Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008. / Cerebral palsy (CP) is a common neurological condition seen in children which results in childhood disability. Damage to the developing brain results in abnormal muscle tone and decreased force generation, which leads to loss of independent function. Previous studies investigating interventions targeting the typical equinus gait pattern seen in spastic CP have reported inconclusive and widespread outcomes. Objectives The objectives of the study were to determine (1) the effect of functional electrical stimulation (FES) after a single botulinum toxin injection into the triceps surae muscle as a functional orthosis on various gait parameters and economy of movement; (2) caregivers’ perceptions of the impact of the intervention on their child’s function and participation, and (3) optimal timing intervals for introducing FES after a botulinum toxin injection. Method Single-subject research with a multiple baseline approach was conducted on five ambulant subjects (average age 5.1 years, SD=1.4) in the Cape Metropole with a dynamic equinus gait due to hemiplegic CP. Two-dimensional gait analysis, isometric dynamometry, Energy Expenditure Index (EEI), and a caregiver questionnaire were used to gather data on walking speed, ankle angles at initial contact of gait, isometric plantarand dorsiflexior muscle strength, energy expenditure during gait, as well as caregiver perception on participation changes. Statistical analysis was conducted by means of ANOVA tests and graphic data illustrations. Results A statistically significant pre- to post intervention (FES after botulinum toxin) change was found for plantarflexor muscle strength. This effect was partially maintained over the withdrawal phase. Caregivers felt the intervention to have a positive influence on their children’s walking speeds, as well as on age-appropriate function and participation. Selfselected walking speed, dorsiflexor muscle strength, and ankle angles at initial contact did not change significantly. A 32-day interval between between botulinum toxin and the FES programme resulted in the most pronounced improvements in terms of walking speed, EEI scores, and plantarflexor muscle strength. Conclusion FES to the lower limb, 32 days after botulinum toxin into the triceps surae, applied for 30 minutes per day, five times a week over a total of four weeks, seemed to improve selected gait parameters as well as caregiver perception of impact on function and activities of daily living. However, further research is needed.

Thesis (MScPhysio)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Aim: The aim of the study was to improve understanding of the hip joint kinematics in cricket fast bowlers and to ascertain whether a relationship exists between hip joint biomechanical parameters, including kinematics, ROM characteristics and lumbar symptoms. Study design: A descriptive cross-sectional study was conducted. Participants: Sixteen adult male fast bowlers between the ages of 18 and 40 years old, playing first-club league, were featured in the study. Main outcome measures: To obtain data with regards to the training history, as well as the nature of lumbar-spine symptoms experienced by the cricket fast bowlers, a newly designed questionnaire was compiled. For analysis of the front foot hip joint ROM and kinematics, the biomechanical equipment used included: a two-dimensional Canon MV950 Digital Video Camcorder, a Kodak EasyShare C310 camera and XSENS Motion Tracking equipment (Xsens Technologies B. V., Enschede, Netherlands). Results: Eight of the sixteen bowlers in our study experienced LBP in the season with seven of these bowlers presenting with recent symptoms most of which are experienced after bowling a spell and described as “tightness” or a “stabbing pain” in the lower back. Intensity of LBP ranged between 1/10 to 8/10. Front foot hip joint kinematics of fast bowlers showed highly individualised patterns of movement between different subjects. Medium amplitude movements in the flexion/extension as well as the rotation plane of movement showed a significant difference in bowlers with- and without LBP. No significant differences between groups with LBP and without LBP were found in the three passive hip ROM measurements. Conclusions: It has proved to be very difficult to improve the understanding of the front foot hip biomechanics in cricket fast bowlers due to the high