Background: Investigating the development of competent occupational therapists through an academic programme and fieldwork placement is an emerging field in South African occupational therapy research. It is an essential aspect of educational research, as new graduates are often required to work autonomously during their community service. Aim: The aim of this study was to explore the perceptions of the final year University of KwaZulu-Natal occupational therapy students and their clinical supervisors’ regarding their undergraduate education and preparedness for independent clinical practice. Methods: Seventeen final year students and seven clinical supervisors participated in focus groups and semi-structured interviews. Document analysis was used to explore the Health Professions Council of South Africa evaluation report of the undergraduate programme and methods used to assess the final year students. The conceptual framework was based on the World Federation of Occupational therapist Minimum Standards for Training Occupational therapists and deductive reasoning was used to analyse the data. Findings: Most final year students and clinical supervisors felt that students were partially prepared for clinical practice and lacked confidence. The students’ level of confidence was linked to the areas of occupation therapy that they enjoyed and their positive experiences during fieldwork placements. Curriculum design and content were some of the areas highlighted as needing review. Conclusion: The overall perception of both the clinical supervisors and the students was that the new graduates would be able to cope with basic clinical practice. However, there were aspects of the curriculum that could be improved to ensure that the new clinicians have more confidence and are equipped to deliver an occupational therapy service that specifically meets the need for diverse African healthcare settings. / Thesis (M.O.T.)-University of KwaZulu-Natal, Westville, 2013.

Thesis (MOccTher)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: The rights of people with disabilities to equal opportunities for employment is acknowledged on a national and international level. A key area whereby this can be addressed is through effective vocational rehabilitation programmes in occupational therapy. The delivery of high quality health care services is an important issue for the consumer and government within the health arena. This implies that standards have to be developed for the various services. The standards will serve the purpose of activating quality assurance and quality improvement processes in all health care services. Vocational rehabilitation of people with disabilities and the emphasis that is placed on good quality care, resulted in the question: "How can occupational therapists ensure that they will deliver a good quality service in a vocational assessment area?". The question is posed specifically in terms of the assessment of a person's work abilities, as this step is viewed as most important in the vocational rehabilitation process. The step(s) that follow will be determined by the results obtained from the assessment. The purpose of the study is to identify a standard statement and generic measurement criteria that will be used to set the standards for Structure, Process and Outcome for vocational assessment areas. The establishment of measurement criteria is viewed as a starting point in the quality assurance cycle. The results of the study will initiate quality assurance and quality improvement in vocational assessment areas. Although the role of the occupational therapist is clearly delineated regarding vocational rehabilitation and the importance of the occupational therapy contribution recognised in this regard, could no information pertaining to standards and measurement criteria for work assessment areas be identified through a literature study. It was therefore decided to develop a standard statement and measurement criteria according to the Donabedian Model of Structure, Process and Outcome for vocational assessment areas in South Africa. Occupational therapists with at least one year experience of vocational rehabilitation of patients were requested to rate the proposed standard statements and measurement criteria. A survey method (adapted Delphi method) was used whereby the participants had to rate the proposed standard statements and measurement criteria on a four-point scale. The results obtained were used to draw up a standard statement and measurement criteria to ensure that quality assurance and quality improvement will become a reality in vocational assessment areas in South Africa. / AFRIKAANSE OPSOMMING: Die regte van persone met gestremdhede tot gelyke indiensneming word op nasionale en internasionale vlak erken. Die aanbieding van effektiewe werkrehabilitasieprogramme deur arbeidsterapeute is een van die belangrikste wyses waarop die situasie aangespreek kan word. Die lewering van hoë gehalte gesondheidsdienste word toenemend deur die verbruikers en die staat vereis. Dit impliseer dat standaarde vir die dienste vasgestel moet word om gehalteverbetering en gehalteversekering in gesondheidsdienste te vestig. Werkrehabilitasie van persone met gestremdhede en die kwessie van hoë gehalte dienste het die volgende vraag laat ontstaan: "Hoe kan die arbeidsterapeut verseker dat 'n hoë gehalte diens in 'n werkbepalingsarea gelewer word?". Die vraag handel spesifiek oor die bepaling van 'n persoon se werkvermoëns aangesien dié stap as baie belangrik binne die werkrehabilitasieprogram beskou word. Die stap(pe) wat hierna sal volg, salop besluit word na aanleiding van die resultate van die bepaling. Die doel van die studie is om 'n standaardstelling en generiese metingskriteria volgens Donabedian se model te identifiseer om die standaarde vir die Struktuur, Proses en Uitkoms van werkbepalingsareas in Suid-Afrika daar te stel. Die bogenoemde metingskriteria sal dit moontlik maak om die gehalteversekeringsiklus te inisieër. Gehalteversekering en gehalteverbeteringsaksies sal as gevolg hiervan in werkbepalingsareas kan plaasvind. Ten spyte van die feit dat die rol van die arbeidsterapeut in werkrehabilitasie duidelik uiteengesit is en die belang daarvan erken word, kon geen inligting oor 'n standaardstelling en metingskriteria vir werkbepalingsareas in die literatuur gevind word nie. Arbeidsterapeute met minstens een jaar ondervinding van werkrehabilitasie van pasiënte het hulle menings ten opsigte van 'n standaardstelling en metingskriteria uitgespreek. 