families, some Blacks experience problems in transporting their children to centres where rehabilitation services are offered. Socio-economic factors also have a bearing on this. The results revealed a general lack of awareness of disability among school children and teachers in Black and the Coloured schools, which may make it difficult for disabled children to be integrated into mainstream schooling. Marriage and childbearing was regarded as a way of increasing the support base of individuals with disability in the Black group, while the Coloured and White groups viewed marriage as a way of enjoying life and having children a matter of individual choice. Concerning employment and the promotion of people with disability, all three groups believed that disabled people have a right to be employed and earn a salary. In the area of beliefs, the results showed that the Black group blamed disability on witchcraft and that they consult health professionals, folk healers and look to God for healing. Most of the Whites and Coloureds believed that disability is a result of natural causes, human error or the will of God. There is an uneven geographic distribution of information about disability. Cultural beliefs towards disability may delay or hinder early identification of children and intervention. Two main recommendations are made arising from these results. Firstly, health professionals should know and understand the culture, values, beliefs and expectations of their clients and, more importantly, bring services to the recipients in their own familiar environment, culture and community, via the CBR model. Secondly, I recommend that an evaluation of knowledge and attitudes towards disability should be done in schools, where the disability awareness has been raised by some NGOs as compared with those where no intervention has taken place. A survey of this kind should be done in all the provinces of South Africa. The findings from this research thus have very serious implications for the provision of inclusive education and quality rehabilitation services for all the disabled children of South Africa. / AFRIKAANSE OPSOMMING: Suid-Afrika het 'n multi-kulturele, veelrassige en veeltalige bevolking ("die reënboog nasie") met uiteenlopende tradisies, waardes en kulturele praktyke. Hierdie diversiteit gee aanleiding tot verskillende sienswyses en praktyke met betrekking tot gesondheidskwessies soos gestremdheid, wat op gestremde persone 'n impak het. Die doel van hierdie studie was om die kennis, sienswyses en kulturele opvattings rakende gestremdheid by die drie breë kulturele groepe van Suid-Afrika (Swartes, Kleurlinge en Blankes) te ondersoek en te bepaal wat die verskille en ooreenkomste is en hoe dit die uitkoms van rehabilitasie van gestremde persone in die Wes-Kaap raak. Sestig respondente (20 Swartes, 20 Kleurlinge en 20 Blankes )is tydens gestruktureerde onderhoude ondervra. Die "Knowledge, attitude and belief' (KAB) onderhoud is gebruik: Beide 'n waarskynlikheids en nie-waarskynlikheids steekproef en 'n kwantitatiewe en kwalitatiewe ondersoekmetode is vir die studie gebruik Die resultate het getoon dat Blankes sowel as Kleurlinge 'n redelike goeie kennis het van gestremdheid en die oorsake daarvan, wat reeds op 'n jong ouderdom opgedoen word. Daarteenoor het Swartes gewoonlik 'n meer oppervlakkige kennis van gestremdheid, wat eers na die geboorte van 'n gestremde kind verwerf word. Kwantitatief is getoon dat al die kultuurgroepe 'n positiewe houding het teenoor rehabilitasie en onderrig van, huwelik met, hê van kinders en indiensneming van gestremdes. Houding teenoor die stigma gekoppel aan gestremdheid was ook bevredigend. In teenstelling hiermee het die kwalitatiewe data ongelykheid tussen die drie kultuurgroepe getoon in houding teenoor rehabilitasie en onderrig van en huwelik met gestremdes. Swartes beskou rehabilitasie as belangrik vir die gestremde sowel as die familie, maar ervaar probleme met toeganklikheid tot rehabilitasie. Sosio-ekonomiese faktore impakteer hierop. Skoolkinders en onderwysers in Swart en Kleurlingskole toon 'n algemene gebrek aan bewustheid van gestremdheid, wat integrasie in die hoofstroom-onderwys kan bemoeilik. Die Swart groep het huwelik met en hê van kinders beskou as 'n manier om die ondersteuningsnetwerk van die gestremde uit te brei, waarteenoor die Blanke en Kleurling groepe die huwelik beskou as 'n manier vir die gestremde om die lewe te geniet en dat die hê van kinders 'n individu se keuse is. AI drie die groepe glo dat die gestremde die reg het op indiensneming en om 'n salaris te verdien. Sover dit die sienswyses oor gestremdheid betref, blameer die Swart groep die toorkuns daarvoor en besoek hulle die tradisionele geneser sowel as professionele gesondheidswerkers. Hulle verwag genesing van God .. Blankes en Kleurlinge glo dat gestremdheid die gevolg is van natuurlike oorsake, menslike foute of die wil van God. Daar was ongelyke geografiese verspreiding van inligting oor gestremdheid. Kulturele sienswyses oor gestremdeheid mag 'n remmende invloed hê op op vroeë identifikasie en intervensie by kinders. Twee hoof aanbevelings kan op grond van die resultate gemaak word. Eerstens behoort professionele gesondheidswerkers ingelig te wees oor die kultuur, waardes, sienswyses en verwagtinge van hul kliënte, en dit te verstaan. Dienslewering behoort na die ontvangers se eie omgewing, kultuur en gemeenskap via die GBR-model gebring te word. Tweedens beveel ek aan dat 'n evaluering van kennis en sienswyses, rakende gestremdheid, in skole gedoen word. 'n Vergelyking kan getref word tussen die skole waar bewusmaking van gestremdheid reeds deur NRO's gedoen is, teenoor die waar geen intervensie was nie. So 'n ondersoek behoort in al die provinsies van Suid-Afrika uitgevoer te word. Die uitkoms van hierdie studie het dus implikasies vir beide die voorsiening van inklusiewe onderrig en kwaliteit rehabilitasie-dienste vir al die gestremde kinders in Suid-Afrika.