inter-subject variability. Variability in movement patterns remains under-researched by sports biomechanics. Although decreased hip mobility could alter mechanical forces transmitted to the lumbar spine and therefore predispose or be a causative factor in LBP development, this study found no significant relation between these parameters. The sample size was very small in this study which will influence the validity of results. Our study confirmed the high incidence of LBP and preventative efforts for bowlers should therefore be strongly supported. / AFRIKAANSE OPSOMMING: Doelwit: Die doelwit van die studie was om die heupgewrig kinematika van krieket snelboulers beter te verstaan en om vas te stel of daar ‘n verwantskap bestaan tussen heupgewrig biomeganiese parameters, insluitende kinematika, omvang van beweging karakter en lumbale simptome. Studie ontwerp: ‘n Deursneë beskrywende studie is onderneem. Deelnemers: Sestien volwasse manlike snelboulers tussen die ouderdomme van 18 en 40 jaar oud wat eerste liga speel maak deel uit van die studie. Hoof uitkoms maatreëls: ‘n Nuut ontwerpte vraelys is opgestel om data aangaande oefen geskiedenis sowel as aard van lumbale simptome wat deur krieket snelboulers ervaar word in te samel. Die biomeganiese apparaat wat gebruik is vir die analiese van die voorvoet heup omvang van beweging, sowel as die kinematika, sluit in: ‘n twee dimensionele Canon MV950 Digitale Video Camcorder, ‘n Kodak EasyShare C310 kamera en XSENS beweging volgende apparaat (Xsens Technologies B. V., Enschede, Netherlands). Resultate: Agt van die sestien boulers in ons studie het lae rug pyn in die seisoen ervaar. Sewe van die boulers het gepresenteer met onlangse simptome waarvan die meeste na ‘n bouler se boulbeurt ervaar is en beskryf was as ‘n “styfheid” of “steekpyn” in die lae rug. Die intensiteit van die lae rug pyn het gewissel tussen 1/10 en 8/10. Voorvoet heup kinematika van snelboulers het hoogs individualistiese patrone van beweging getoon tussen verskillende deelnemers. Medium amplitude bewegings in die fleksie/ekstensie sowel as die rotasie plein van beweging het ‘n beduidende verskil tussen boulers met- en sonder lae rug pyn getoon. Geen beduidende verskille tussen die groep met- en sonder rugpyn is gevind met die drie passiewe heup omvang van beweging meetings nie. Gevolgtrekkings: Dit blyk baie moelik te wees om die voorvoet heup biomeganika in krieket snelboulers beter te verstaan a.g.v. die hoë inter-deelnemer veranderlikheid. Veranderlikheid in bewegings patrone is nog nie genoeg nagevors deur sport biomeganici nie. Alhoewel ingekorte heup mobiliteit meganiese kragte wat deur die lumbale werwelkolom gaan kan wysig, en sodoende die ontwikkeling van lae rug pyn kan predisponeer of ‘n oorsakende faktor kan wees, het hierdie studie nie ‘n beduidende verwantskap tussen die parameters gevind nie. Die steekproef groote was baie klein en dit sal die geldigheid van die resultate beïnvloed. Ons studie het die hoë insidensie van lae rug pyn bevestig en pogings tot voorkomende maatreëls moet daarom ten sterkste ondersteun word.

Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction-Groin injuries are among the top six most cited injuries in soccer and account for 10-18 per cent of all injuries reported in contact sport. Groin pain can result from a variety of pathologies, but according to literature, 63 per cent of groin pain is due to adductor pathology. Objective-The objective of this study was to explore if there are kinematic differences in the hip joint in sports participants with groin pain compared to matched healthy controls. Study design A cross sectional, descriptive study was conducted. Study setting-The study was conducted at the FNB -3D motion analysis laboratory at the University of Stellenbosch, South Africa. Outcome variables-The dependent variables included hip kinematics in the sagittal, frontal and transverse planes at foot strike, lowest vertical point of the pelvis and total range of hip motion during a single leg drop landing. Methodology-The study sample comprised 20 male club level soccer-and, rugby players, running and cycling participants between the ages of 18-55 years of age. Ten of the subjects had chronic groin pain and the other ten were healthy matched controls. An eight-camera Vicon system was used to analyse the kinematics of the hip joint during single leg drop landing. For the purpose of comparison, the data was analysed for participants