'n Opname metode (gewysigde Delphi metode) is gebruik en deelnemers het op 'n vierpuntskaal hul voorkeure ten opsigte van 'n standaardstelling en metingskriteria aangedui. Die resultate wat op dié wyse bekom is, is gebruik om 'n finale standaardstelling en voorkeur metingskriteria voor te stel. Die gebruik hiervan in werkbepalingsareas sal daartoe lei dat gehalteversekering en gehalteverbetering in dié areas in Suid-Afrika tot uitvoer gebring sal word.

This thesis presents and discusses the results of research undertaken to explore the concept 'professional confidence'. The term 'confidence', is frequently to be found In previous research, yet this has not adequately been defined. The conceptions held by occupational therapists were not clear, and the events or circumstances that fostered professional confidence in occupational therapists have not been identified. Each of these aspects was identified as an area for research in the profession. Three studies were undertaken to gain greater insights and to add to the body of knowledge in terms of our understanding of 'professional confidence'. The studies included a concept analysis of the concept of 'professional confidence', a phenomenographic study of the conceptions of professional confidence that novice occupational therapists hold and finally, the sources or determinants of professional confidence beliefs in occupational therapy students were explored using an interpretative methodology. The research undertaken yielded antecedents and attributes or characteristics of professional confidence, and from these a definition was crafted. The conceptions or understanding of professional confidence held by the community service therapists, namely knowing, believing and being, were closely related to the attributes raised in the concept analysis, confirming the findings of the analysis. Final year occupational therapy students highlighted a number of determinants of professional confidence, including events, situations and circumstances within their control, the control of their clinical supervisors and/or the profession. These sources in turn had been confirmed as antecedents in the concept analysis. The research confirmed that professional identity, competence and professional confidence are inter-related and inter-dependent phenomena. Professional confidence involves a dynamic, maturing self-belief closely related to, and informed by both professional identity and competence. As such, equal attention should be given during the educational endeavour and initial employment opportunities, to the fostering of both professional identity and professional confidence while enhancing competencies. The recommendations provided within the research provide a rich source of information from which further research can be undertaken and interventions developed to assist students and novice practitioners to enhance their professional confidence. / Thesis (Ph.D.)-University of KwaZulu-Natal, Westville, 2013.

Obstetric brachial plexus palsy, a traumatic birth palsy, results in the paralysis of the upper limb/s. The birth injury is treated at the Brachial Plexus Clinic at King Edward VIII th Hospital, where the Candidate forms part of the Rehabilitation Team. In keeping with worldwide trends, the focus of treatment was on rehabilitation of the upper limb/s. During the course of treatment of these patients, it was observed that the performance of these children varied from excellent to poor. This observation, has not been recorded previously, hence a Research study was initiated to invesitigate this aspect of performance. The study comprised thirty children, between the ages of four and seventeen, whose paralysis was assessed in the conventional pattern. In addition, the visual perceptual abilities of these children were assessed in a variety of batteries, catering for the wide age range. These were: Developmental Test of Visual Motor Integration (1989), Motor Free Perception Test (1972), Developmental Test of Visual Perception (2nd edition), Test of Visual Perceptual Skills - Upper and Lower levels ( Gardner), Jordan's Left-Right Reversal Test (1974), Clinical (Ayres) and General Observations. Although traditionally viewed as a physical disorder, the results of the study indicate that children with obstetric brachial plexus injury present with a significant incidence of below average performance, against the normal population, on most of the assessment batteries. No significant relationship could be established between the severity of the lesion and visual perceptual abilities, owing to the disproportionate numbers of children amongst the different lesions. Further research is required to support and consolidate the findings of this study. It is also recommended that Occupational therapists screen for visual perceptual deficits in such injuries, thus facilitating holistic patient management. / Thesis (M.O.T.)-Unversity of Durban-Westville, 1998.

