Magister Scientiae (Physiotherapy) - MSc(Physio) / This study aimed to determine health promotion needs of physically disabled youth with spinal cord injury. The study specifically explored health-related behaviours with reference to participation in physical activity and substance usage, factors that influenced these behaviours and major issues that needed to be targeted in health promotion. / South Africa

The study purposes were to identify changes in resilience, satisfaction with life (SWL), depression, spirituality, and functional independence (FI) and to examine the relationship between these variables, during the inpatient rehabilitation for a spinal cord injury (SCI). The sample included 42 individuals with a SCI, 33 males and 9 females, who were inpatients with a mean stay of 52 days (SD = 15.78). A repeated measures design was employed with questionnaires completed at three times during rehabilitation. Results indicated that there were significant changes in depression, satisfaction with life, spirituality, and FI during inpatient rehabilitation. Findings also indicated significant correlations between resilience, SWL, spirituality, and depression. Future studies developing interventions, and examining factors that predict resilience could help build resilience and may improve rehabilitation outcomes.

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Thesis (Ph.D. (Health Sciences)) -- University of Limpopo, 2021 / Rehabilitation programmes for PLWSCI aim to give them as much independence as possible and perfect integration at a later stage. Proper rehabilitation involves effective community integration of a person with the SCI. Rehabilitation and community integration are key to return the person with an SCI to play his/her role in the community as an effective, independent, and important person. Globally, PLWSCI are facing numerous barriers and limitations, especially in rural areas, where rehabilitation resources are limited. There is a dearth of rehabilitation centres in the Limpopo Province, which might impact negatively on the rehabilitation and community integration outcomes for PLWSCI in this region. The absence of rehabilitation centres in this province point to the need for the development of extra skills for the professionals who work in the rehabilitation team in this Province. Aim and Objectives The overall aim of this study was to develop a rehabilitation programme to enhance community reintegration for PLWSCI in rural areas of the Limpopo Province, South Africa. Methodology This study used a convergent parallel mixed method design in phase 1. A mixed methodology approach consists of a set of designs and procedures in which both quantitative and qualitative data are collected, analysed, and mixed in a single study. Quantitative data were generated and collected regarding the rehabilitation and community integration challenges of PLWSCI using the Spinal Cord Injury Community Reintegration Measure (SCICRM) tool. Qualitative data were collected through focus group discussions (FGDs). In phase 2 of the study, the Delphi study design was utilised and conducted as a forecasting method based on the results of phase 1. vi Results Quantitative results show that 37% of the respondents were fully reintegrated. Moderate reintegration was above average (54.4%), while 5.7% were minimally integrated, and 3.9% failed to reintegrate into their communities. The rehabilitation teams’ home visits were further rated as “never happened” (51%) and “rarely happened” (14.3%). Patients who received a home visit from their rehabilitation team were more likely to fully reintegrate into their community, in this case, 75%. Of those who did not receive any home visits, only 39% managed to fully reintegrate into their communities. The qualitative findings, which is based on information-rich interviews with participants, indicated an urgent need for the implementation of a rehabilitation programme to enhance a successful and better community reintegration for PLWSCI. The qualitative results also highlighted the importance of home visits and following up on the patients after they have returned to their communities. The qualitative findings were presented according to six themes that were also divided into several sub-themes. In phase 2 of this study, experts agreed that the rehabilitation programme to enhance community integration for people with SCIs in the Limpopo Province should include the identification of the rehabilitation team, distribution of powers between the team members, documentation and referral letters, mobility, assistive devices, sub-acute rehabilitation tasks, home programmes, and the outcome of the successful rehabilitation. Conclusion Rehabilitation is the bridge between the SCI and successful community integration. A comprehensive rehabilitation programme implemented by a multidisciplinary team should enhance the successful reintegration of PLWSCI.