with unilateral groin pain and matched controls (n=14) and participants with bilateral groin pain and controls (n=6). The full set of data was subdivided for analysis into three distinct sub-groups. Unilaterally injured groin cases (n=7) were matched with seven healthy controls for analysis. Bilaterally injured groin cases (n=3) were matched with three healthy controls. Results-Cases with unilateral groin pain at initial contact had significantly more abduction of the hip joint when compared to controls (p<0.05). The effect size of this difference was large (0.94). Cases with unilateral groin pain also demonstrated greater hip internal rotation while the controls had external rotation (p<0.05) during a drop landing activity. Bilaterally injured groin cases landed with significantly (p=?) greater ranges of hip flexion as well as in significantly (p=?) more hip abduction during a drop landing activity. They also demonstrated greater total range of motion in the frontal plan when compared to controls. Groin pain cases overall demonstrated greater ranges of motion and tended to land in more abduction compared to controls. Conclusion-This study found that during a single leg drop landing, sports participants with unilateral chronic groin pain landed with significantly greater hip abduction and exhibited larger total range of motion in the transverse plane, which may indicate impaired stability of the hip complex when compared to controls. / AFRIKAANSE OPSOMMING: Inleiding-Liesbeserings is een van die top ses mees prominente sokker beserings. Dit beloop 10-18 persent van alle beserings wat in kontaksport aangemeld word. Liespyn kan die gevolg wees van ‘n verskeidenheid patologië, maar volgens die literatuur is 63 persent van liespyn as gevolg adduktor patologie. Doelwitte-Die doelwit van hierdie studie was om ondersoek in te stel of daar enige kinematiese veranderinge in die heupgewrig is in spelers met liespyn in vergelyking met dieselfde vergelykbare spelers sonder liespyn. Studie Ontwerp-‘n Deursnit, beskrywende studie was onderneem. Studie Omgewing-Die studie was uitgevoer by die FNB-3D bewegingsanalise laboratorium van die Stellenbosch Universiteit, Suid-Afrika. Uitkomsveranderlikes-Die afhanklike veranderlikes het in gesluit die heup kinematika in die sagitale, frontale en transvers vlakke met voet kontak endie laagste vertikale punt van die pelvis sowel as die totale heup omvang van beweging gedurende een been landing. Metodologie-Die studie populasie het bestaan uit 20 manlike sokker- en, rugbyspelers, hardlopers en fietsryers tussen die ouderdomme van 18 en 55 jaar. Tien van die deelnemers het kroniese liespyn gehad en die ander tien in die gelyke gesonde groep was sonder liespyn. Die agt kamera Vicon sisteem was gebruik om die kinematika van die heupgewrig te analseer tydens een been landing. Vir die doel om ‘n vergelyking te kan maak, was die data geanaliseer van deelnemers met unilaterale liespyn en die vergelykende groep sonder liespyn (n=14) en deelnemers met bilaterale liespyn en hulle vergelykende groep sonder liespyn (n=6).. Die volledige stel data was onderverdeel in drie afsonderlike sub groepe. Vir die analiese was unilaterale liesbeserings (n=7) vergelyk met sewe deelnemers sonder liespyn in die kontrolegroep. Deelnemers met bilaterale liesbeserings (n=3) was vergelyk met drie in die kontrolegroep. Resultate-Die deelnemers met unilaterale liespyn het met eerste kontak beduidend meer abduksie van die heupgewrig gehad in vergelyking met die kontrolegroep (p<0.05). Die effek van hierdie verskil was groot (0.94). Die deelnemers met unilaterale liespyn het ook ‘n grooter interne rotasie getoon, terwyl die kontrole groep meer eksterne rotasie gedemonstreer het (p<0.05) met landing. Deelnemers met bilaterale liespyn het beduidend (p=?) meer heup fleksie en abduksie omvang van beweging tydens landing. Hulle het ook ‘n groter totale heup omvang van beweging in die frontale vlak gehad in vergelyking met die kontrolegroep. Deelnemers met liespyn het oor die algemeen ‘n grooter omvang van beweging getoon, en was geneig om met meer abduksie van die heup te land as die kontrolegroep. Gevolgtrekking-Die studie toon dat deelnemers met kroniese unilaterale liespyn, tydens een been landing, beduidende meerheup abduksie toon en dat die heup in die transverse vlak meer totale omvang van beweging gebruik wat kan dui op onstabiliteit in die heupkompleks in vergelyking met die kontrolegroep.