The existing selection criteria and procedures applied at universities training occupational therapists in South Africa are not meeting the country's need for selecting students who adequately fulfill the demographic mix which represents the South African population. The aims of this research were: to investigate the existing criteria and procedures used for the selection of occupational therapy students; to establish recommendations with regard to how these criteria and procedures can be adapted to allow for more appropriate and equitable selection of students, and to obtain opinions from qualified therapists about those characteristics deemed most important for them to possess in the current South African Health System. A combination of quantitative and qualitative methodology was adopted. A survey was undertaken to obtain basic information and statistics about the numbers of applicants selected, and the existing selection criteria and procedures currently used to select occupational therapy students in South African universities. A series of two focus groups for each of the eight existing universities were carried out i.e. one incorporating the views of lecturers and clinicians and the other the views of students. The purpose of these groups was to obtain existing and emerging views of qualified therapists and students on current selection processes, what could be recommended to make selection fairer for disadvantaged applicants and what specific characteristics of qualified therapists would be most desirable in the current health system. The results indicate that the proportion of African students admitted into occupational therapy degrees is still far below numbers of other race groups, particularly white South Africans. That existing selection criteria and procedures are still dominated by eurocentric influence, particularly in the historically white universities, although there are definite attempts on the part of all occupational therapy training centres to overcome this, and that there are serious problems related to recruitment of African applicants which are partly the cause of the low numbers of African applicants. Characteristics deemed most desirable in qualified occupational therapists included many, most significant were: flexibility, particularly a special ability to be able to adjust to all types of people and cultures which included good communication and interpersonal skills; the ability to be assertive where appropriate; a "life-Iong-Ieamer" attitude including a visionary mentality/attitude; creativity and inriovative thinking; perseverance, determination and good management skills. / Thesis (M.Sc.)-University of Durban-Westville, 1997.

Introduction: Elderly females are predominantly left impaired by the degenerative impact which osteoarthritis has on the 1st CMC joint. Research supports the successful implementation of early stage conservative management. Aim: To determine the viability of performing a full scale study to investigate the influence of an abductor pollicis longus strengthening program on the symptoms experienced by elderly females presenting with early stage osteoarthritis of the 1st CMC joint. Objectives: Validating data gathering instruments; evaluating methods and procedures used for recruiting, randomization; retaining, assessing and facilitating compliance of participants. Evaluation of the data capturing process. Required resources and sample size for a scientifically valid full scale study was estimated. Method: The pilot study made use of the quantitative research design proposed for a full scale study. Tools such as cost sheets and compliance logbooks were implemented along with qualitative components such as feedback questionnaires and field notes. Three retirement homes participated; 25 residents qualified to participate of which 15 were allocated to the experimental group and 10 to the control group. The experimental group participated in an 8 week exercise program; while the control group received an assistive device. Both the experimental and control groups were assessed at baseline; four weeks and after eight weeks. The assessment battery included the Kapandji index for thumb opposition, voluntary isometric total grip, 2-point pincer, 3-point pincer and key grasp strength, Visual Analogue Scale for pain and the Michigan Hand Outcome Questionnaire (MHQ). Data analysis: Data was captured by the researcher; the MHQ and feedback questionaires were independantly completed by the partiticpants. Data cleansing was conducted manually where corectness was verified by a third uninvolved party. Quantitative data was summarized and tested with the vi Generalized Estimating Equations (GEE) to detect possible changes over time. Inferential analysis and comparisons of results for the experimental and control groups could not be made. The researcher detected themes and subthemes within the qualitative data. Results/Discussion: Recruitment techniques’ response rate did not exceed 27%; qualitative data sets identified influencing factors An inclusion age of 60 years and older were suggested and to extend the research to various ethic groups. A large enough sample group for randomization was not obtained. Recommended adjustments to the assessment battery: using an adjusted MHQ as the full MHQ includes unapplicable questions; using a Numerical Rating Scale (NRS) for pain potentially being more user friendly for an elderly population; and an additional abduction active range of motion goniometer assessment for the thumb is recommended as the Kapandji scale for opposition provided limited information concerning the range of motion of the 1st CMC joint. The calculated cost per participant was R1921.60 for the control group and R3179.79 for the experimental group. Human resources were calculated at 64.2% of the entire budget. Compliance was affected by poor memory and health. Population attrition rates were calculated at an average of 48%. The feedback questionaires indentified personal gain and the feeling of contributing to a research initiative as the predominant themes for retaining the target population. Conclusion:The conducted pilot study can be used to define the parameters necessary to conduct then mentioned full scale research study, as well as assist with research designs envolving a similar target population. One more pilot study is recommended prior to a full scale study addressing topics such as including diverse races; recommended additional assessment tools and intervnetion components. / Thesis (M.O.T.)-University of KwaZulu-Natal, Durban, 2014.