Thesis (MScPhysio (Interdisciplinary Health Sciences. Physiotherapy))--University of Stellenobosch, 2010. / Background: Low back pain (LBP) has a high prevalence worldwide. LBP is significantly associated with a range of poor socio-demographic circumstances which should be addressed in preventive programs. Despite this there is a dearth of information about the prevalence and associated factors among low-income communities in South Africa. It is speculated that the burden of LBP may be most significant in these underprivileged communities. Objective: The objective of this study was to assess the prevalence of LBP among the lowincome communities in the Cape Town Metropole and to establish associated factors in order to make recommendations for management. Study design: A cross-sectional study was conducted among the visitors of eight community health centres (CHCs) in the Cape Town Metropole. Methodology: A new measurement tool was developed based on existing validated outcome measures and initial testing of the psychometric properties of the questionnaire was conducted. The questionnaire was administered to 489 eligible subjects. Descriptive analysis was used to describe the sample and logistic regression analytical techniques were applied to determine associated factors. Main findings: Lifetime prevalence for LBP was 76.49% (n=358). About 37% (n=133) suffered from chronic LBP. LBP was significantly associated with belonging to the black ethnic group, any co-morbidity, poor perceived general health, and any type of pain medication. Lifting weights > 20 kg and kneeling and squatting were physical factors significantly associated with LBP. Severe psychological distress was significantly associated with acute and chronic LBP. Having a better or same perceived general health compared to a year ago, was protective for LBP. Conclusion: LBP has a high prevalence among the low income communities, visiting the CHCs, in the Cape Town Metropole. Multiple factors were associated with LBP, which imply that a tailormade multidisciplinary program addressing lifestyle issues, self management strategies, medication use, chronic diseases and psychosocial factors may be required for this population to combat LBP.

Thesis (MScPhysio)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Aim: The aim of this study is to determine if the addition of a pre-extubation recruitment manoeuvre to standard care is safe and will improve lung compliance and subsequent PaO2/FiO2 (PF ratio) after extubation in postoperative coronary artery bypass graft surgery patients. Design: Prospective, triple blind, randomised, controlled trial. Method: This study was conducted in a private hospital in the Northern suburbs of Cape Town, South Africa. All patients admitted between 03/10/2010 and 22/11/2011, for uncomplicated elective coronary artery bypass graft (CABG) surgery were eligible for inclusion into the study. Patients were randomly allocated into either the intervention group or the control group. The intervention group received a gradual build-up lung recruitment manoeuvre (RM). The primary outcome was PaO2/FiO2 (PF ratio). The secondary outcomes were safety and static lung compliance. ICU length of stay (LOS) and hospital LOS were also recorded. The pre-RM hemodynamic stability of the patient was checked before the intervention and repeated at 5 minutes after the intervention by the nursing sister. Data to calculate static lung compliance was captured at the same time. Criteria for safety and discontinuation of the RM were monitored during the intervention by the principle investigator only. Results: Of the 69 patients eligible for the study 47 were randomly allocated into the intervention group (n=22) and control group (n=25) respectively. Groups were the same at baseline with regards to sex, pulmonary risk, sedation and surgical procedures. The RM could be completed in all patients. The prior defined criteria for discontinuation of the RM were not reached in any of the patients. No adverse effects were noted. The PaO2/FiO2 (PF ratio) decreased significantly in