Thesis (PhD)--Stellenbosch University, 2012. / Includes bibliography / ENGLISH ABSTRACT: Introduction: The increased prevalence of adolescent upper quadrant musculoskeletal pain (UQMP) is becoming a great concern to health professionals. The risk factors associated with adolescent UQMP are complex and multifactorial, including, among others sitting as a physical risk factor. However, no evidence exists to support sitting postural angles as a potential predictive factor for adolescent UQMP in computing high school students. Thus, the current project aimed to describe the three-dimensional (3D) sitting postural angles of computing South African high school students in a real-life setting, using a well-tested and documented posture measurement instrument. Methodology: This research project is comprised of seven related studies. Part I of the dissertation presents a systematic review describing the reliability and validity testing of posture measurement instruments. This is followed by three primary correlation and repeated measures observational studies aimed at ascertaining the reliability and validity of a newly developed 3D Posture Analysis Tool (3D-PAT) in the measurement of nine sitting postural angles of computing high school students. Part II of the dissertation presents a systematic review, that evaluates the latest published research evidence of whether sitting is related to UQMP, and, if so, to identify the elements of sitting that significantly contribute to UQMP. This review is followed by a description of a cohort study, with a prospective period of one year. The 3D-PAT was implemented in a clinical research setting in order to measure the 3D sitting posture of a cohort of asymptomatic computing high school students and in order to assess the outcome, seated-related UQMP, prospectively. The prospective study design enabled the research project to contribute to an understanding of any causative relationship between the exposure (sitting postural angles) and the outcome (seated-related UQMP) in a subgroup of adolescents (computer users). Results: After the first phase of psychometric testing of the 3D-PAT using high school students, the findings indicated that the instrument required modifications prior to further psychometric testing. The second phase of testing revealed that the 3D-PAT compared very well with the reference standard for measurement of the X-, Y- and Z-coordinates of the reflective markers on a mannequin. The findings from the phase three study, again using high school students, indicated that the 3D-PAT compared very well with the reference standard and justified its use for the measurement of six sitting postural angles of the upper quadrant in computing high school students. For the cohort study, a 60% response rate for participation was achieved at baseline, with 98% of the students participating at six-month and 80% at one-year follow up. Of the students, 33.5% complained of seated-related UQMP during the follow-up period. Exposure to increased head flexion (>80°) (ρ=0.0001) and the combination of increased head flexion and decreased cranio-cervical angles (ρ=0.007) were significant predictors of seated-related UQMP for those computing high school students complaining of pain greater than the 90th percentile for such. Conclusion: The project described in the current dissertation is the first research project to assess sitting postural angles in asymptomatic high school students, while they worked on desktop computers in a school computer classroom and to assess UQMP prospectively. The research project reports a causal relationship between increased head flexion and seated-related UQMP as increased head flexion was found to be a predictor of seated-related UQMP developing within six to 12 months for computing high school students with a pain score equal or greater than the 90th percentile for pain. The research project emphasises that further research is warranted to investigate the causal pathway between sitting posture and adolescents’ UQMP. / AFRIKAANSE OPSOMMING: Inleiding: Die stygende voorkoms van boonste-kwadrant muskuloskeletale-pyn (BKMP) onder adolessente is besig om ’n groot bron van