Thesis (MOccTher)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Background Temperament and sensory thresholds play an important part in how a person processes sensory information. Because people are differently construed, the way we perceive sensory information and act on the information will differ. Any person who suffers from an ailment or condition that interferes with this process of receiving, interpreting and acting on stimuli from our environments may find this process even harder. Behavioural observations that deviate from the "norm" are often found in children with attention-deficit/hyperactivity disorder (ADHD) and sensory processing disorder (SPD). More recent research focused on the relationship between ADHD and SPD. Dunn developed the Sensory Profile Caregiver1 and Sensory Profile School Companion2 (SPSC) measures to identify children’s sensory processing difficulties. Although many studies have been conducted using the Sensory Profile, no studies have been conducted outside the United States of America (USA) to establish whether Dunn’s SPSC will differentiate between children who are considered to be "normal" and those diagnosed with ADHD. Aim The aim of this study was to investigate how learners with ADHD in the Western Cape would perform on Dunn’s Sensory Profile School Companion (SPSC) and the ADHD Rating Scale-IV³ in order to assess the sensory processing problems of learners with ADHD in South Africa (see note end of abstract). Methodology A descriptive study was conducted using a convenience sample (n=108) from learners in the Western Cape between the ages of five and ten years and diagnosed with ADHD. Data collection consisted of a demographical form completed by the parents/legal guardians of the learners, as well as the completion of two questionnaires by the educator of the learners. The first questionnaire, the ADHD Rating Scale-IV, was used to classify the learners into subtypes of ADHD. The second questionnaire was Dunn’s SPSC, which is a teacher-report measure of learners’ responses to sensory input in the school environment. The following statistical analyses were performed: • descriptive statistics to provide means, medians and measurements of dispersion of the learners in the Western Cape on the SPSC; • The Kruskal-Wallis one-way ANOVA probability value to consider if significant differences existed between the medians of the 13 group scores of the SPSC; and • The Welsh T-test to compare learners with ADHD in the Western Cape with SPSC norms and Dunn’s sample of learners with ADHD. Results The results showed that there were significant differences (p=0.000) on all 13 group scores of the SPSC in learners with ADHD in the Western Cape showing significantly more behaviours characterising poorer sensory processing, when compared to Dunn’s normal sample. The comparison to Dunn’s sample of learners with ADHD did not yield significant differences in 11 of the 13 group scores, indicating that learners with ADHD in the Western Cape did not differ from Dunn’s ADHD learners. Avoiding and School Factor 4 showed significant differences, with the Western Cape group showing more extreme behaviours related to sensory input than Dunn’s group. The results using the ADHD Rating Scale-IV were less significant and it was found that the rating scale could not differentiate between the two types of ADHD, although some inferences could be made regarding the use (or not) of medication. There was a significant difference (p < 0.01) on the inattentive, hyperactive-impulsivity and total scores of the ADHD Rating Scale-IV with learners not on medication showing a higher frequency of ADHD behaviours. Conclusion Dunn’s SPSC was found to be a good measure to assess learners with ADHD’s sensory processing problems. The ADHD Rating Scale-IV, on the other hand, could not classify the learners into the subtypes and therefore cannot be used when learners are already using medication. Further investigation is recommended to try to establish a link between the different subtypes of ADHD and the placement of learners on the different quadrants of Dunn’s SPSC as well as the School Factors and Sensory Section Scores. / AFRIKAANSE OPSOMMING: Agtergrond Temperament en sensoriese drempels speel 'n belangrike rol in die wyse waarop 'n persoon sensoriese