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The activity and participation profile of persons with traumatic spinal cord injury in the Cape Metropole, Western Cape, South Africa : a prospective, descriptive studyMaclachlan, Mirda 03 1900 (has links)
Thesis (MScPhysio)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Background
Traumatic spinal cord injury (SCI) remains one of the most serious and devastating injuries often
resulting in permanent disability and with life changing implications for the individual and his/her
family. Successful reintegration into community life and employment after SCI is considered
important goals of rehabilitation as this has been positively associated with quality of life, self
esteem and life satisfaction. The International Classification of Functioning, Disability and Health
(ICF) allows researchers to identify the impact of environmental factors on functioning and
disability. Minimal research, particularly in South Africa, has been done on the impact of the
environment on persons living with various health conditions and specifically spinal cord injury.
Objectives
The main purpose of this study was to describe and compare the level of participation of persons
with traumatic SCI at two time points (discharge and six months after discharge) from the inpatient
rehabilitation setting and to identify the environmental barriers experienced.
Methods
A prospective, descriptive study was conducted using consecutive sampling. All patients with
traumatic SCI that were discharged from September 1, 2008 from the Western Cape Rehabilitation
Centre (WCRC) who were eligible for this study were included. Two questionnaires (one based on
the ICF and one purposely-developed) and the International Standards for the Classification of SCI
(ISCSCI) were used. Data were analyzed with the statistical software package STATISTICA.
Results
A person sustaining a traumatic SCI in the Cape Metropolitan area of the Western Cape Province is
most likely to be a male, young (20 to 29 years), of the Black or Coloured race and living in the
Cape Flats suburbs. More than half of the subjects had a grade eight to ten level of education which
together with the lack of employers’ responsibilities towards part-time workers might explain the
low percentage (11%) of employment at six months after discharge from the WCRC.
Complete paraplegia, occurring mainly in the thoracic cord, was the most common neurological
disability found in this study. The most common secondary condition was pain followed by
spasticity limiting function. The low incidence of pressure sores and urinary tract infections found
in this study contradicts findings of previous studies.The majority of the subjects were discharged to the same house they were living in at the time of
their injury. However, due to various architectural barriers, some of them were not able to function
independently in their homes.
Inaccessibility of public transport, the lack of recreational and sport facilities, lack of social support
structures in the community and inadequate financial resources were the main environmental
barriers experienced by these individuals.
Conclusion
The main finding of this study was the low employment rate and the difficulty experienced with
reintegration at community level after SCI. The results of this study confirm the significant
contribution of environmental factors in participation, especially those of transport and education in
return to work. Fourteen years after the publication of the Integrated National Disability Strategy
(INDS) White Paper (1997), legislative strategies to ensure that people with disabilities have equal
access to social and economic opportunities remain lacking. / AFRIKAANSE OPSOMMING: Agtergrond
Traumatiese spinaalkoordbesering (SKB) lei dikwels tot permanente verlamming en dit het
lewensveranderende implikasies vir die individu en sy/haar familie. Suksesvolle herintegrasie in die
gemeenskap en werkverrigting na SKB is belangrike doelstellings vir rehabilitasie omdat dit
positief met lewenskwaliteit, selfrespek en lewens-bevrediging geassosieer word. Die Internasionale
Klassifisering van Funksionering, Gestremdheid en Gesondheid (IKF) bied aan navorsers die
geleentheid om die impak van omgewingsfaktore op funksionering en gestremdheid te identifiseer.
Daar is veral in Suid-Afrika beperkte navorsing oor die impak van die omgewing op mense met
verskillende gesondheidstoestande, spesifiek SKB.
Doel
Die hoofdoel van hierdie studie was om die vlak van deelname van mense met traumatiese SKB op
twee verskillende tye te beskryf en te vergelyk, onmiddellik na hulle uit die rehabilitasiesentrum
ontslaan is, en ses maande later. Die studie het ook ten doel gehad om die omgewingsfaktore te
identifiseer wat deelname negatief beïnvloed.
Metode
Daar is van ’n beskrywende studie gebruik gemaak. Alle pasiënte met traumatiese SKB wat vanaf 1
September 2008 vanaf die Wes-Kaapse Rehabilitasiesentrum (WKRS) ontslaan is en wat voldoen
het aan die insluitingskriteria is ingesluit. Twee vraelyste is gebruik om data in te samel – een is op
die IKF gebaseer en een is spesifiek vir die studie ontwikkel. Daar is ook van die Internasionale
Standaarde vir die Klassifisering van SKB (ISKSKB) gebruik gemaak om data in te samel. Data is
met behulp van STATISTICA, ’n statistiese sagteware pakket, geanaliseer.
