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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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COPD patients in the northern suburbs of the Western Cape Metropole hospitalised due to acute exacerbation : baseline studyPienaar, Lunelle Lanine 03 1900 (has links)
Thesis (MScPhysio)--Stellenbosch University, 2008. / ENGLISH ABSTRACT: Acute exacerbation is an important event of COPD as it causes significant disability and
mortality. Especially repeated hospitalisation of patients with acute exacerbation has been
associated with reduce quality of life and excessive hospitalisation cost. Chronic Obstructive
Pulmonary Disease causes significant functional limitations that translate into enormous
economic and societal burden.
Study Aim: To describe the profile and selected outcomes of Chronic Obstructive Pulmonary
Disease (COPD) patients admitted with acute exacerbation to hospitals in the northern
suburbs of the Western Cape.
Study design: A multicenter retrospective descriptive single subject design was used.
Method: Patients admitted with the diagnosis of COPD with acute exacerbation in the time
period 01June 2004-01June 2005 were followed up retrospectively for a period of 12 months.
The demographics, medical condition on admission and past presentation of acute
exacerbation, length of stay in hospital and the number of readmissions for acute
exacerbation in the 12 month period were collected and recorded on a self designed data
capture sheet.
Results: One hundred and seventy eight patients were admitted with acute exacerbation at
the three hospitals. The mean age of the patients were 63 (±11.73), more males than females
(103: 75) were admitted. Subjects spent a mean of 5.67 (±6.55), days in hospital with every admission and admission frequency of up to eight periods were recorded. Of the n=178
admitted, 56% had one admission and 44% had 2 or more admissions in the study year. This
resulted in a total of 338 hospital admissions with the 78 subjects responsible for the majority
of admissions (238) Subjects presenting with two or more co-morbidities had a significantly
greater risk of multiple re admissions. Subjects with three or more admissions had two or
more co morbidities (p=0.001), comparatively those with one admission had only one co
morbidity. Congestive cardiac failure (p=0.01) as well as the lack of Long Term Oxygen
Therapy p=0.017) were associated with increase risk of three or more admissions.
Conclusion: Patients admitted with acute exacerbation to the hospitals where the study was
conducted presented with an age ranging from 30-95 years. Patients with 2 or more
admissions experience up to eight readmissions episodes in the study year. This is a cause of
concern in respect of the burden of disease on especially the younger economically viable
South African population. In the current study factors that influenced readmission were the
presence of two or more co morbid diseases, specifically the presence of congestive cardiac
failure as well as the lack of LTOT. Interventions including a pulmonary rehabilitation
programme post discharge should be aimed at decreasing frequency of hospitalisation
especially in those patients who are a risk of readmission. / AFRIKAANSE OPSOMMING: Verergering van simptome in Kroniese Obstruktiewe Lugweg Siekte (KOLS) is baie belangrik
as gevolg van die ongeskiktheid en mortalitieit wat dit veroorsaak. Dit veroorsaak
vermindering in die kwaliteit van lewe en verhoog hospitaal koste verbind met die siekte. Die
beperkings toe te skrywe aan die Kroniese Obstruktiewe Lugweg Siekte veroorsaak
ontsettende ekonomiese en sosiale druk.
Doelstelling: Om die profiel en geselekteerde uitkomste van pasiente met Kroniese
Obstruktiewe Lugweg Siekte toegelaat met verergering in die hospitale van die noordelike
voorstede van die Wes Kaap te beskryf.
Studie ontwerp: ʼn Multisentrum retrospektiewe beskrywende enkel persoon studie.
Studie metode: Pasiente toegelaat met verergering van Kroniese Obstruktiewe Lugweg
Siekte in die periode 01Junie 2004-01Junie 2005 was retrospektief opgevolg vir ‘n periode
van 12-maande. Demografiese data, mediese toestand op toelating en ontslag, lengte van
hospitaal verblyf en getal toelatings in die 12- maande was gekollekteer en gedokumenteer
op self ontwerpde vorms.