inligting verwerk. Omdat mense verskillend is, sal die manier waarop ons sensoriese inligting waarneem en dan daarop reageer, verskil. Enige persoon wat aan 'n kwaal of toestand ly wat inmeng met hierdie proses van hoe sensoriese insette uit die omgewing opgeneem, geïnterpreteer en dan op gereageer word, sal dit moeilik vind. Gedrag wat afwyk van die "norm" word dikwels in kinders met aandagafleibaarheid/hiperaktiwiteitsteuring (AAHS) en sensoriese prosesseringsdisfunksie (SPD) waargeneem. Meer onlangse navorsing fokus op die verhouding tussen AAHS en SPD. Dunn het die Sensory Profile Caregiver4 en die Sensory Profile School Companion5 (SPSC)-skale ontwikkel om kinders se sensoriese prosesseringsprobleme te identifiseer. Alhoewel baie studies gedoen is wat die Sensory Profile gebruik het, is daar geen studies buite die VSA gedoen om te bepaal of Dunn se SPSC tussen kinders wat as normaal beskou word en dié wat met AAHS gediagnoseer is, kan differensiëer nie. Doelstelling Die doel van hierdie studie was om ondersoek in te stel na hoe leerders met AAHS in die Wes- Kaap op Dunn se Sensory Profile School Companion (SPSC) en die ADHD Rating Scale-IV6 sou presteer om die sensoriese prosesserings probleme van leerders met AAHS te assesseer. Metodiek 'n Beskrywende studie is gedoen met 'n gerieflikheidsteekproef (n=108) van leerders tussen die ouderdomme vyf en tien jaar oud in die Wes-Kaap wat met AAHS gediagnoseer is. Datainsameling het bestaan uit 'n demografiese vorm wat deur die ouers/wettige voogde van die leerders ingevul is, sowel as die voltooiing van twee vraelyste deur die opvoeder van die leerders. Die eerste vraelys, die ADHD Rating Scale-IV, is gebruik om die subtipes van AAHS te klassifiseer. Die tweede vraelys was die Sensory Profile School Companion (SPSC) wat 'n meting met behulp van die onderwyser se verslag is wat die leerders se reaksie ten opsigte van sensoriese insette in die skoolomgewing meet. Die tweede vraelys (Dunn se SPSC) is deur onderwysers ingevul ten einde leerders se response op sensoriese insette in die skoolomgewing te bepaal. Die data is aan die volgende ontledings onderwerp: beskrywende statistiek wat die gemiddelde, mediane en metings van die verspreiding van leerders in die Wes-Kaap op die SPSC verskaf; • die Kruskal-Wallis-eenrigting-ANOVA waarskynlikheidswaarde om vas te stel of daar beduidende verskille tussen die mediane van die 13 groeptellings van die SPSC is; en • die Welsh T-Toets om leerders met AAHS in die Wes-Kaap te vergelyk met die SPSCnorme en Dunn se steekproef van leerders met AAHS. Resultate Die resultate het beduidende verskille getoon (p=0.000) op al 13 groeptellings van die SPSC by leerders met AAHS in die Wes-Kaap, wat dui daarop dat hierdie groep aansienlik meer probleme kenmerkend aan sensoriese verwerking toon as wat in Dunn se normale steekproef waargeneem is. Die vergelyking met Dunn se steekproef met AAHS het in 11 van die 13 groeptellings nie beduidende verskille getoon nie wat aandui dat leerders met AAHS in die Wes-Kaap nie veel verskil het van Dunn se AAHS-leerders nie. Avoiding en School Factor 4 het beduidende verskille getoon met leerders in die Wes-Kaapse groep wat meer uiterstes in gedrag getoon het ten opsigte van sensoriese insette as dié van Dunn se groep. Die resultate waar die ADHD Rating Scale gebruik is, was minder beduidend en daar is bevind dat die skaal nie kon differensiëer tussen die twee tipes AAHS nie, alhoewel daar afleidings gemaak kon word ten opsigte van die gebruik (of nie) van medikasie. Daar was 'n beduidende verskil (p < 0.01) in die onoplettende, hiperaktief-impulsiwiteit en totale tellings van die ADHD Rating Scale-IV met leerders nie op medikasie nie, wat 'n hoër frekwensie van AAHS-gedrag getoon het. Slot Daar is bevind dat Dunn se SPSC 'n goeie maatstaf is om die sensoriese verwerkingsprobleme van leerders met AAHS te assesseer. Die ADHD Rating Scale-IV aan die ander kant kon nie die leerders in die verskillende subtipes klassifiseer nie en kan dus nie gebruik word wanneer die leerders reeds medikasie gebruik nie. Verdere ondersoek word aanbeveel in ’n poging om 'n skakel te kry tussen die verskillende subtipes AAHS en die plasing van leerders op die verskillende kwadrante van Dunn se SPSC sowel as die School Factors- en Sensory Section-tellings.