One of the consequences of traumatic brain injury is the postconcussion syndrome. The symptoms in this syndrome include headache, dizziness, poor memory, poor concentration, easy fatigue, drowsiness, irritability, sensitivity to light, sensitivity to noise, low alcohol tolerance, visual problems, auditory problems, nausea, vomiting, anxiety, and depression. Several factor analytic studies have shown that these symptoms load onto cognitive and noncognitive factors (Bohnen, Twijnstra, & Jolles, 1992). The aim of this study was to determine whether patients who report different symptoms also evidence differences in cognitive deficits, as indexed by reaction time. For this purpose 106 subjects (mean age 25.92 years; SD=6.05) of both sexes were tested on 8 reaction time tasks adapted from Shum, McFarland, Bain, and Humphreys (1990). There were 54 traumatic brain injury patients (mean age 26.40 years; SD=6.23) drawn from three Pretoria hospitals. They were heterogeneous with respect to diagnosis and severity of injury. For the controls (N=52), the mean age was 25.43 years (SD=5.88). The eight reaction time tasks constituted 4 task variables, each with 21evels. From these tasks, 36 reaction time indexes were derived. The indexes were classified into 4 groups, viz., reaction time (RT), movement time (MT), total reaction time (TT), and subtraction scores (SB, the difference between the 2 levels for each task variable). RT reflects the decision component and MT reflects the response execution component of reaction time. Partial correlation coefficients for all symptoms (p0,01) showed that some symptoms were most frequently associated with RT whilst others were most frequently associated with MT. On factor analysis with varimax rotation, symptoms loaded predominantly with SB scores. Symptoms also loaded with different task variablseuiggesting that they correlated with deficits on different stages of information processing. Taking into account possible methodological constraints that were discussed, these results confirm that different symptoms within the postconcussion syndrome correlate with different cognitive deficits. The correlations between symptoms and indices of reaction time are moderated by the characteristics of the symptoms (frequency & intensity), and the duration since injury. These findings have significance for understanding the aetiology of the postconcussion symptoms and for planning treatment. / Psychology / Ph. D. (Psychology)

Thesis (M.Tech.: Chiropractic)-Dept.of Chiropractic, Durban Institute of Technology, 2003 / Medial Tibial Stress Syndrome Type II (MTSS), otherwise known as shin splints, accounts for approximately 13% of injuries in American runners. Van Mechelen (1992) reported that 37-57% of recreational runners experience an injury over the course of a year, from which 54-75% of all injuries are caused by overuse. The American Medical Association defines shin splints as “pain and discomfort in the leg from repetitive activity on hard surfaces, or due to forceful, excessive use of foot flexors. The diagnosis should be limited to musculoskeletal inflammations excluding stress fractures and ischemic disorders.” (Thacker et al., 2002) Treatment protocols vary from biomechanical interventions (orthotics), to non-steroidal anti-inflammatory drugs and modalities such as ultrasound all with varying degrees of success (Noakes, 2001). Apart from therapeutic interventions it is the overriding symptom of pain, which patients are left with (Noakes, 2001). A therapeutic intervention called periosteal pecking has received increased interest with regards to symptomatic treatment of shin splints. Periosteal pecking is a form of *dry needling in which the tip of the needle contacts the periosteum (Raso,1997). The aim of this study is to establish the effect of periosteal pecking in the clinical setting with and against that of an established intervention, namely therapeutic ultrasound.

