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

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

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

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

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

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

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

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.