both groups from pre-surgery measurements compared to when measured before the RM (p<0.001). There was a tendency noted for the intervention group to return to pre-surgery measurements of PF ratio within 12 hours after extubation when compared to the control group. There was no significant difference between the groups from extubation to 24 hours (p = 0.6). The static compliance improved at 5 minutes following the RM (p<0.001) and remained improved until extubation (p<0.001) for the intervention group. No difference was noted in the static compliance of the control group over the same time period. The mean hospital length of stay for the intervention group was 8.61 (95% confidence interval 7.26 to 9.96 days) and 10.08 (95% confidence interval 8.52 – 11.63 days) for the control group. Conclusion: A gradual recruitment manoeuvre at 30cmH2O 30minutes before extubation significantly improved static lung compliance within 5 minutes with no adverse hemodynamic side effects. There was noted maintained improved PF ratio at extubation or immediately afterwards for the intervention group and no difference in the PF ratio between the intervention group and control group. / AFRIKAANSE OPSOMMING: Doel: Die doel van hierdie studie is om te bepaal of die toevoeging van ’n pre-ekstubasie herwinningstegniek tot standaard sorg veilig is, en of dit longvervormbaarheid en gevolglike PaO2/FiO2 (PF-verhouding) na ekstubasie in post-operatiewe kroonaaromleidingchirurgiepasiënte sal verbeter. Ontwerp: Prospektiewe, trippel-blinde, ewekansige, gekontroleerde proefneming. Metode: Hierdie studie is uitgevoer in ’n privaat hospitaal in die noordelike voorstede van Kaapstad, Suid-Afrika. Alle pasiënte wat tussen 03/10/2010 en 22/11/2011 gehospitaliseer is vir ongekompliseerde elektiewe kroonaaromleidingchirurgie, kon in aanmerking kom vir die studie. Pasiënte is op ewekansige wyse ingedeel in die intervensie- en kontrolegroepe. ’n Geleidelike-opbou-van-druk-longherwinningstegniek (HT) is op die intervensiegroep toegepas. Die primêre uitkoms was die PaO2 /FiO2 (PF-verhouding). Die sekondêre uitkoms was veiligheid en statiese longvervormbaarheid. ISE-verblyf en hospitaalverblyf is ook genoteer. Die navorsingsassistent het data van bestaande eenheiddokumentasie geneem. Die pre-HT-hemodinamiese stabiliteit van die pasiënte is gemonitor voor en weer 5 minute na die intervensie. Inligting om die statiese longvervormbaarheid te bereken is terselfdertyd genoteer. Kriteria vir veiligheid en vir die staking van die HT is gemonitor tydens uitvoering deur die primêre ondersoeker en die verpleegkundige. Resultate: Van die 69 pasiënte wat in aanmerking kon kom vir die studie is 47 op ewekansige wyse ingedeel in die intervensiegroep (n=22) en die kontrolegroep (n=25). Die groepe was dieselfde by die basislyn. Die herwinningstegniek kon volledig op alle pasiënte uitgevoer word. Die vooraf gedefinieerde kriteria vir staking van die HT is met geen pasiënte bereik nie. Geen nadelige uitwerking is genoteer nie. Die PaO2 /FiO2 (PF-verhouding) het beduidend verminder in beide groepe van pre-operatiewe metings in vergelyking met meting voor die HT (p<0.001). ‘n Neiging is genoteer dat die intervensiegroep binne 12 uur na ekstubasie tot pre-chirurgie PF-metings teruggekeer het. Daar was geen merkbare verskil tussen die groepe vanaf ekstubasie tot 24 uur (p=0.6) nie. Die statiese vervormbaarheid het verbeter teen 5 minute na HT (p<0.001) en het verbeter gebly tot ekstubasie (p<0.001) vir die intervensiegroep. Daar was geen verskil in die statiese vervormbaarheid van die kontrolegroep nie. Die gemiddelde hospitaalverblyf vir die intervensiegroep was 8.61 (95% betroubaarheidsinterval 7.26 tot 9.96 dae) en 10.08 (95% betroubaarheidsinterval 8.52 – 11.63 dae) vir die kontrolegroep. Gevolgtrekking: ’n Geleidelike herwinningstegniek teen 30cmH2O 30 minute voor ekstubasie het statiese longvervormbaarheid beduidend verbeter binne 5 minute, met geen nadelige hemodinamiese newe-effekte nie. Daar was geen verskil in die oksigenasie-indeks tussen die intervensie- en kontrolegroep na ekstubasie nie.