Resultate
Iemand wat ’n traumatiese SKB in die Kaapse metropolitaanse gebied van die Wes-Kaap provinsie
opdoen, is mees waarskynlik ’n jong man (20 tot 29 jaar) van die Swart of Kleurling ras wat
woonagtig in die voorstede op die Kaapse Vlakte is. Meer as die helfte van die deelnemers in die
studie het slegs ’n opvoedingsvlak van graad agt tot tien. Hierdie aspek, tesame met die gebrek aan
werkgewers se verantwoordelikheid teenoor deeltydse werknemers is dalk die rede waarom slegs
11% van die deelnemers ses maande na hulle uit die WKRS ontslaan is, werksaam was.
Volledige paraplegie, hoofsaaklik as gevolg van ’n besering van die torakale spinaalkoord, was die
algemeenste neurologiese besering wat in hierdie studie gevind is. Die algemeenste sekondêre
komplikasie wat voorgekom het, was pyn gevolg deur spastisiteit. Die lae voorkoms van druksere
en urienweginfeksies in dié studie is in teenstelling met bevindings van vorige studies.
Die meeste deelnemers is ontslaan na dieselfde huis waar hulle voor die besering gewoon het, maar
as gevolg van verskeie argitektoniese hindernisse, kon sommige van hulle nie onafhanklik binne
hulle wonings funksioneer nie.
Die ontoeganklikheid van openbare vervoer, die gebrek aan ontspannings- en sportfasiliteite, die
gebrek aan sosiale ondersteuningsnetwerke in die gemeenskap en onvoldoende finansiële
hulpbronne was die algemeenste omgewingshindernisse wat deur die deelnemers ondervind is.
Samevatting
Die belangrikste bevinding van dié studie was dat slegs ’n klein persentasie van die deelnemers ses
maande na hul ontslaan is, werksaam was en dat herintegrasie in die gemeenskap na ’n SKB baie
moeilik is. Die resultate van die studie bevestig die belangrike rol wat omgewingsfaktore by
deelname speel, veral die faktore wat te make het met vervoer en die opvoedingsvlak wanneer daar
na ’n werk teruggekeer word. Veertien jaar na die publikasie van die Geïntegreerde Nasionale
Gestremdheidstrategie in 1997, is wetgewende strategieë om gelyke toegang tot sosiale en
ekonomiese geleenthede vir persone met gestremdhede te verseker, steeds gebrekkig.
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On traumatic lesions to the spinal cord and dorsal spinal roots : factors influencing axonal regrowth across the border between the central and peripheral nervous system in rat and man /Lindholm, Tomas, January 2002 (has links)
Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.
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The psycho-social impact of pain on spinal cord injured patientsColley, Jennifer Margaret 24 August 2012 (has links)
M.A. / Spinal cord trauma resulting in paraplegia or quadriplegia is one of the most devastating injuries. A frequent complication of spinal cord injury is intractible pain. It compounds a host of personal and social consequences: disruption of personal roles, dysfunctional marital and family relationships, unemployment, financial hardship, depression, anxiety, lowered self-esteem and hopelessness. There is an abundance of research on pain in general, but a dearth of literature on chronic pain in the spinal cord injured population - especially in the South African context. This study examined the psychosocial impact of pain on spinal cord injured patients in a hospital setting. Specifically, it addressed six core research questions, concerned with the physiological components of pain, and the social, affective and rehabilitation consequences of pain for spinal cord injured patients. The effects of etiology and level of lesion, age, gender and culture on the general pain experience were investigated. The purpose of this study was to accurately describe the phenomenon of pain as experienced by spinal cord injured (SCI) patients. The evidence showed that pain was a serious problem for SCI patients. A variety of physical and social modifiers of the pain experience were identified, as were several important temporal features of pain. SCI patients reported high frequencies of social, affective (depression, low selfesteem, suicidal responses and partner relationship problems), and rehabilitation consequences. The etiology of spinal cord injury was found to be related to pain intensity, while the level of the lesion was not associated with pain intensity or frequency. Some effect was found for age, however, gender did not contribute to the variance of any of the dependent variables. The culture of SCI patients plays an important role in both pain perception and the psychosocial and rehabilitation consequences of chronic pain. The results suggest that pain in SCI patients, as in other pain populations, needs to be recognized as a complex, multidimensional phenomena. Successful treatment requires an understanding of the SCI patient's emotional and psychological, as well as his physical requirements. The role of pain assessment is fundamental to any pain management programme.