kommer vir professionele gesondheidswerkers te word. Die risiko-faktore waarmee adolessente BKMP gepaard gaan, is kompleks en multifaktories. Dit sluit onder andere sit as ’n fisiese risiko-faktor in. Daar is egter nog geen bewyse om sittende posturale hoeke as potensiële voorspeller van adolessente BKMP te ondersteun nie. Dus beoog hierdie projek om die drie-dimensionele (3D) sittende posturale hoeke van Suid-Afrikaanse hoërskoolleerders wat ook rekenaargebruikers is, in ’n werklike omgewing te beskryf, deur gebruik te maak van ’n instrument wat postuur meet en wat goed getoets en gedokumenteerd is. Metodiek: Hierdie navorsingsprojek is saamgestel uit sewe studies. Gedeelte I van die proefskrif bied ’n sistematiese oorsig van betroubaarheids- en geldigheidstoetsing van instrumente wat postuur meet. Dit word gevolg deur drie primêre korrelasie studies en studies vir die waarneming van herhaalde meting wat die betroubaarheid en geldigheid van n nuut-ontwikkelde 3D instrument vir posturale analise (3D-PAT) bepaal, wanneer nege sittende posturale hoeke van hoërskoolleerders wat rekenaars gebruik, gemeet word. Gedeelte II van die proefskrif bied ’n sistematiese oorsig van die jongste gepubliseerde navorsing om te evalueer of daar bewyse is dat sit verband hou met BKMP, en, indien wel, om die elemente van sit wat betekenisvol bydra tot BKMP, te identifiseer. Die sistematiese oorsig word deur ’n beskrywing van ‘n jaarlange kohortstudie gevolg. Die 3D-PAT is gebruik in ’n kliniese-navorsingsraamwerk om die 3D-sitpostuur van ’n kohort simptoomvrye hoërskoolleerders wat rekenaargebruikers is, te meet en sitverwante BKMP as uitkoms in die vooruitsig te stel. Die studie ontwerp het dit vir die navorsingsprojek moontlik gemaak om ’n insiggewende bydrae te lewer tot begrip vir enige oorsaaklikheidsverwantskap tussen die blootstelling (sittende posturale hoeke) en die uitkoms (sitverwante BKMP) in ’n subgroup van adolessente (rekenaargebruikers). Resultate: Na afloop van die eerste psigometriese toesting van die 3D-PAT, waarin hoërskoolleerders gebruik is, het bevindings daarop gedui dat die instrument verander moet word voordat toetsing kan voortgaan. Die tweede fase van toetsing het getoon dat die 3D-PAT baie goed vergelyk met die verwysingstandaard vir die meet van die X-, Y- en Z-koördinate van die reflektiewe merkers op ’n mannekyn. Die bevindings van die derde fase van die studie, waartydens hoërskoolleerders weer gebruik is, het aangedui dat die 3D-PAT baie goed vergelyk met die verwysingstandaard. Dit het die gebruik van die instrument om ses sittende posturale hoeke van die boonste kwadrant van hoërskoolleerders wat rekenaars gebruik te meet, bevestig. Die kohortstudie het ’n 60%-reaksiesyfer vir deelname behaal tydens die basislynmetings, waarvan 98% leerders deelgeneem het aan die sesmaande-opvolgmetings en 80% aan die eenjaaropvolgmetings. ’n Totaal van 33.5% van die leerders het gekla van sitverwante BKMP gedurende die eenjaar opvolgperiode. Blootstelling aan ’n vergrootte kopfleksie-hoek (>80°) (ρ = 0.0001) en die kombinasie van ’n vergrootte kopfleksie- en verminderde kranio-servikale hoek (ρ = 0.007) was betekenisvolle voorspellers van sitverwante BKMP vir die hoërskoolleerders wat rekenaars gebruik en kla van groter pyn as die 90ste persentiel daarvan. Gevolgtrekking: Hierdie projek is die eerste navorsing wat sittende posturale hoeke van simptoomvrye hoërskoolleerders wat op tafelrekenaars in die skool se rekenaarklaskamer werk, meet en BKMP voorspel. Die navorsingsprojek rapporteer ‘n oorsaaklikheidsverwantskap tussen ‘n vergrootte kopfleksie-hoek en sitverwante BKMP omdat vergrootte kopfleksie ‘n voorspeller is van sitverwante BKMP wat binne ses tot 12 maande by hoërskoolleerders wat rekenaars gebruik, met ‘n pyntelling gelyk of groter as die 90ste persentiel van pyn, ontwikkel. Die navorsingsprojek beklemtoon dat verdere navorsing om die oorsaaklikheidsroete tussen sitpostuur en adolessente BKMP te ondersoek, geregverdig is. / Medical Research Council of South Africa / National Research Fund / Division of Research Development and Support of Stellenbosch University