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Chronic groin pain is widespread across many sporting disciplines. The aim of our research was to determine if there are kinematic differences of the thoracic spine in active sports people with chronic groin pain, compared with healthy controls. A cross-sectional descriptive design was followed. Participants were required to complete six single leg drop landings with each leg from a 20cm height. The study was done in the 3D Movement Analysis Laboratory at the University of Stellenbosch. Ten male participants with unilateral or bilateral chronic groin pain of more than 3 months duration and 10 asymptomatic males, matched for age and sports participation, were recruited. The main outcome measures were: thoracic spine angle at initial foot contact, maximum thoracic spine angle, range of movement (ROM) (difference between the minimum and maximum values) and thoracic spine angle at lowest vertical point of the pelvis. This was assessed in all 3 movement planes: the sagittal plane (X plane), the coronal plane (Y plane) and the transverse plane (Z plane). The results of our study showed that for the unilaterally affected groin pain group, the cases landed in significantly more thoracic flexion (P<0.001 with large effect size) and were in significantly more thoracic flexion still at the lowest point. Peak thoracic flexion was significantly more in the cases than the controls. (P<0.001 with medium effect size) The same was true for the bilaterally affected group when landing on the most painful side, although this was not statistically significant. There were no significant differences in the frontal or transverse planes. In the bilaterally painful group, axial rotation ROM was significantly reduced when landing on either leg (worst affected side: P=0.040 with medium effect size and least affected side: p=0.006 with large effect size). The same occurred in the unilaterally affected group, although this was not statistically significant. Our study suggests that, in participants with chronic groin pain, there is greater thoracic forward flexion away from neutral during landing and that total axial rotation ROM during landing is diminished. / AFRIKAANSE OPSOMMING: Kroniese liespyn kom dikwels en in verskeie sportsoorte voor. Die doel van ons studie was om te bepaal of daar kinematiese verskille van die torakale werwelkolom is in aktiewe sportmense met chroniese liespyn, in vergelyking met gesonde kontroles. ‘n Dwars-deursnit beskrywende studiemetode is gevolg, en uitgevoer in die 3D Beweging Analise Laboratorium, Universiteit van Stellenbosch. Deelnemers moes ses landings op een been doen, met elke been, vanaf 'n 20cm hoogte. Tien mans met eensydige of bilaterale chroniese liespyn vir langer as 3 maande, en 10 asimptomatiese mans (ooreenstemmende ouderdom en sport deelname) het deelgeneem. Die hoof uitkomste wat gemeet is, was torakale werwelkolom krommingshoek by aanvanklike voet-kontak, maksimum torakale werwelkolom krommingshoek, omvang van beweging (OVB) (verskil tussen die minimum en maksimum waardes) en torakale werwelkolom krommingshoek by die laagste punt van die bekken. Dit is beoordeel in al 3 beweging vlakke: die sagittale (X) vlak, die koronale/frontale (Y) vlak en die transversale (Z) vlak. Die resultate van die studie het getoon dat, in die eensydig-geaffekteerde liespyn groep, die deelnemers in beduidend meer torakale fleksie geland het(P < 0.001, met 'n groot effekgrootte), asook met aansienlik meer torakale fleksie by die laagste punt na landing. Piek torakale fleksie was aansienlik meer in die liespyn-gevalle as in die kontroles. (P < 0.001, met middelmatige effekgrootte ) Dieselfde het vir die bilateraalgeaffekteerde groep gegeld wanneer hulle op hul mees pynlike kant geland het, hoewel dit nie statisties beduidend was nie. Daar was geen betekenisvolle verskille in die frontale of transversale vlakke van beweging nie. In die bilateraal pynlike groep, was aksiale rotasie OVB aansienlik verminder wanneer die gevalle op hul pynlikste been óf op hul minder pynlike been geland het ( mees pynlike been : P = 0,040, met 'n middelmatige effekgrootte en minder pynlike been : p = 0,006, met 'n groot effekgrootte ). Dieselfde het in die eensydig-geaffekteerde groep gebeur, hoewel dit nie statisties beduidend was nie. Ons studie dui daarop dat, in deelnemers met chroniese liespyn, daar meer torokale fleksie weg van neutraal tydens landing is en dat die totale aksiale rotasie OVB tydens die landing verminder is, in vergelyking met die kontrolegroep.