Thesis (MOccTher (Interdisciplinary Health Sciences. Occupational Therapy))--University of Stellenbosch, 2007. / Objectives: The study aimed to identify the functions that occupational therapy leaders perform in clinical settings in the Metropole District of the Provincial Administration of the Western Cape (PAWC) and determine the influence of these functions on clinical practice. Methodology: The researcher used a descriptive design and a non-standardised questionnaire which was compiled to collect the data for the study. The questionnaire was piloted with a group of occupational therapy leaders from the Boland Overberg Region. Feedback was used to refine the final study questionnaire. Thirty-five study questionnaires were mailed or handed to the participants in the study and the researcher received 25 completed questionnaires; therefore, the response rate was 71.4%. The data were analysed using the Statistical Package for the Social Sciences (SPSS 10.0) for all the questions. Descriptive statistics were used to report the data. Inter-observer reliability was checked by using the split-half method. The results revealed that the study questionnaire was reliable as Cronbach's Alfa was calculated at 0.90, correlation coefficient Pearson’s r was calculated at 0.51, and Spearman-Brown was calculated at 0.67. Results: The results were presented in relation to the respondents’ number (N = 25). The participants identified 57 leadership functions, grouped as managerial, ethics-related, education, research, and consultation functions. The participants reported to have high performance in both direct and indirect occupational therapy services. Performance in the direct occupational therapy services functions was higher than the performance in the indirect occupational therapy services. Minimal performance in occupational therapy leadership functions was reported for consultation, ethics related, and research functions which need to be addressed by in-service training. The indirect occupational therapy services enabled the participants in the study to perform on a more optimum level regarding the direct occupational therapy services. The occupational therapy leaders had many empowering factors in their work place such as subordinates, supervisors, and top management. Conclusion: The 57 leadership functions identified in the study culminated in an occupational therapy leadership functions framework (OTLFF) which represents the managerial activities of the occupational therapy leaders in the PAWC. These study findings are useful guidelines for occupational therapy professionals and students as guidelines for leadership training, participant facilities to compile job descriptions, and educational facilities to set educational curricula. Recommendations: The study had many shortcomings; therefore, generalisation of results can't be done. The researcher recommends replication of the study using a larger and more representative sample.