Resultate: Een-honderd agt en seventig pasiente was toegelaat met verergering by die drie
hospitale. Die gemiddelde ouderdom van die studie populasie was 63 (±11.73) met meer
mans as vrouens (103: 75) toegelaat. Die studie populasie het gemiddelde dae van 5.67
(±6.55), in die hospitaal deurgebring en toelating frekwensie van agt episodes was
gedokumenteer. Van die n=178 toegelaat was 56% eenkeer toegelaat en 44% het 2 of meer toelatings in die studie jaar gehad. Dit het in 338 hospital toelaatings veroorsaak en 78 van
die studie populasie verantwoordelik vir die meeste van die toelatings (238). Die groep met
drie of meer toelatings in die studie jaar het twee of meer siektetoestande (p=0.001) gehad,
teenorgesteld met die wat net een toelaat was met een siektetoestand. Hart versaaking
(p=0.01) en die gebrek aan suurstof by die huis (p=0.017) was verbind met meer risiko van
drie of meer toelating.
Samevatting: Die ouderdoms verskil was wydbeskrywend van 30-95 jaar van die pasiente
wat in die studie jaar toegelaat is by die drie hospitale. Pasiente wat 2 of meer keer toegelaat
is het tot agt hertoelatings in die studie jaar gehad. Kommerwekkend is die uitwerking van die
siekte op die jonger werkend populasie in Suid Afrika. In die studie was hertoelating beinvloed
deur die teenwoordigheid van twee of meer siektetoestande, spesifiek hart versaaking sowel
as die gebrek aan suurstof by die huis. Intervensies insluitende pulmonale rehabilitasie na
ontslag se doel moet wees om vermindering van heraaldelike hospitalisasie in hoë risiko
pasiente vir hospitalisasie.
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The effect of gluteal taping on gait in ambulant adults with hemiplegiaLabban, Wasim 03 1900 (has links)
Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2009. / Introduction
Decreased hip extension in the paretic leg is a common impairment after stroke. Gluteal
taping was introduced as a technique that helped in increasing hip extension of the paretic
leg, and step length in the unaffected leg. The aim of this study was to further investigate the
effect of gluteal taping on other temporal spatial and kinematic parameters using a 3D
motion analysis system (Moven System).
Methods
The study was conducted in two phases. Phase 1 entailed examining the intra trial reliability
of the Moven System, where eight subjects were recruited and tested twice at their normal
pace of walking, and twice again at their maximum speed. Phase 2 involved studying the
effect of gluteal taping on temporal spatial and kinematic parameters. Thirty subjects
participated and were tested under three taping conditions (no tape, therapeutic tape, and
placebo tape), while walking at their self selected walking speed. Intra-class correlation
coefficient ICC determined around 95% confidence intervals was used to examine the intra
trial reliability of the Moven System. Repeated measures-ANOVA was used to study the
temporal spatial, and kinematic variables during the three taping conditions.
Results
The Moven showed moderate to excellent reliability in measuring the gait variables including
temporal spatial parameters and sagittal kinematic parameters in addition to the lateral
pelvic tilt. Taping caused significant increase in hip extension and reduction in knee flexion
at terminal stance for the paretic leg. There was a trend toward better hip flexion at terminal
stance, and a mild trend toward more planter flexion at terminal stance. Both treatment and
placebo tapes caused an increase in the step lengths of either leg, and a significant increase
in gait velocity and cadence.
Conclusion
Gluteal taping may be beneficial in producing important clinical effects post stroke, and can
be used as an adjunct strategy during gait rehabilitation. Further research is needed to
understand the mechanism of how taping produces effects, and to further explore its effect
on kinetic and muscle activation variables.
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Knee kinematics during a single-leg drop-landing in sports participants with chronic groin painVisser-Maritz, Karien 04 1900 (has links)
Thesis (MScPhysio)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction: Groin injuries are among the top six injuries in contact sports and may lead to career ending chronic pain. Research on the role of knee kinematics in developing chronic groin pain in sport is scarce.
Objective: The purpose of this study was to determine if there are differences in knee kinematics during a single-leg drop-landing in sports participants with chronic groin pain compared to asymptomatic controls.