Thesis (M.Thec.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 110 leaves ; ill. ; 30 cm / According to Wood (1998), patellofemoral pain syndrome (PFPS) refers to a syndrome that comprises of the following signs and symptoms: anterior knee pain, inflammation, imbalance, instability, or any combination thereof. Prevailing literature suggests that the presence of myofascial trigger points (MFTP’s) in quadriceps femoris (QF) muscle could result in a combination of the following signs and symptoms: - Retro- or peripatella pain, - Weakness of the quadriceps muscle (Chaitow and DeLany, 2002) - Loss of full lengthening (Travell and Simons, 1983:248-250) The aetiology of PFPS is poorly understood (Kannus et al. 1999). The current trend in literature suggests an extensor mechanism dysfunction as the most probable aetiology (Galantly et al., 1994; Juhn, 1999). There appears to be a clinical overlap between the two syndromes, in terms of an extensor mechanism dysfunction and of signs and symptoms. The aim of this investigation was to evaluate the role of active myofascial trigger points in the vastus lateralis (VL) muscle as perpetuating, causative or concomitant factors in the alteration of VL/VM Total Work (TW) in PFPS in distance runners.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007 121 leaves / Ankle sprains account for 85% of all injuries to the ankle (Garrick, 1997). Inversion sprains result from a twisting of a weight-bearing foot into a plantarflexed and inverted position leading to lateral ankle ligament injury. Louwerens and Snijders (1999) state that there are multiple factors involved in ankle sprains or lateral ankle instability. These include injury to the lateral ankle ligaments, proprioceptive dysfunction and decrease of central motor control. Other factors that still need further research include the role of the fibularis muscles, the influence of foot geometry and the role of subtalar instability in ankle sprains (Louwerens and Snijders, 1999). This study focused on the fibularis muscles. Fibularis longus and brevis muscles are found in the lateral compartment of the leg and function to evert/pronate the foot and plantarflex the ankle. Fibularis tertius is found in the anterior compartment and its function is to evert and dorsiflex the foot. Myofascial trigger points in these three muscles refer pain primarily over the lateral malleolus of the ankle, above, behind and below it (Travell and Simons, 1993 2: 371). This is the exact area where ankle sprain patients experience pain. Travel and Simons (1993 2:110) state that a once off traumatic occurrence can activate myofascial trigger points. When considering the mechanism of injury of a lateral ankle sprain, the importance of the fibularis muscles becomes obvious. When the ankle inverts during a lateral ankle sprain, these muscles are forcefully stretched whilst trying to contract to bring about their normal action. Therefore these muscles are often injured from traction when the foot inverts (Karageanes, 2004). It stands to reason that as a result of this mechanism of injury myofascial trigger points may develop in the fibularis muscles. It was hypothesised that fibularis muscle trigger points would prove to be more prevalent in the injured leg when compared to the uninjured leg. To further investigate this hypothesis, an analytical, cross sectional study (phase 1) was done on 44 participants between the ages of 15 and 50. Consecutive convenience sampling was used and participants were screened according to phase 1’s inclusion and exclusion criteria. According to Travel et al. (1999 1: 19) myofascial trigger points (whether active or latent) can cause significant motor dysfunction. Trevino, et al. (1994) stated that fibularis muscle weakness is thought to be a source of symptoms after an inversion sprain. Treatment for ankle sprains involves minimising swelling and bruising and encouraging adequate ankle protection in the acute phase. The patient is advised to rest for up to 72 hours to allow the ligaments to heal (Ivins, 2006). After the acute phase has passed, rehabilitation is focused on. This includes improving the ankle range of motion and proprioception. Attention is also given to strengthen the muscles, ligaments and tendons around the ankle joint. In the recommended treatment protocol however, no mention is made of evaluating the musculature around the ankle joint for myofascial trigger points and or treating these points. McGrew and Schenck (2003) noted that if the musculature and neural structures surrounding the ankle joint were affected during an ankle sprain injury, and were left unresolved, they would lead to chronic instability. It was hypothesised that lateral ankle pain due to inversion ankle sprain injuries may be due to referred pain from the fibularis muscle trigger points. Patients treated with dry needling of the fibularis muscle trigger points would therefore show a greater improvement in terms of subjective and objective clinical findings when compared to a placebo treatment (detuned ultrasound) applied to the fibularis muscle trigger points.

Thesis (M.Tech.: Chiropractic)-Dept of Chiropractic, Durban Institute of Technology, 2005 x, 58, Annextures A-L, 20 leaves / An inversion ankle sprain can be defined as an injury caused by landing forcefully on an inverted, plantarflexed and internally rotated foot. This results in the fibres of the surrounding ligaments to become ruptured without disturbing the continuity of the ligament. Chronic stable ankle sprains was defined as the recurrent giving way of the ankle and there may be residual pain and swelling with no mechanical instability. According to literature, mechanisms involved in the development of chronic ankle sprains are: the lack of appropriate and early immobilization in severe cases, the development of scar tissue, lack of strengthening exercises or the development of hypermobility. Many treatments have been suggested to address these factors and would include: peripheral manipulation of the ankle joint, Muscle Energy Technique, muscle strengthening and stretching, proprioceptive training and deep transverse friction massage. Of the above mentioned treatments, Muscle Energy Technique has not been researched in a clinical setting for the treatment of chronic stable ankle inversion sprains. Therefore the purpose of this study was to investigate the relative effectiveness of Muscle Energy Technique compared to Manipulation in the treatment of chronic stable ankle inversion sprains.

Thesis (M.Tech,: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 62, 19 leaves :|bill. ;|c30 cm / To document the relationship between total work and myofascial trigger points in the vastus lateralis and vastus medialis portion of the quadriceps femoris muscle, whilst providing baseline graphs of these muscles with the use of a Cybex 700 Isokinetic Dynanometer in long distance runners both with and without patellofemoral pain syndrome. Methods: A quantitative, non-intervention clinical exploratory study. Fifty participants were divided into two groups, Group A (40 symptomatics) and Group B (10 asymptomatics). Both groups were screened for vastus lateralis and vastus medialis trigger points. Subjective data was obtained from Group A only, using the Numerical Pain Rating Scale and the Patient Specific Functional Scale. Objective data was obtained from both groups using the algometer, Myofascial Diagnostic Scale, and the Cybex 700 Isokinetic Dynanometer. For descriptive analysis frequency tabulations, box and whisker plots were used to display distributions graphically. Comparisons of categorical and quantitative variables between independent groups were run using chi square and Mann-Whitney testing consecutively. Finally Spearman’s correlation, multivariate generalized linear modelling and repeated measures ANOVA were also used. All statistical analysis was completed at the 95% (p<0.05) level of confidence.