Thesis (MScPhysio)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Muscle weakness is a problem for many young people with spastic cerebral palsy (CP). Many studies have reported that selective strength-training programs can improve muscle strength. However, most of these studies are of single group design and do not adequately control for confounding variables. Objective: To determine the impact of a comprehensive strength training program targeting multiple muscle groups on adolescents with CP, using basic inexpensive free weights and resistance devices. Method: A randomised clinical trial evaluated the effects of an eight-week strength-training program on 31 independently ambulant adolescents with spastic CP, with or without walking aids, from Eros School (19 males, 12 females; mean age 16 years 1 month; range 13 - 18 years). The Kin-Com dynamometer, 3-D gait analysis, the Economy of Movement test and a questionnaire was used to evaluate selected muscle strength, the degree of crouch gait, free walking velocity and stride length, energy consumption during walking and perceptions of body image and functional competence. Twenty one subjects took part in the strength-training program and were compared with 10 control subjects. Results were analysed using repeated measures ANOVA and bootstrap analysis. Results: Compared with the control, significant improvement in the degree of crouch as measured by the sum of the ankle, knee and hip angles at midstance (p=0.05) and perceptions of body image (p=0.01) were noted for the experimental group. Significant trends were also noted for isometric knee extension muscle strength at 30° as well as for hip abduction at 10° and 20°. Walking efficiency, -velocity and stride length remained unchanged as well as perceptions of functional ability. Conclusion: A strength-training program targeting multiple muscle groups including upper and lower limbs as well as the trunk, can lead to changes in muscle strength and improve the degree of crouch gait with improved perception of body image. Successful participation in such a program at school may motivate children with CP to continue with home-based basic strength training. Strength training alone did not decrease oxygen consumption during walking and inclusion of aerobic exercise is recommended. / AFRIKAANSE OPSOMMING: Spierswakheid is 'n probleem vir baie jong mense met serebrale verlamming (SV). Navorsing het getoon dat selektiewe versterkende oefenprogramme selektiewe spiere kan versterk, maar die meeste studies bestaan uit 'n enkel groep met onvoldoende beheer oor verstrengelde veranderlikes. Doel: Om die impak van 'n omvattende versterkende oefenprogram met basiese, goedkoop gewigte en weerstandsaparaat wat vele spiergroepe teiken, op adolesente met spastiese SV te evalueer. Metodologie: Die effekte van 'n agt weke lang versterkende oefenprogram is op 31 onafhanklik mobiel adolesente met spastiese SV, met of sonder loophulpmiddel, van Eros Skool deur middel van 'n ewekansige kliniese proef geevalueer (19 manlike, 12 vroulike deelnemers; gemiddelde ouderdom 16 jaar 1 maand; omvang 13 - 18 jaar). Die Kin-Com dinamometer, "3-D gait analysis", die "Economy of Movement" toets en 'n vraelys is gebruik om geselekteerde spiersterkte, die hoeveelheid knie fleksie gesien in die onderste ledemaat tydens loop, loopspoed en treelengte, energieverbruik tydens loop asook persepsies van liggaamsbeeld en funksionelevermoë te evalueer. Een en twintig het in die versterkende oefenprogram deelgeneem en is met 10 kontrole deelnemers vergelyk. Resultate is met behulp van herhaalde metings "ANOVA" en "bootstrap analysis" geanaliseer. Resultate: In vergelyking met die kontrole groep, het die experimentele groep betekenisvolle verbetering getoon in die hoeveelheid fleksie gesien in die ondersteledemaat (p=0.05) soos bereken deur die som van die enkel-, knie- en heuphoek in midstaan fase tydens loop, asook in liggaamspersepsie (p=0.01). Beduidenisvolle tendense is ook gesien by die experimentele groep vir isometriese knie ekstensie spiersterkte by 30° asook vir heup abduksie by 10° en 20°. Energieverbruik tydens loop asook loopspoed en treelengte was onveranderd asook persepsie van funksionele vermoë. Gevolgtrekking: 'n Versterkende oefenprogram wat verskeie spiergroepe teiken, insluitende die onderste en boonste ledemate asook die romp, kan lei tot In verbetering in spiersterkte, minder fleksie in die onderste ledemate tydens loop asook 'n verbetering in ligaamspersepsie. Suksesvolle deelname aan so 'n program op skool, mag kinders dalk motiveer om In basiese versterkende oefenprogram tuis voort te sit. Versterkende oefening alleen het geen vermindering in suurstofverbruik tydens loop veroorsaak en die insluit van aerobiese oefening word aanbeveel.