Methodology: A descriptive study was conducted. Twenty active sports’ participants were recruited from soccer and rugby clubs situated around the Cape Peninsula area, Western Cape, South Africa. The three-dimensional (3D) knee kinematics of ten cases with chronic groin pain and ten asymptomatic controls was analysed. Knee kinematics was analysed in the FNB-3D Vicon Laboratory at Stellenbosch University, using an eight camera Vicon system. A positive adductor squeeze test was used as a diagnostic test to include cases with chronic groin pain. Each participant performed six single-leg drop landings. The main outcome measure was 3D knee kinematics at initial foot contact and at the lowest vertical position of the drop landing. The following sub-groups were analysed: seven unilateral groin pain cases compared to their seven matched controls; three bilateral groin pain cases where their most painful leg and least painful leg were compared to their matched controls, respectively. Descriptive statistical techniques were used for all outcome measures; means and standard deviations (SD) were calculated, followed by a Student’s t-test to determine significant differences between the cases and controls. For all outcomes with p-values equal to or below 0.05, the effect size was calculated using the Cohen’s D.
Results: The findings of this study indicated a significant difference (p=0.0001) between cases with unilateral groin pain having less knee internal rotation compared to the controls at the lowest vertical position of the drop landing in the transverse plane. Significantly less internal rotation (p<0.0001), was also noted in the cases with bilateral groin pain (in the most painful leg and the less painful leg), although this was noted at foot contact. Cases with bilateral groin pain also had significantly (p<0.001) more knee varus (adduction) during the landing phase.
Conclusion: Differences in knee kinematics between sports participants with chronic groin pain and asymptomatic controls were found. These findings imply that the knee joint should be included during assessment and rehabilitation of individuals suffering with chronic groin pain. Due to the cross-sectional study design of the current study, it cannot be stated for certain whether the knee kinematics noted in the groin pain group are causative or as a result of groin pain. Future prospective studies are thus recommended; these studies should focus on the effect of contralateral knee kinematics on the hip adductors and may include exploration of the muscular components during a single-leg drop landing. / AFRIKAANSE OPSOMMING: Inleiding: Lies beserings is een van die top ses beserings in kontak sport en kan lei tot chroniese lies pyn en selfs die be-eindigging van ‘n sportloopbaan. Navorsing oor die rol van knie kinematika in die ontwikkeling van chroniese liesbeserings in sport is skaars.
Doelwit: Die doel van hierdie studie was om te bepaal of daar verskille in die knie kinematika is tydens 'n enkel been val landing in sport deelnemers met chroniese lies pyn in vergelyking met gesonde kontroles.
Metode: 'n Beskrywende studie was uitgevoer. Twintig aktiewe sport deelnemers is gewerf van rugby en sokker sportklubs geleë rondom die Kaapse Skiereiland, Wes-Kaap, Suid-Afrika. Die 3D knie kinematika van tien gevalle met chroniese lies pyn en tien asimptomatiese bypassende kontroles is ontleed. Knie kinematika was ontleed in die FNB-3D Vicon Laboratorium by die Universiteit van Stellenbosch, met behulp van 'n agt-kamera Vicon stelsel. 'n Positiewe Adduktor druk toets was gebruik as 'n diagnostiese toets om gevalle met chroniese lies pyn in te sluit. Om die knie kinematika te analiseer, het elke deelnemer ses enkel been val landings uitgevoer . Die belangrikste uitkomsmeting was 3D knie kinematika by die aanvanklike voet kontak en by die laagste vertikale posisie van die enkel-been val landing. Die volgende sub-groepe was ontleed: sewe unilaterale lies pyn gevalle in vergelyking met hul sewe bypassende kontroles; drie bilaterale lies pyn gevalle waar hul mees pynlike been, sowel as minder pynlike been onderskeidelik vergelyk was met hul bypassende kontroles. Beskrywende statistiese tegnieke was gebruik vir alle uitkoms maatreëls; gemiddeldes en standaardafwykings (SA) was bereken, gevolg deur 'n Studente’s t-toets om beduidende verskille tussen die gevalle en kontroles te bepaal. Vir al die uitkomste met p-waardes gelyk of onder 0.05, is die effekgrootte bereken deur die Cohen’s D.
Resultate: Die bevindings van hierdie studie dui op 'n beduidende verskil (p=0,0001) tussen gevalle met unilaterale lies pyn met minder interne knie rotasie in vergelyking met die kontroles by die laagste vertikale posisie van die val landing in die dwars vlak. Aansienlik minder interne rotasie (p<0,0001), is ook opgemerk in gevalle met bilaterale lies pyn (in die mees pynlike been en die minder pynlik been), alhoewel tydens voet kontak. Gevalle met bilaterale lies pyn het ook betekenisvol (p <0.001) meer knie varus (adduksie) tydens die landingsfase gehad.