Thesis (MScPhysio)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Access to wheelchairs is considered a basic human right. Wheelchairs enhance function, improve independence, and enables persons with disabilities to successfully live in the community. An inappropriate wheelchair may however limit function rather than promote it. Achieving an ideal match between user and technology, however is challenging. A recent audit in the Eastern Cape revealed that standard folding frame type wheelchairs were predominantly being issued and waiting list for wheelchairs is long. The need for investigation into prescription practice, from the perspective of both prescribing therapists as well as wheelchair users, was identified. Aims: To describe wheelchair prescription practice in the public sector of the Eastern Cape; and to determine whether the wheelchairs being issued address the psychosocial needs of users. Study design: A descriptive mixed-method cross-sectional study design was used. Quantitative and qualitative data from questionnaires and functional wheelchair skills tests of wheelchair users (Phase 1) and from semi-structured interviews with prescribing therapists (Phase 2) was used to describe prescription practice and investigate the psychosocial needs of wheelchair users. Methods: A small sample of convenienve according to home address was obtained that included 30 users (15 from a rural; 15 from a semi-rural setting). The Psychosocial Impact of Assistive Devices Scale (PIADS) questionnaire, Functioning Everyday with a wheelchair (FEW/FMA) scale and a self-compiled wheelchair specifications checklist (WSC) were used to determine user functionality and level of satisfaction with the wheelchair. Purposive sampling was done to identify the therapists that had prescribed the wheelchairs for the participants in the first phase of the study. A semi- structured interview was used to determine prescription practice including perceived barriers of wheelchair prescription with ten prescribing therapists. Data analysis: Qualitative data was analysed deductively and frequency of responses tabulated. Quantitative data was summarised as means and standard deviations and subgroup analysis comparisons were done using the Chi-square test and relationships between variables investigated using Pearson/ Spearman correlation or ANOVA. A p < 0.05 was deemed significant. Results: Eighty three % of wheelchairs issued were urban wheelchairs. These are generally perceived by users as sufficient to address their psychosocial needs regarding mobility and transport, however, seem to fail users in terms of accessibility and independence within their rural/ semi- rural environment. According to the WSC scores, peri-urban wheelchairs were found to be more appropriate for the users than urban wheelchairs (p < 0.01). No significant relationships were found between wheelchair fit, use of a cushion, occurrence of pressure sores and self-perceived psychosocial needs in this sample. The users experienced most difficulty with outdoor mobility (57% needed full assistance) and transport (63% needed full assistance) within their current wheelchairs. Ten prescribing therapists participated in the study. Most valued appropriate seating, are knowledgeable regarding prescription practice, but reported several barriers to this practice including budget restraints (90%), time to delivery (100%) and lack of training (40%). The need for more appropriate wheelchair designs to suit multi- level manoeuvrability of persons in rural/ semi-rural environments was also reported (60%). Conclusion: The results of this study show that wheelchair prescription in the Western Region of the Eastern Cape (WRoEC) has various challenges. Although the wheelchair users were mostly satisfied with their wheelchairs, this study identified areas for improvement in the users’ functioning, postural support and biomechanics within their wheelchairs, especially as it relates to their home environment. There is scope for improvement of wheelchair delivery to persons in the WRoEC – from on-going training of therapists and clients to more appropriate wheelchair designs for persons in rural settings. Further research in this field is recommended. / AFRIKAANSE