Thesis (MOccTher)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Despite the existence of many guidelines for rehabilitation services both internationally and in South Africa, there is a need for a uniform format for the measurement and reporting of outcomes reached by clients utilising these services. Traditionally, statistics on client numbers fail to report actual outcomes attained by clients. Aim: This aim of the study was to describe the outcomes achieved by clients after participating in rehabilitation at the Bishop Lavis Rehabilitation Centre (BLRC) over a three month period. It was done by describing clients’ function according to the World Health Organisation’s International Classification of Function (ICF) model, and included both the environmental and personal factors impacting on an individual’s function. Method: The study employed a descriptive design and used six measuring instruments which exceeded acceptable test-retest requirements to gather data from within the framework of the ICF Model. A field worker was trained to administer the majority of instruments which were pilot-tested for pre and post-test purposes. A sample of 78 clients who met the inclusion criteria was selected from the five main diagnostic categories seen at the BLRC. All clients were evaluated on referral, and again after receiving rehabilitation services for three months. An open-ended questionnaire was also administered as part of the post-test to obtain clients’ personal perspective on outcomes reached, as well as their subjective opinion of the rehabilitation experience. Data on the impact of various demographic and environmental factors on function was also gathered and statistically analysed in conjunction with the qualitative data obtained from the interviews in order to identify the rehabilitation outcomes achieved by the clients included in this study. Results: Clients reported a statistically significant decrease in the impact of disability on their function, with ‘mobility’ emerging as the aspect of function which improved the most after rehabilitation. The effect of most demographic and environmental factors investigated were perceived as facilitating rather than debilitating to rehabilitative outcomes, with ‘faith’ reported to be most facilitating and ‘monthly income’ the most debilitating of all factors. Subjectively, clients perceived their participation in rehabilitation to be a contributing factor to the improvement in their function, and generally expressed a positive attitude toward the rehabilitation experience. Recommendations based on the results of this study are presented to inform governing bodies involved in rehabilitation in South Africa. / AFRIKAANSE OPSOMMING: Ten spyte van die bestaan van veelvuldige riglyne vir rehabilitasie dienste, beide internasionaal en in Suid-Afrika, is daar steeds ‘n behoefte vir uniforme riglyne vir die meting en rapportering van die uitkomste wat kliënte bereik met deelname aan hierdie dienste. Tradisionele statistiek rakende kliëntegetalle rapporteer nie die werklike uitkomste wat kliënte bereik het nie. Doel: Die doel van die studie was om die uitkomste te beskryf wat kliënte bereik na hul deelname aan rehabilitasie by Bishop Lavis Rehabilitasiesentrum (BLRS) oor ‘n drie maande periode. Dit is gedoen deur kliënte se funksionering te beskryf volgens die Wêreld Gesondheidsorganisasie se Internasionale Klassifikasie van Funksie (IKF) model, insluitend beide die omgewings- en persoonlike faktore wat ‘n impak op ‘n individu se funksionering kon hê. Metode: Die studie het gebruik gemaak van ‘n beskrywende studiestruktuur. Dit het ses meetinstrumente gebruik wat beter as aanvaarbare vereistes vir toets-hertoets-betroubaarheid getoon het om data binne die raamwerk van die IKF-model in te samel. ‘n Veldwerker is opgelei vir die administrasie van die meerderheid van die meetinstrumente wat vir voor- en na-toets doeleindes in ‘n loodstudie getoets is. ‘n Steekproef van 78 kliënte wat aan die insluitingskriteria voldoen het, is geselekteer uit die vyf hoof diagnostiese groepe gesien by BLRS. Alle kliënte is geevalueer met verwysing en weer na hulle drie maande se rehabilitasie dienste ontvang het. Administrasie van ‘n oop-einde vraelys is ook as deel van na-toetsing gedoen om kliënte se persoonlike perspektief van die uitkomste wat hulle bereik het in te samel, sowel as hulle subjektiewe opinie van die rehabilitasieproses. Data oor die impak wat verskeie demografiese en omgewingsfaktore op funksionering kon hê is ingesamel, statisties ontleed en gebruik saam met die kwalitatiewe data wat met onderhoudsvoering ingesamel is om sodoende die rehabilitasieuitkomste te identifiseer wat behaal is deur kliënte wat ingesluit was in die studie. Resultate: Kliënte rapporteer ‘n statisties beduidende vermindering in die impak van gestremdheid op hulle funksionering, met ‘mobiliteit’ wat uitstaan as die area van funksionering wat die meeste verbeter het na rehabilitasie. Die effek van die meeste demografiese en omgewingsfaktore wat ondersoek was, is as fassiliterend eerder as inhiberend tot rehabilitasieuitkomste ervaar, met ‘geloof’ gerapporteer as die mees fassiliterende en ‘maandelikse inkomste’ as die die mees inhiberende faktor. Op 'n subjektiewe vlak het kliënte hul deelname aan rehabilitasie as ‘n bydraende faktor tot hul verbetering in funksionering ervaar, en het hulle oor die algemeen ‘n positiewe houding teenoor rehabilitasie gerapporteer.