Gevolgtrekking: Verskille bestaan in die knie kinematika tussen sport deelnemers met chroniese liesbesering pyn en gesonde kontroles. Hierdie bevindinge impliseer dat die knie behoort ingesluit te word tydens die assessering en rehabilitasie van individue met chroniese lies pyn. As gevolg van die deursnee-studie ontwerp van hierdie studie, kan dit nie bevestig word of die knie kinematika die oorsaak van die chroniese pyn is nie. Toekomstige voornemende studies word dus aanbeveel, hierdie studies moet fokus op die effek van die kinematika van die kontralaterale knie op die heup adduktore en kan moontlik die ondersoek van die spier kinetika tydens hierdie aktiwiteit insluit.
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Virtual reality exposure therapy as treatment for pain catastrophizing in Fibromyalgia patients : proof-of-conceptMorris, Linzette Deidre 03 1900 (has links)
Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Research objective
To test a novel concept that exposing patients with fibromyalgia syndrome (FMS) to visuals of exercise activities elicits neurophysiological changes in functional brain areas associated with pain catastrophization; thereby providing preliminary support for the further development/testing of a virtual reality exposure therapy (VRET) exercise program aimed at reducing pain catastrophization toward exercise therapy in patients with FMS.
Methods
The main study of this research consisted of a three-phase exploratory fMRI study. Phase 1 involved the development/validation of the fMRI visual task. Phase 2 involved the exploration of the differences in neural correlates associated with pain catastrophizing between participants with FMS and healthy controls when exposed to various visuals of exercise and passive/relaxing activities. Phase 3 involved the testing of the preliminary efficacy of a novel VRET exercise program on pain catastrophization in participants with FMS. The fMRI task consisted of two stimuli: active (exercise activity visuals)/passive (relaxing activity visuals). Structural images as well as blood-oxygenation-level-dependent (BOLD) contrasts were acquired for the conditions and compared within-subjects/groups and between-groups. The condition of interest was the active>passive condition (where brain activations for the passive condition were subtracted from the active condition). The brain volumes collected during ‗on‘ conditions were compared with the brain volumes collected during ‗off‘ conditions using Students‘ t test. Statistic images were thresholded using clusters determined by Z>2.3 and a (corrected) cluster significance threshold of p=0.05. Results
The right (R) middle and inferior frontal gyrus and R posterior cerebellum were significantly activated for the participants with FMS, and not the healthy control group, during the active>passive condition (phase 2). At baseline, during the active>passive condition (phase 3), the intervention/VRET group showed significant activation (p<0.05) in the R insular cortex, R anterior and posterior cerebellum, R parahippocampal gyrus, R middle frontal gyrus, R corpus callosum, R thalamus, R supramarginal gyrus and R middle and superior temporal gyrus; the control group showed significant activation in the R anterior and posterior cerebellum, R middle and superior temporal gyrus, R middle frontal gyrus, R insular cortex, R supramarginal gyrus and R precentral gyrus. Post-intervention, during the active>passive condition, R posterior cerebellum activation was still significant (p<0.05) for the intervention group; R anterior cerebellum, left (L) middle and inferior frontal gyrus, and R superior parietal lobe activation was found to be significant (p<0.000) for the control group, although these areas were not found to be significantly activated at baseline for the control group.