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction-The golf swing is a complex, sequenced movement of body segments. This movement is smooth and well timed and is referred to as the kinematic golf sequence. This kinematic sequence illustrates the rotational speed, which occurs between the upper and lower body segments. Hip rotation plays an integral part to a sound kinematic sequence by providing a pivotal point between the upper and lower body segments, ensuring a synchronised golf swing. Hip rotation kinematics during a golf swing has received relatively little attention compared to other body segments’ movements. However, clinicians need to have a clear understanding of the rotational contribution that each hip make during golf swing in order to enhance the athlete’s performance and reduce the risk of injury. The aim of this descriptive research project was to obtain and investigate the total passive and total dynamic rotation range of movement in both the lead and trail hips of healthy, young adult, male golfers. Methodology-Seven, low handicapped, male golfers between the ages of 18 and 40 years were randomly selected in the Western Cape region from areas surrounding Stellenbosch University’s Tygerberg campus. A questionnaire gathered participant demographics that determined participatory eligibility. A preliminary reliability study established a baseline measurement for passive total articular hip rotation. Seatadjusted total passive hip rotation ranges of motion (ROM) measurements were collected with a hand-held inclinometer. Dynamic total hip rotation kinematic data was captured during a golf swing with an 8-camera video analysis system (VICON). Data analyses were performed with Statistica version 10. Hand-held inclinometer intra-rater reliability was determined with a two-way interclass correlation, standard error of measurement and a 95% confidence interval level. A Spearman correlation coefficient determined correlation between the total passive and total dynamic rotation range of movement in both the lead and trail hips. Results-Passive intra-rater reliability was reported as 0.81 (95% CI: 0.46-0.96). The total average passive articular range between the lead (62.1° ±6.4°) and trail hip (61.4° ±3.8°) did not report any significant difference (p=0.8). The total average dynamic golf swing articular range between the lead (29° ± 6.5°) and trail hip (35.° ±7.8°), was reported as significantly (p=0.04) asymmetric. The findings also demonstrated a positive correlation between the passive and dynamic total articular range in a lead hip, whereas a negative correlation was reported in a trail hip. During the golf swing the lead hip utilised 46.4%(± 8) of the total passive available hip rotation, whereas the trail hip utilised 58.8% (±13.2). Discussion and Conclusions-The findings of this study show that, the passive rotation ROM in a hip (LH=62°; TH=61°) of a golf player does not exceed the available range it has during a golf swing. The golfer’s hip utilises 46% of the available passive range of movement in the lead hip and 59% in the trail hip. In the clinical field careful consideration should be given to the motivation behind mobilizing, treating or stretching the hips of a golf player. These findings can be incorporated in future research on the relationship between hip-rotation ROM and reduction in the incidence of injuries amongst golfers. / AFRIKAANSE OPSOMMING: Inleiding-Die gholfswaai is n komplekse, opeenvolgende beweging van verskeie liggaamsegmente. Hierdie gladde opeenvolgende bewegings word die kinematiese gholfpatron genoem. Hierdie kinematiese opeenvolgende bewegings bied ’n illustrastrasie van die rotasiespoed waarteen die beweging tussen die boonste en onderste liggaamsegmente plaasvind. Heuprotasie speel ’n deurslaggewende rol in hierdie glad verlopende kinematiese proses. Dit dien as ’n spilpunt tussend die boonste en onderste kwadrant, wat op sy beurt weer ’n gesinkroniseerde gholfswaai verseker. Die heuprotasie kinamtieka tydens n gholfswaai het relatief minder aandag ontvang in vergelyking met ander liggaamsegmente. Klinici moet instaat gestel word om ’n duidelike begrip aangaande die bydrae wat heuprotasie tydens ’n golfswaai lewer, te ontwikkel. Die atleet se prestasie kan sodoende verbeter word, en die risiko tot beserings kan ook sodoende voorkom word. Die doel van hierdie beskrywende navorsingsprojek was om te bepaal wat die totale passiewe en die totale dinamies rotasie omvang van die leidende en volgende heupe van gesonde jong mans wat gholf speel, te ondersoek. Metodologie-Sewe gholf-geskoolde manlike gholf spelers met ’n lae voorgee en tussen die ouderdom van 18 en 40 jaar is ewekansig gekies. Hierdie kandidate is gekies uit die omliggende gebiede van die Stellenbosch Tygerberg kampus in die Wes-Kaap waar hulle relatief naby woonagtig was. ’n Vraelys is aangewend om demografiese eienskappe van elke deelnemer in te samel. Hierdie inligting wat deur die vraelys bekom is, is gebruik om te bepaal of die deelnemers in aanmerking is vir die studie. ’n Voorlopige, intra-meter betroubaarheidstudie is gedoen vir passiewe, totale artikulêre heuprotasiemetings wat met ’n hand hanteerbare hoek meter geneem is. ’n Algemene fisiese ondersoek is in die biomeganiese labaratorium afgehandel om te bepaal of die deelnemers geskik is vir die toetse. Sit-aangepaste passiewe totale hip rotasie beweging metings was ingesamel met 'n hand hanteerbare hoek meter. Intra-meter betroubaarheid is bepaal met ’n twee-rigting