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Evaluation of the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) in a spinal cord injury population.Reed, Kristin 08 1900 (has links)
Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR has the potential to be a valid measure with this population and further analysis of the psychometric properties with patients with SCI is warranted.
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Påverkan av spinal immobilisering : en litteraturstudie / Effects of spinal immobilization : a literature rewievSörell, Susanne January 2016 (has links)
SAMMANFATTNING Den prehospitala vården börjar när samtalet inkommer till SOS och avslutas när patienten avlämnas på mottagande enhet. Den prehospitala vården innefattar undersökning, övervakning och behandling av skadade och sjuka. Kompetensen det senaste årtiondet har förändrats från att ha varit enbart en transportorganisation till att utföra avancerade medicinska bedömningar och åtgärder. I Sverige drabbas ca 4000 personer varje år av skador i hals-, bröst- och ländrygg. Dessa frakturer orsakas ofta av hög energi och uppkommer samtidigt med andra svåra skador. Ryggradsskador innebär stort lidande för patienten och även höga kostnader för samhället. När den prehospitala personalen kommer fram till en patient med misstänkt skada på kotpelaren så är spinal immobilisering den åtgärd som utförs. Spinal immobilisering innebär att patienten påförs en hård nackkrage och sedan läggs och spänns fast på en spineboard. Detta i syftet att minimera rörelse i kotpelaren under transport in till mottaganade enhet. Syftet med studien var att belysa påverkan av att vara spinalt immobiliserad. Den metod som användes var litteraturstudie. Tjugo vetenskapliga artiklar valdes ut och sammanställdes efter sökning i olika databaser. Artiklarnas kvalitet har bedömts utifrån ett protokoll för att värdera dess kvalitet. Resultatet presenteras under fyra kategorier. Det främsta resultatet som framkom var att spinal immobilisering är obekväm och framkallar smärta. Detta på grund av att metoden framkallar kraftigt ökat tryck på vissa utsatta områden av kroppen så som bakhuvudet, skuldror och rumpa. Spinal immobilisering ger även en negativ påverkan på andningen och minskar cirkulationen till hjärnan och den hud och vävnad som utsätts för tryck. Slutsatsen var att många negativa effekter finns av att spinalt immobilisera patienterna på spineboard. Få studier eller inga studier visar att det faktiskt är en åtgärd som har någon positiv effekt eller ens den effekt som eftersträvas med spinal immobilisering.
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Clinical signs and histopathologic changes of the spinal cord in pigs treated with tri-o-cresyl phosphateMaydew, Marcus Scott January 2011 (has links)
Typescript (photocopy). / Digitized by Kansas Correctional Industries
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Evaluating the relationship between external markers and internal vertebral kinematics in the cervical spineDe Beer, N., Christelis, L., Van der Merwe, A.F. January 2012 (has links)
Published Article / The objective of this study was to examine the relationship between external markers typically used in external motion capturing devices and the true vertebral kinematics in the cervical spine. Twenty one healthy subjects were subjected to low dosage X-rays in five different positions, while radio opaque markers were attached to the skin at each vertebral level. Distance and angle parameters were constructed for vertebral prediction from skin surface markers. The causes of variation in these parameters were identified by investigating the correlations of these parameters with anthropometrical variables. Strong correlations of the parameters were observed in flexion, but in extension, especially full extension, the correlations were poor to insignificant. In neutral, half flexion, and full flexion it is possible to predict the vertebral position from surface markers by using the parameters and anthropometrical variables. In half extension this prediction is less accurate and in full extension alternative methods should be investigated for external motion capturing.
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The immediate effect of low back manipulation on serum cortisol levels in adult males with mechanical low back painPadayachy, Keseri January 2005 (has links)
Thesis (M.Tech-: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005
x, 57 leaves, Annexures 1-10 / To determine if serum cortisol levels are increased following Spinal Manipulation Therapy (SMT) to the low back region and to determine the effect of a short rest interval on the cortisol levels
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The immediate and short term effect of spinal manipulative therapy (SMT) on asymptomatic amateur golfers in terms of performance indicatorsLe Roux, Stefan January 2008 (has links)
Thesis (M.Tech.: Chiropractic)-Durban University of Technology, 2008. xviii, 83, [29 ], 25 leaves / Golfing literature today recommends to both the amateur and professional golfers to try and achieve maximum performance with each golf club (Seaman, 1998 and Bulbulian, Ball and Seaman, 2001). This encourages golfers to use a state of maximum spinal rotation in their golf swing in order to achieve optimal performance (Seaman, 1998), thus resulting in back pain becoming endemic in the golfing population.