Conclusion
We could not provide confirmatory evidence for the efficacy of a novel VRET program for pain catastrophization in patients with FMS. However, the findings of this study does suggest that pain catastrophization in patients with FMS could be confirmed with fMRI. Research is therefore warranted to further develop a proper VRET exercise program and to test the effect of this program on pain catastrophization in patients with FMS. / AFRIKAANSE OPSOMMING: Navorsing doelstelling Om 'n nuwe konsep dat die blootstelling van pasiënte met fibromialgie sindroom (FMS) aan beeldmateriaal van oefening, ontlok neurofisiologiese veranderinge in funksionele brein-areas wat verband hou met pyn katastrofering te toets; sodoende voorlopige steun vir die verdere ontwikkeling/toetsing van 'n virtuele realiteit blootstelling terapie (VRET) oefenprogram wat gemik is op die vermindering van pyn katastrofering na oefenterapie in pasiënte met die FMS te bied. Metodes Die hoofstudie van hierdie navorsing bestaan uit 'n drie-fase verkennende fMRI studie. Fase 1 het die ontwikkeling/validering van die fMRI visuele taak behels. Fase 2 het die ondersoek van die verskille in die neurale korrelate geassosieer met pyn katastrofering tussen deelnemers met FMS en gesonde kontroles wanneer hulle blootgestel word aan verskeie beeldmateriaal van oefening en passiewe/ontspannende aktiwiteite behels. Fase 3 het die toets van die voorlopige effektiwiteit van 'n nuwe VRET oefenprogram op pyn katastrofering in deelnemers met FMS behels. Die fMRI taak het bestaan uit twee stimuli: aktiewe (oefening aktiwiteit beeldmateriaal)/passiewe (ontspannende aktiwiteit beeldmateriaal). Strukturele beelde sowel as bloed-suurstof-vlak-afhanklike (BSVA) kontraste is vir die toestande verkry en vergelyk binne-deelnemers/groepe en tussen-groepe. Die toestand van belang was die aktiewe>passiewe toestand (waar brein aktivering vir die passiewe toestand afgetrek is van die aktiewe toestand). Die brein volumes wat ingesamel tydens die 'aan' toestande is vergelyk met die brein volumes wat ingesamel is gedurende die 'af' toestande met die gebruik van Studente se t-toets. Drempel statistiek beelde is gegroepeer deur Z> 2,3 en 'n (gekorrigeerde) groepeerde betekenisvolle drempel van p = 0.05. Resultate Die regter (R) middel- en inferior-frontale gyrus en R posterior serebellum is betekenisvol geaktiveer vir die deelnemers met FMS, maar nie vir die gesonde kontrole groep nie, gedurende die aktiewe>passiewe toestand (fase 2). By basislyn, tydens die aktiewe>passiewe toestand (fase 3), die intervensie / VRET groep het betekenisvolle aktivering (p <0.05) in die R insulaire korteks, R anterior en posterior serebellum, R para- hippokampus gyrus, R middel-frontale gyrus, R korpus kallosum, R talamus, R supramarginale gyrus en R middel- en superior-temporale gyrus; die kontrole groep het betekenisvolle aktivering in die R anterior en posterior serebellum, R middel- en superior-temporale gyrus, R middel-frontale gyrus, R insulaire korteks, R supramarginale gyrus en R presentrale gyrus. Post-intervensie, tydens die aktiewe>passiewe toestand, was R posterior serebellum aktivering betekenisvol (p <0.05) vir die intervensie groep; R anterior serebellum, links (L) middel- en inferior-frontale gyrus en R superior pariëtale lob aktivering was betekenisvol (p <0.000) vir die kontrole groep, alhoewel geen betekenisvolle basislyn aktivering in hierdie areas by die kontrole groep plaasgevind het nie. Gevolgtrekking Ons kan nie bewyse vir die effektiwiteit van 'n nuwe VRET program vir pyn katastrofering in pasiënte met FMS bevestig nie. Nietemin, dui die bevindinge van hierdie studie wel daarop dat pyn katastrofering in pasiënte met FMS bevestig kon word met fMRI. Verdere navorsing is dus geregverdig om 'n behoorlike VRET oefenprogram te ontwikkel en die uitwerking van hierdie program op pyn katastrofering in pasiënte met FMS te toets.
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Computer-related musculoskeletal dysfunction among adolescent school learners in the Cape Metropolitan regionSmith, Leone 03 1900 (has links)
Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007. / INTRODUCTION
Computer use has been identified as a risk factor for the development of musculoskeletal
dysfunction among children and adolescents internationally. Computer exposure has
increased in the Western Cape since 2002, with the inception of a project to install computer
laboratories in all schools in the province. As musculoskeletal dysfunction experienced
during adolescence is predictive of musculoskeletal disorders in adulthood, it is essential to
identify all risk and/or associative factors.