interklas korrelasie, standaard foutmeting en ’n 95% vertroue interval vlak. Dinamiese totale heup kinematiese rotasiedata is afgeneem met ’n hoë-spoed 3-D videografiestelsel (VICON) tydens 'n gholfswaai. Data-ontleding is bereken met ’n Statistica weergawe 10. Die gemiddelde en Spearman korrelasie koëffisiënt is gebruik as aanwysers van verspreiding. Resultate-Passiewe inter-meter betroubaarheid word geraporteer as 0.81 (95% KI: 0.46-0.96). Die resultate dui op ’n onbeduidende totale passiewe artikulêre reeks verskille tussen die leidende (voorste) (62.1 ± 6.4 °) en volgende (agterste) heupe (61.4 ° ± 3.8 °). ’n Beduidende totale dinamiese artikulêre reeks van die leidende (29 ° ± 6.5 °) en volgende heupe (35.9 ° ± 7.8 °) is tydens die gholfswaai bereik. Verdere resultate toon ’n positiewe korrelasie tussen die passiewe en dinamiese totale artikulêre reeks in die leidende heup, terwyl ’n negatiewe korrelasie gerapporteer word vir die volgende (agterste) heup. Tydens ’n gholfswaai gebruik die leidende heup 46.4% (± 8%) van die totale passiewe beskikbaar heuprotasie, terwyl die opvolgende (agterste) heup 58.8% (± 13.2%) aanwend. Bespreking en gevolgtrekking-Die bevindinge van hierdie studie toon dat tydens ’n gholfswaai, ’n gesonde gholfspeler nie die beskikbare passiewe beweging wat in sy heup bestaan oorskry nie. Slegs 46.4% van die beskikbare passiewe beweging in sy leidende heup word gebruik, en 58.8% van sy agterste heup. Die klinisie moet deeglike oorweging gegee word aan die motivering agter die mobilisering, strekke en die behandeling van die heupe van ’n gholfspeler. Hierdie bevindings kan in toekomstige navorsing geimplimenteer word om die verhouding wat tussen die omvange vand heuprotasie bestaan te ondersoek. Die voorkoming van moontlike toekomstige beserings in gholfspelers kan ook verhoed word.

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Aims: This study aims to ascertain if there are differences in ankle kinematics and ground reaction force in sports participants with chronic groin pain compared to healthy controls. Methods: A cross sectional descriptive study design was used. Twenty participants - 10 cases with chronic groin pain and 10 healthy controls participated. The 10 cases included participants with unilateral pain (n=7) and bilateral pain (n=3). For analysis, the bilateral pain group was divided into the most and less painful side. The study was conducted at the FNB 3D Motion Analysis Laboratory, Stellenbosch University. Sagittal plane kinematics and VGRF was analysed during a single leg drop landing. Results: The group with unilateral groin pain had a higher peak force compared to the matched side of the controls. The bilateral pain groups had less plantarflexion at foot contact (most affected p=<0.001; least affected p=<0.001) and total range of motion (p=<0.05) compared to the control group. The bilaterally injured groin pain groups demonstrated less peak force when compared to controls. Conclusion: This is the first study to indicate alterations in ankle kinematics and VGRF and that these changes are more apparent in sports participants with bilateral pain. Less range of motion during the landing task illustrated by the bilateral pain group suggests less effective force absorption of the distal segments. In the bilateral groups it suggests that force attenuation may have occurred high up the kinetic chain which may place more strain on the groin. Clinically rehabilitation of the athlete with chronic groin pain should include the distal segments of the lower limb. Further research should be conducted in larger groups. / AFRIKAANSE OPSOMMING: Doelstellings: Hierdie studie poog om vas te stel of daar verskille in enkelbeweging en grondvloer-reaksiekrag is in deelnemers van sport met chroniese liespyn in vergelyking met gesonde kontrole deelnemers. Metode: ‘n Deursnee beskrywende studieontwerp is gebruik. Twintig deelnemers, 10 gevalle met chroniese liespyn en 10 gesonde kontrole het deelgeneem. Die 10 gevalle het ingesluit deelnemers met eensydige pyn (n=7) en bilaterale pyn (n=3). Vir die analise, is die bilaterale pyngroep verdeel in die mees en mins geaffekteerde kant. Die studie is gedoen by die FNB3D Beweginsanalise-laboratorium, Universiteit van Stellenbosch. Sagitaal-platvlak kinematiek en vertikale reaksiekrag is geanaliseer gedurende ‘n enkele beenlanding. Resultate: Die groep met eensydige liespyn het ‘n hoër piekkrag gehad in vergelyking met dieselfde kant van die kontrolegroep. Die bilaterale pyngroep het minder plantaarfleksie met voetkontak getoon (mees geaffekteer p=<0.001; minste geaffekteer p=<0.001) en totale beweginsomvang (p=<0.05) in vergelyking met die kontrolegroep. Die bilateraal-liesbeseringsgroep het minder piekkrag getoon in vergelyking met die kontrolegroep. Gevolgtrekking: Hierdie is die eerste studie om veranderings in enkelbeweging en grondreaksiekrag aan te toon, asook dat hierdie veranderinge meer opvallend is in persone wat aan sport deelneem wat bilaterale pyn ondervind. Verminderde beweginsomvang gedurende die landingstaak deur die bilaterale pyngroep suggereer minder effektiewe kragabsorpsie van die distale segmente. In die bilaterale groep suggereer dit dat kragvermindering waarskynlik hoog op die kinematiese ketting voorgekom het wat weer meer stremming op die lies plaas. Kliniese rehabilitasie van die atleet met chroniese pyn behoort die distale segmente van die onderste ledemaat in te sluit. Verdere navorsing behoort in groter groepe uitgevoer te word.