Thus if it is considered that performance, in terms of the golf swing, is mainly influenced by;
• the strength and power of the torso, i.e. the low back and abdominal muscles (Chek, 2003),
• as well as muscle balance and flexibility, i.e. those muscles which are responsible for the static and dynamic postural stability of the golf swing (Chek, 2003).
It then stands to reason that any decrease in the range of motion of the lumbar or thoracic spine of the amateur golfer, in terms of biomechanics, could affect their performance (Nordin and Frankel, 2001). In this regard it is hypothesised that altered biomechanics could be that of asymptomatic segmental joint dysfunction .
In terms of interventions Kirkaldy-Willis and Burton (1992) explained the effect of SMT in the treatment of low back pain, similarly Bergmann et al. (1993) and Vernon and Mrozek (2005) further proposed the following effects of spinal manipulative therapy (SMT):
• SMT may stretch or break intra-articular adhesions that form from immobilised facet joints due to acute synovial reactions.
• SMT allows entrapped menisci to exit the facet joint in which it became entrapped.
• If the capsule of the facet gets lodged between two adjacent articular surfaces, the process of SMT could allow this to be freed.
• SMT re-aligns misaligned spinal segments to conform to the centre of gravity.
It was thus assumed that if these mechanical and reflex mechanisms occur in the symptomatic amateur golfer, they should also occur in the asymptomatic amateur golfer. Currently however very little is known about the effects of spinal manipulative therapy (SMT) on asymptomatic segmental joint dysfunction.
Objective:
Therefore, the purpose of this study was to evaluate the immediate and short term effect of spinal manipulative therapy (SMT) on asymptomatic amateur golfers in terms of performance indicators.
Methods:
Forty three asymptomatic participants were randomized to four equal groups consisting of ten participants each (and three drop outs). Three of the groups received a single intervention, i.e. spinal manipulative therapy (SMT) while the last group acted as a placebo control group and received no intervention. Objective measurements were taken using the EDH Sports-FlightScope Pro Electronic Swing Analyser. All objective data collection took place pre and post SMT. Statistical analysis included various statistical methods and correlation analyses, by means of the latest version of SPSS.
Results and conclusions:
The main findings were that certain outcomes seem to be better with lumbar manipulation alone (smash, horizontal azimuth) and others better with thoracic manipulation alone (CHV, vertical azimuth, distance), but none are better with both lumbar and thoracic manipulation. Therefore in terms of future studies of this nature the treatment groups should be analysed separately and the research powered for such analyses (e.g. larger sample sizes).
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An investigation into the relative effectiveness of Transeva and spinal manipulative therapy for mechanical low back painMarshall, Caryn Natalie January 2009 (has links)
Mini-dissertation in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, in the Department of Chiropractic at the Durban University of Technology, 2009 / The aim of this study was to investigate the relative effectiveness of Transeva and spinal manipulative therapy for mechanical low back pain. The objectives evaluated the effectiveness of only administering Transeva therapy alone, or Spinal manipulative therapy alone as well as Transeva therapy with Spinal manipulative therapy on mechanical low back pain with respect to the patients’ subjective and objective responses to the respective treatment group. The final objective was to correlate the subjective and objective data collected to determine the effectiveness of each of the therapies in comparison with another. Design: A sample of thirty patients diagnosed with mechanical low back pain were accepted into the study. These patients were randomly divided into three groups of 10, which received different treatment protocols for mechanical low back pain. Outcome Measure: The following outcomes were measured; a decrease in pain (measured with the Numerical Pain Rating Scale (NRS), a decrease in disability (measured with the Roland-Morris Questionnaire), a decrease in local tenderness (measured with the pressure Algometer) and an increase in lumbar range of motion (measured with the Inclinometer). The data was collected prior to treatment one, prior to treatment four and at the sixth follow-up visit. Results and Conclusion: All groups improved with the treatments they received; however, no single treatment was statistically better than any other treatment intervention tested.
However, the Spinal manipulative therapy group had a statistically significant faster reduction in pain on the NRS readings with p=0.048.
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