METHODOLOGY
A descriptive study was conducted with the aim to investigate whether the musculoskeletal
dysfunction of high school learners in the Cape Metropolitan region was related to their
computer use. This study was conducted in two phases. Phase 1 of the study entailed the
completion of a new questionnaire, the Computer Usage Questionnaire, by grade 10-12
learners. The learner sample was divided in a computer and a non-computer group
depending on their exposure to the school computer. Phase 2 of the study involved the
assessment of the ergonomic design of the computer laboratories at randomly selected high
schools within the Cape Metropolitan region.
RESULTS
A total of 1073 learners (65% girls & 35% boys), aged 14-18 years, completed the CUQ in
phase 1 of the study. The results indicated that learners in the computer group had greater
weekly exposure to computers than the non-computer group. The prevalence of
musculoskeletal dysfunction among this learner sample was 74%. The most common body
areas of dysfunction were the head, low back and neck. The female gender, playing sport
and using the school computer for more than three years were associated with
musculoskeletal dysfunction. Weekly computer use of more than seven hours was
predictive of general musculoskeletal dysfunction, low back pain and neck pain.
Twenty nine computer laboratories within 16 selected high schools were assessed by
means of the Computer Workstation Design Assessment (CWDA). Out of a total score of
40, the computer laboratories obtained average scores of less than 45%, indicating
compliance with less than half of the standard ergonomic requirements.
The average scores for the workspace environment was less than 40%. The design of the
desk, chair and computer screen had the poorest compliance to ergonomic guidelines.
DISCUSSION AND CONCLUSION
The prevalence of musculoskeletal dysfunction among this sample was higher than among
other similar samples on the same study topic. The higher prevalence may be attributed to
the poor ergonomic design of the computer laboratories in the Cape Metropolitan region.
Learners’ reduced participation in activities such as sport and working on a computer due to
their musculoskeletal dysfunction, may impact on their choice of a future career. The
tendency of learners not to seek medical advice for their musculoskeletal dysfunction may
predispose the development of chronic musculoskeletal disorders.
Education of related parties on safe computing habits as well as advice on the ergonomic
design of computer laboratories is recommended to prevent the progression of adolescent
musculoskeletal dysfunction into chronic disorders in adulthood.
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The profile of a surgical ICU in a public sector tertiary hospital in South AfricaHanekom, Susan 12 1900 (has links)
Thesis (MScFisio)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Objective: To describe the baseline data of a surgical ICU in South Africa before the
implementation of an evidence-based physiotherapy practice protocol. Design:
Prospective cohort observational study Setting: Ten-bed closed surgical unit in a
university affiliated tertiary hospital. Patients: All adult ICU admissions from 16 June -
30 September 2003. Measurements: The patient’s clinical data including demographic
information, admission diagnosis, surgery classification and co-morbidities were
recorded on admission to the unit. APACHE II score was calculated. The physiotherapy
techniques, positions and functional activities used, the frequency and duration of
physiotherapy treatment sessions, the provision of after-hours service and the diagnosis
of pulmonary complications were also recorded daily. The time of mechanical ventilation
was calculated and the number of re-intubations documented. The ICU length of stay or
mortality was recorded. Results: 160 patients were admitted. Patients were 49 +/-
19.95 years of age. The mean APACHE II score was 12.3 +/ 7.19 and a 12.3% mortality
was observed. Thirty seven percent of patients were admitted to the unit following
elective surgery. Patients stayed in the unit for 5.94 +/- 6.55 days. Hypertension was the
most frequent co-morbidity found in this cohort (42%), and 21% of patients tested,
tested positive for HIV. Co-morbidities had no significant association with ICU LOS or
mortality. Nine hundred and twenty seven physiotherapy records were obtained.
Students were responsible for 39% (n=366) of treatment sessions, the unit therapist for
34% (n=311) and the on-call therapists for 27% (n=250). Despite routine daily
physiotherapy for all patients in the unit, 39% (n=62) developed excessive secretions,
30% (n=48) of patients developed pneumonia and 27% (n=43) of patients were
diagnosed with basal atelectasis. Nineteen patients (12%) died in the ICU. Patients
spent a mean of 5.94 (SD 6.55) days in the unit. One hundred patients (63%) were
ventilated. Almost a third of ventilated patients (31%) were intubated more than once.