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction: Chronic groin injuries are common among athletes and have the potential to lead to chronic and career-ending pain. There is no evidence available whether pelvic kinematics can be perceived as a risk factor in developing chronic groin pain in sport or be the cause of further injuries of the lower quadrant or lumbar spine. Objective: The purpose of this study was to determine if there are any differences in pelvic kinematics of active sports participants with chronic groin pain compared to healthy controls during a single-leg drop-landing. Methodology: A descriptive study was conducted. The three-dimensional (3D) pelvic kinematics of ten cases with chronic groin pain and ten asymptomatic controls was analyzed. Pelvic kinematics was analyzed at the FNB 3D Vicon Laboratory at Stellenbosch University using an eight camera Vicon system. A physical examination, including functional movements, posture analysis, hip, knee and ankle passive range of motion measurements, sacro-iliac tests and anthropometric measurements was done by two physiotherapists prior to the 3D analysis. To analyze the pelvic kinematics, each participant performed six single-leg drop-landings. The main outcome measure was 3D pelvic kinematics at initial foot contact (IFC) and foot contact at lowest vertical position (LVP). The following sub-groups were analyzed: seven with unilateral groin pain and three with bilateral groin pain; the latter was further divided into those with the most painful leg and the least painful leg. Mean and standard deviations (SD) for pelvic kinematics were calculated and significant differences between sub-groups were determined using two-tailed Student’s t-tests. The Cohen’s D effect size calculator was used to calculate the effect size of significant differences in pelvic kinematics between case and control groups. Results: The findings indicated a significant difference (p=0.03) in frontal plane pelvic kinematics at IFC for the unilateral group. The most painful groin group showed significant differences at IFC (p=0.004) and at LVP (p=0.04) in the frontal plane pelvic kinematics. The least painful groin group showed a significant difference at LVP (p=0.01). All cases landed with pelvic downward lateral tilt during the landing phase compared to matched controls. The groin pain group with bilateral pain showed significant differences at IFC (p < 0.001) and LVP (p=0.005) for the most painful groin; and the least painful groin at IFC (p=0.01) and LVP (p=0.01) in the sagittal plane pelvic kinematics. The bilateral groin pain group showed an increase of anterior pelvic tilt in the sagittal plane during the landing phase when compared to matched controls. Increased internal pelvic rotation in the transverse plane was significant for the unilateral group at IFC (p=0.04) and for the most painful groin group at IFC (p < 0.001) and LVP (p < 0.001) compared to matched controls. Conclusion: Results from this study shows that pelvic kinematic changes in the frontal, sagittal and transverse planes do occur in patients with chronic groin pain when compared to controls. This may imply that muscle weakness around the hip and pelvis may contribute to the development of chronic groin pain in active sports participants. Rehabilitation of these muscles should be taken into consideration when treating patients with chronic groin injuries. Further research should be focused on muscular recruitment patterns in sports participants with groin pain to critically define the muscular causal factors in more depth. / AFRIKAANSE OPSOMMING: Inleiding: Kroniese lies beserings is ‘n algemene verskynsel onder die aktiewe sport populasie. Dit mag tot kroniese pyn lei en het die potensiaal om ‘n sport loopbaan te be-eindig. Tans, is daar geen verdere navorsing beskikbaar oor die invloed van bekken kinematika op onderste ledemaat beserings asook die moontlike oorsaak tot kroniese lies pyn in atlete nie. Oogmerk: Die doel van hierdie studie was om vas te stel watter verskille in die bekken kinematika ontstaan tussen aktiewe sport deelnemers met kroniese lies pyn teenoor aktiewe sport deelnemers sonder enige pyn of beserings tydens ‘n enkel been aftrap beweging. Metodologie: Tien deelnemers met kroniese lies pyn en tien asimptomatiese deelnemers is gebruik om die verskille tussen die 3D bekken kinematika te bepaal. Die FNB 3D Vicon Lab by die