OPSOMMING: Agtergrond: Toegang tot rolstoele word as ‘n basiese mensereg geag. Rolstoele dra by tot verbeterde funksionaliteit, groter onafhanklikheid, en bemagtig mense met gestremdhede om suksesvol in die gemeenskap te lewe. Nietemin, ‘n onvanpaste rolstoel mag funksie beperk eerder as om dit te bevorder. Om die ideale pas tussen rolstoel gebruiker en tegnologie te vind is uitdagend.’n Onlangse oudit in die Oos- Kaap het getoon dat standaard vou-raam tipe rolstoele oorwegend uitgereik word, en dat die waglys vir rolstoele lank is. Die gaping vir verdere ondersoek rakende voorskrif praktyk, vanaf beide die perspektief van die terapeute wat voorskryf asook rolstoel gebruikers, is geidentifiseer. Doel: Om rolstoel voorskrif praktryk in die publieke sektor van die Oos- Kaap te beskryf; en om vas te stel of die rolstoele wat uitgereik word die psigososiale behoeftes van gebruikers addresseer. Studie Ontwerp: ‘n Beskrywende gemengde metode deursnee studie ontwerp is gebruik. Kwantitatiewe en kwalitatiewe data van vraelyste en funksionele rolstoelvaardigheids toetse van rosltoel gebruikers (Fase 1) en van semi- gestruktureerde onderhoude met voorskrywende terapeute (Fase 2) is gebruik om voorskrif praktyk te beskryf en om die psigososiale behoeftes van gebruikers te ondersoek. Metodes: Dertig rolstoel gebruikers (15 van ‘n landelike; 15 van ‘n gedeeltelik- landelike opset) het deelgeneem in die studie. Die PIADS vraelys, “Functioning Everyday with a Wheelchair” (FMA/ FEW) skaal en ‘n self-opgestelde rolstoel spesifikasie kontrolelys (WSC) is gebruik om gebruiker funksionaliteit en tevredenheid met die rolstoel vas te stel. ‘n Semi- gestruktureerde onderhoud is gebruik om rolstoel voorskrifpraktyk insluitend persepsies van beperkinge tot die voorskrifte van rolstoele vas te stel onder tien terapeute. Dataverwerking: Kwalitatiewe data is deduktief geanaliseer en getal response is getabuleer. Kwantitatiewe data is opgesom as gemiddeldes en standaardafwykings en subgroep analise vergelyking is gedoen deur middel van die Chi- square toets. Verhoudings tussen veranderlikes is ondersoek deur middel van die Pearson/ Spearman korrelasie/ ANOVA. P < 0.05 is as statisties beduidend aanskou. Resultate: Drie-en-tagtig % van die uitgereikte rolstoele was landelike rolstoele. Hierdie stoele word oor die algemeen deur gebruikers ervaar as genoegsaam om hulle psigososiale behoeftes rakende vervoer en mobilitiet te bevredig, maar skiet nietemin tekort as dit kom by toeganklikheid en onafhanklikheid binne hulle landelike-/ semi- landelike omgewing. Volgens die WSC resultate, is die semi- landelike rolstoele meer toepaslik vir die gebruikers as die stedelike rolstoele. Geen merkwaardige verhoudings is gevind tussen rolstoel pas, gebruik van kussing, druksere en persepsie van psigososiale behoeftes nie. Die gebruikers het die meeste gesukkel met buitemuurse mobiliteit (57% het volle bystand benodig) en vervoer (63% het volle bystand benodig) in hulle huidige rolstoele. Tien terapeute het aan semi-gestruktureerde onderhoude deelgeneem. Daar is bevind dat hulle korrekte “seating” waardevol ag, kundig is rakende voorskrif praktyk, maar het talle beperkinge geidentifiseer in die praktyk insluitend: begrotings beperkings (90%), tyd tot aflewering (100%) en tekort aan opleiding in dié veld (40%). Die behoefte aan meer toepaslike rolstoel ontwerpe om multi- dimensionele beweeglikheid van persone in landelike/ semi- landelike omgewings te verseker, is ook vasgestel (60%). Gevolgtrekking: Die resultate van hierdie studie toon dat die voorskryf van rolstoele in die Westelike streek van die Oos- Kaap (WSvOK) vele uitdagings het. Alhoewel die rolstoel gebruikers grotendeels tevrede was met hulle rolstoele, het hierdie studie areas vir verbetering geidentifiseer in die gebruikers se funksionaliteit, posturale ondersteuning en biomeganika in hulle rolstoele, veral soos dit van toepassing is op hulle tuis omgewing. Daar is ruimte vir verbetering vir rolstoel lewering aan persone in die WSvOK; vanaf deurlopende opleiding vir terapeute en gebruikers, tot meer toepaslike rolstoel ontwerpe vir persone in landelike gebiede. Verdere navorsing in dié veld word aanbeveel.