The patients spent a mean time of 3.8 days (SD 6.30) on the ventilator every time they
were re-intubated. The development of pulmonary complications significantly increased
the time on the ventilator and the LOS. Conclusions: This baseline study of a surgical
ICU presents a picture of a unit providing care comparable to first world environments.
The picture of the physiotherapy service provided in this unit is of a “traditional” service
based neither on the available evidence regarding the prevention or management of
pulmonary complications, nor on the incorporation of early rehabilitation into the
management of mechanically ventilated adult patients in ICU. / AFRIKAANSE OPSOMMING: Doel: Om die basis lyn van ‘n chirurgiese intensiewe sorg eenheid in Suid Afrika te
beskryf voor die implementering van ‘n bewysgesteunde fisioterapie protokol in die
eenheid. Studie struktuur: Prospektiewe kohort observerende studie. Eenheid: Tien
bed geslote eenheid in ‘n tertiêre opleidingshospitaal. Pasiënte: Alle volwasse pasiënte
opgeneem in die eenheid tussen 16 Junie en 30 September 2003. Meetings:
Demografiese data, diagnose met opname, chirurgie klassifikasie en ko-morbiditeite is
aangeteken by opname. APACHE II is bereken. Die fisioterapie tegnieke, pasiënt
posisies en funksionele aktiwiteite gebruik in behandelingssessies, die frekwensie en
duur van behandelingssessies, die verskaffing van na-ure diens aan die eenheid asook
die komplikasies gediagnoseer is daagliks aangeteken. Die tyd wat pasiënte geventileer
is asook die aantal kere geher-intubeer is bereken. Die tydsduur van eenheid verblyf
asook mortaliteit is aangeteken. Results: 160 pasiënte is opgeneem, met ‘n
gemiddelde ouderdom van 49 +/- 19.95. Die gemiddelde APACHE II telling was 12.3 +/
7.19 en die mortaliteit was 12.3%. Sewe en dertig persent van pasiënte is opgeneem na
elektiewe chirurgie. Pasiënte bly in die eenheid gemiddeld vir 5.94 +/- 6.55 dae.
Hipertensie was die mees algemene ko-morbiditeit (42%), en 21% van die pasiënte wat
getoets is, het positief getoets vir HIV. Ko-morbiditeite het geen beduidende verband
getoon met die tyd in die eenheid of mortaliteit nie. 927 Fisioterapie rekords is
aangeteken. Studente was verantwoordelik vir 39% (n=366) van die
behandelingssessies, die eenheid terapeut vir 34% (n=311) en die op-roep
fisioterapeute vir 27% (n=250). Ten spyte van daaglikse roetine fisioterapie behandeling
van alle pasiënte in die eenheid het 39% (n=62) oormatige sekresies ontwikkel, 30%
(n=48) is met pneumonie gediagnoseer en 27% (n=43) met basale atelektase.
Negentien pasiënte (12%) is dood in die eenheid. Die tydsduur van eenheid verblyf was
5.94 (SD 6.55) dae. Een honderd pasiënte (63%) is geventileer. Byna een derde (31%)
van pasiënte is geher-intubeer. Met elke her-intubasie het die pasiënte gemiddeld 3.8
(SD 6.30) dae langer op die ventilator gebly. Pulmonale komplikasies het beide die
tydsduur in die eenheid as op die ventilator betekenisvol verleng. Gevolgtrekkings:
Hierdie basislyn studie beskryf ‘n eenheid waar pasiënte mediese sorg ontvang
soortgelyk aan eerste wêreld lande. Die fisioterapeutiese diens wat gelewer word is
egter nie gebasseer op die nuutste bewyse in die literatuur nie. Nog, in die voorkoming
of in die behandeling van pulmonale komplikasies, nog in die vroëere inkorporasie van
rehabilitasie in die hantering van volwasse pasiënte in ‘n intensiewe sorg eenheid.
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The impact of functional electrical stimulation to the lower leg after a single botulinum toxin injection in children with a spastic equinus gait due to cerebral palsySeifart, Anja 03 1900 (has links)
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.
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Low back pain and front foot hip joint kinematics in Western Province first league fast bowlersSaayman, Merike 03 1900 (has links)
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.
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Investigation of hip kinematics in adult sports participants during single leg drop landing with chronic groin painDare, Michael Robert 04 1900 (has links)
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.
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