Stellenbosch Universiteit is gebruik vir die data analise en insameling. Deelnemers het ‘n fisiese ondersoek ondergaan wat die voglende ingesluit het: funksionele bewegings, postuur analise, omvang van beweging van die heup, knie en enkel, toetse ter uitsluiting van die ilio-sakrale gewrig asook antropometriese aftmetings. Elke deelnemer is versoek om ses enkel-been aftrap sessies te doen. Die hoof uitkomsmeting was die bekken hoeke in the frontale vlak by inisiële voet kontak (IVK) asook die voet kontak teen die laagste vertikale posisie (LVP). Resultate: Die resultate wys ’n beduidende verskil (p=0.03) in die frontale vlak vir bekken kinematika by IVK vir die unilaterale groep. Die mees geaffekteerde been wys ’n beduidende verskil by IVK (p=0.004) en by LVK (p=0.04) in die frontale vlak vir bekken kinematika. Die groep met die minste geaffekteerde been toon ’n beduidende verskil by LVP (p=0.01). Alle simptomatiese deelnemers het met die bekken in afwaartse bekken kanteling geland tydens die landings fase. Die groep met bilaterale pyn toon ’n beduidende verskil by IVK (p < 0.001) en by LVP (p=0.005) vir die mees geaffekteerde been en vir die minste geaffekteerde been by IVK (p=0.01) en LVP (0.01) in die sagittale vlak vir bekken kinematika. Die bilaterale groep met kroniese lies pyn land met meer anterior bekken kanteling in die sagittale vlak gedurende die landings fase teenoor die asimptomatiese groep. Interne bekken rotasie was beduidend meer vir die unilaterale groep by IVK (p=0.04) en vir die mees geaffekteerde been by IVK (p < 0.001) en LVP (p < 0.001) teenoor asimptomatiese deelnemers. Gevolgtrekking: Die resultate van hierdie studie bewys dat daar wel ‘n verskil is in die bekken kinematika van deelnemers met kroniese lies pyn teenoor asimptomatiese deelnemers. Hierdie verskille is waarneembaar in die frontale, sagittale en transverse vlakke. Dit impliseer dat spier swakheid van die bekken en heup spiere ‘n bydrae mag he tot die ontwikkeling van kroniese lies beserings in atlete. Rehabilitasie van bogenoemde spiere is belangrik in die behandeling van kroniese lies beserings. Verdere navorsing oor spier aktiverings patrone in aktiewe, sports deelnemers met kroniese lies pyn word benodig, om die oorsprongs faktore te ondersoek.

Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2009. / The ability to walk has been rated by stroke patients as one of the most important goals of their rehabilitation. Knee control is a key element in normal gait. Currently, treatment options aimed at improving poor knee control in stroke patients are often costly, need specialised equipment and have poor patient compliance. The purpose of the current study was to assess whether medial patellar taping could improve knee control in stroke patients. Gait speed, dynamic standing balance, knee alignment and whether the subjects experienced any subjective stabilising effect on the knee after taping were tested. Twenty subjects diagnosed with hemiplegia after a stroke served as their own controls in a repeated measures experimental study. Results indicated that dynamic standing balance as tested by the Step Test (p=0.063) and the Timed-up-and-go test (p=0.099) (Wilcoxon test) showed marginal improvement after taping. This improvement in dynamic standing balance may indicate that neuro-motor control and/or eccentric knee control had improved. There was no change in walking speed and knee alignment as tested by change in the Q-angle (Wilcoxon test). However, a decrease in the Q-angle correlated with an improvement in dynamic standing balance as tested by the Step Test (p=0.029) (Spearman‟s test). Participants with decreased Q-angles after taping possibly had better knee alignment and were more willing to accept weight on their affected leg indicating a change in quadriceps activation. No change in walking speed (p=0.351) (Wilcoxon test) before and after taping may indicate that there was no change in the magnitude of contraction and/or concentric activity in the quadriceps muscle. Thirty percent of the participants reported a subjective change in knee stability after taping. Subjective change did not, however, significantly correlate with either of the balance tests, walking speed or Q-angle measurements. The possibility that medial patellar taping may be useful in treating poor knee control in stroke patients during dynamic balance activities should be investigated further.